A novel development of liver-targeted androgen therapy for sarcopenia and synergistic benefit of resistance training in elderly

Oral crystalline unconjugated testosterone 40 mg/day for 6 months. Testosterone will be administered in 1 capsule (13.3 mg/capsule) 3 times a day. Adherence will be monotored by returned unused capsules. Participants will be randomized to either receive progressive resistance training or no training for 6 months. Participants in the resistance training group will perform a partially supervised resistance training program for 6 months. Individually supervised sessions (~40 min) will be performed twice per week at the exercise laboratory at UNSW. For each session, participants will perform a warm-up of 5 minutes’ of low-intensity walking on the treadmill and lower-body flexibility exercises. This will be followed by ~ 30 minutes of upper- and lower-body resistance training, such as leg press, leg extension, calf raise, chest press, and seated row. In addition, resistance bands and adjustable dumbbells will be used to strengthen the muscle groups not targeted specifically by the resistance machines. The final 5 min of each session will be a cool down period, involving stretching of the major muscle groups. In addition to supervised sessions, participants will be asked to perform one home-based resistance training session per week, with 8-10 exercises targeting the major muscle groups using adjustable dumbbells and body weight loading. Online instructional videos and a printed training manual will also be provided for each exercise. Compliance to training will be recorded in a training log by the participants. Thus, there will be four groups (active drug+training, active drug no training, placebo drug + training, placebo drug no training).