Relationship between the Saint Louis University ADAM questionnaire and sexual hormonal levels in a male outpatient population over 50 years of age.

OBJECTIVES: To determine the relationship between the ADAM questionnaire and the sexual hormonal levels in a male population older than 50 yr, and to know the predictive capacity of this questionnaire with regard to biochemical hypogonadism in the ageing male.
METHODS: A prospective study was carried out on 230 Spanish men. Patients were evaluated by clinical history. The ADAM questionnaire and the Yesavage's Geriatric Depression Scale were completed by each patient. Blood tests were performed including total testosterone, SHBG, free testosterone (FT), dehidroepiandrosterone sulfate (DHEA-S), androstenedione, 17-beta-estradiol, FSH, LH, and prolactin. The relationship between positive ADAM questionnaire and age, clinical and sociodemographic backgrounds, and hormone levels was analysed by means of uni- and multivariate tests. The capacity of the ADAM questionnaire to predict biochemical hypogonadism was determined with a chi-square test.
RESULTS: ADAM questionnaire (excluding men with positive Yesavage's Scale) was positive in 140 patients (67.9%). With respect to clinical backgrounds, diabetes mellitus and age had a significant relationship with an ADAM-positive questionnaire. With respect to hormones, FT and DHEA-S levels were significantly lower when the ADAM questionnaire was positive. In the multivariate analysis, age, FT, and diabetes were independently related to an ADAM-positive questionnaire. Prevalence of biochemical hypogonadism (FT<0.228 nmol/l) was 24.6%. The ADAM test had a sensitivity of 84.0% and a specificity of 36.6% to detect biochemical hypogonadism.
CONCLUSIONS: FT is inversely related to the ADAM-positive questionnaire, independently of age. The ADAM questionnaire is a valid test to detect hypogonadism but has low specificity.