A new ‘aging males’ symptoms' rating scale

Unlike in women, where instruments are available to measure the severity of symptoms, standardized instruments are lacking for aging males. However, a new ‘aging males’ symptoms' (AMS) rating scale has been developed in the present study, as well as reference values.

A total of 116 medically well-characterized males (aged over 40 years) were recruited to complete a questionnaire of symptoms, the prevalence of which commonly changes with increasing age. Factor analysis was used to establish the raw scale and to identify the dimensions of the scale. This raw scale was applied to a large representative population sample of 992 German males, to establish reference values for the severity of symptoms in males over 40 years.

Three dimensions of symptoms were identified in the patient group: a psychological, a somatovegetative and a sexual factor, that explained 51.6% of the total variance. Reference values of the three dimensions were defined to be used in daily practice. The severity of symptoms assessed using the AMS scale was found to be related to the clinically defined ‘male climacteric’ in the patient group.

The AMS scale is a new and valuable tool for assessing aging males' symptomsc and can be easily used in practice.     

Prevalence of sarcopenia and its association with functional and nutritional status among male residents in a nursing home in Turkey

Introduction The Aging Male Symptoms' (AMS) scale was designed as a health-related quality of life (QoL) scale and standardized as a self-administered scale, first, to assess symptoms of aging (independent from those which are disease-related) between groups of males under different conditions, second, to evaluate the severity of symptoms/QoL over time, and, third, to measure changes pre- and post-androgen replacement therapy. The scale is in widespread use (17 languages currently available) and a recent review of methodological data documented good psychometric characteristics and ability as a clinical utility. This paper describes test characteristics of the AMS (positive and negative predictive values), taking two internationally established and published screening scales for androgen deficiency as the available standard.

Method A sample of 150 German males aged 40–69 years completed the AMS scale and two screening scales for androgen deficiency: the ADAM scale of Morley and colleagues and the screener of Smith and colleagues. The technique of a computer-assisted telephone interview was applied.

Result The comparison of the AMS with the two screening instruments for androgen deficiency showed sufficiently good compatibility despite conceptual differences. The AMS scale sufficiently predicted the results of the two screening instruments. A positive predictive value of 92% and a negative predictive value of 50% were found regarding the ADAM scale. The respective figures regarding Smith's screener were 65% and 49% for positive and negative predictive values, respectively.

Conclusion The AMS scale obviously measures a similar phenomenon as the two established and widely used screeners for androgen deficiency, although it was not developed as a screening instrument.     

The aging male in Malaysia

Interest in clinical investigations about the health-related quality of life (HRQoL) of aging men has increased in recent years. The aim of this paper is to inform the scientific community about a harmonized French Aging Males' Symptoms (AMS) Scale. There were two slightly different French AMS Scales, which both underwent an up-to-date linguistic and cultural translation process, i.e. were valid to be applied in research. However, it was felt to be unfortunate that two versions of one language in one country existed. Therefore, an ad hoc committee of both translation teams were asked to develop a harmonized single French AMS Scale. The harmonization meeting developed a consensus item-by-item and the new French reference scale was agreed upon. It was agreed that only this scale should be published to avoid confusion among future users. The French AMS Scale published in this paper should be used for future research and necessary cultural/linguistic adaptations in the French-speaking world.     

Harmonized Italian version of the aging males' symptoms scale

Introduction.?The interest in clinical investigations in health-related quality of life (HRQoL) of aging men has increased over recent years, particularly in the context of partial androgen deficiency. The aim of this paper is to inform the scientific community about a harmonized Italian Aging Males' Symptoms (AMS) scale.

Methods.?There were two slightly different Italian AMS scales, which both underwent an up-to-date linguistic & cultural translation process, i.e., were both valid to be applied in clinical research. However, there are potential long-term problems associated with having two Italian language versions of the scale in the same country. Therefore, an ad hoc committee of key persons related to both versions met with the scale's developer, to create a harmonized single Italian AMS.

Results.?The harmonization meeting came up with a consensus item-by-item and the new Italian reference scale was agreed upon. It was decided that this scale should be published to avoid any confusion among future users.

Conclusion.?The Italian AMS scale published in this paper should be used for future clinical and other research.     

Aging male's symptoms in a Southern Brazil population: lifestyle effects after the age of 40

Background.?The interest of epidemiological research about male's aging increased in recent years along with the need to evaluate health-related quality of life. We conducted a population-based cross-sectional study to identify the prevalence of aging male's symptoms (AMS) and factors associated to this condition.

Methods.?The study included 421 men aged 40 years or older, living in the urban area of Pelotas, Southern Brazil. The questionnaire covered sociodemographic, behavioral, and health variables, and to verify the aging male's symptoms, the AMS Scale was used.

Results.?Moderate/severe male's symptoms was considered positive (AMS scores equal or above 37 points) in 20% of men (95% CI 16.1; 24.3). After controlling for confounders, the AMS was significantly associated with aging, self-perceived health status and smoking. The symptoms were more severe among physically inactive men.

Conclusions.?Our findings support the necessity to maintain healthy behaviors like not smoking and regular physical activity since such changeable behaviors could reduce the AMS acceleration and increase life quality and expectancy.     

The aging male: the Asian perspective

Introduction: Issues of men’s health have been greatly researched by scholars in recent decades. At men’s health clinics, many patients complain of both insomnia and aging males’ symptoms (AMS). These symptoms might be influenced by biological, psychological or even social factors. The aim of this study was to investigate different aspects of the relationship between insomnia and aging symptoms. Methods: This cross-sectional study included 231 males from a men’s health clinic. Participants completed a set of general data and screening assessments, including the AMS rating scale, insomnia severity index (ISI), Beck depression inventory-II (BDI-II) and Beck anxiety inventory Chinese version (BAI), to investigate the severity of aging symptoms, insomnia, depression and anxiety. Results: The ISI correlated significantly with the AMS scale, both with (partial correlation coefficient?=?0.470) and without (r?=?0.580) controlled variances of depression and anxiety. Using linear regression, aging symptoms were statistically predicted by the severity of the ISI, and a substantial proportion of the variance was explained (adjusted R²?=?0.410). When all variables were included, this proportion rose to 55.3% (adjusted R²?=?0.553). Conclusion: We suggest that insomnia is a good predictor of aging symptoms across all age groups of men.     

Clinical trial of treatment with saikokaryukotsuboreito for eugonadal patients with late-inset hypogonadism-related symptoms

The purpose of this study was to evaluate the efficacy and safety of saikokaryukotsuboreito (SKRBT), which is widely used for a variety of clinical conditions, neuropsychiatric disorders, for patients with LOH-related symptoms. Twenty-two eugonadal patients over 40 years of age with LOH-related symptoms were included in this study. SKRBT was given orally to these patients three times daily to a total of 7.5 g/day for more than two months. Laboratory and endocrinological profiles were reviewed, and LOH symptoms were judged by means of several health assessment instruments such as the Aging Males' Symptoms (AMS) scale, Self-rated Depression Scale (SDS), International Prostate Symptom Score (IPSS), and King's Health Questionnaire (KHQ). Total AMS scores and AMS subscores were significantly decreased after the treatment. The KHQ, general health perception and impact on life scores were also significantly decreased, although no significant improvement was observed in other KHQ factors or the SDS score or IPSS. The serum concentrations of testosterone fractions did not change with treatment. Laboratory values did not change, and no adverse effects were identified after treatment. We conclude that SKRBT may be considered for treatment of patients with LOH-related symptoms for eugonadal patients.     

Quick Exposure Check (QEC): a cross-cultural adaptation into Brazilian-Portuguese

Most instruments used by occupational safety and health professionals have been originally developed in English. Cross-cultural adaptation enables the use of these instruments in other countries, cultures and languages in countries like Brazil, where the official language is not English. This methodology ensures that the translation process includes the cultural and linguistic equivalence between the original instrument and the translated version. Therefore, this study aimed to translate and cross-culturally adapt the instrument Quick Exposure Check (QEC) into Brazilian-Portuguese. The process of cross-cultural adaptation followed the steps of translation, synthesis, back-translation, expert committee review and pretesting. The final questionnaire was pretested by two raters in 40 workers employed in an expedition of knitting and textile industry. All versions resulting from the translation process (T1, T2) and back-translation (BT1, BT2) showed good agreement. During the pre-test was not presented any difficulty in understanding or completing the instrument adapted QEC for Brazilian language.     

Age and social gradients in the intensity of aging males' symptoms in Poland

Background. We performed the study in order to describe the age-related changes and social gradients in the intensity of aging males' symptoms in healthy men in Poland.

Methods. We examined 405 men aged 32–79, healthy inhabitants of Poland. Severity of aging males' symptoms was assessed using the Polish version of AMS scale. The social position was expressed using their educational level, commonly accepted as a reliable and specific index of social status in Poland.

Results. Male aging in Poland was accompanied by an increase in the intensity of all groups of evaluated symptoms (psychological, sexual and somato-vegetative symptoms, respectively: r = 0.36, r = 0.72, r = 0.59, all p < 0.0001). The results of ANOVA revealed the independent effects of both age and social status on the intensity of psychological symptoms (F = 17.89, p < 0.0001 and F = 9.51, p < 0.0001 for age and educational level, respectively), sexual (F = 114.70, p < 0.0001 and F = 5.90, p < 0.01), and somato-vegetative symptoms (F = 52.86, p < 0.0001 and F = 3.85, p < 0.05). The better the education of Polish men, the less intense the aging males' symptoms, irrespective of their age.

Conclusions. Age and social position constitute major determinants of the intensity of aging males' symptoms in Poland.     

Communicating globalization in Bombay cinema: Everyday life,imagination and the persistence of the local

Abstract

Bollywood films increasingly portray the life-worlds of India's urban middle class and their transnational connections. Characters in the Hindi-language films use English phrases, cell phones and computers, celebrate Valentine's Day and are seen to frequent exercise clubs and shopping malls. The non-resident Indian, or NRI, symbol of the diaspora, is now a fixture in these films, often the hero and portrayed as part of the familial world and social circle of the urban middle classes. This, combined with the way a large portion of the films depict settings outside India, in Switzerland, Mauritius, the UK and North America, have led critics to question the Indian-ness of the films. This article examines the deterritorialized narrative of Bollywood film for its communication of globalization and transnationalism. It argues that Bombay films address broader debates in the study of transnationalism, such as the significance of the local in a postnational world. The films offer insights into the production of locality by communicating a sense of place as feeling rather than representations based solely on geography or territory, so making a case for a topography of affect as meaningful for a phenomenology of globalization.     

Measuring emotional intelligence in Moroccan Arabic: the Wong and Law Emotional Intelligence Scale / Medidas de la inteligencia emocional en árabe marroquí: la escala de inteligencia emocional de Wong y Law

Emotional intelligence is a widespread concept that has been analysed in different countries. However, it has been barely measured in African-Arab societies’ cultures due to their scarce tradition in validating instruments. In Morocco, the mere translation of instruments is a common practice that should be avoided to incorporate cultural and linguistic singularities. Thus, the aim of our study was to culturally adapt the Wong and Law Emotional Intelligence Scale to Morocco. This version could be widely used in other Arab North African countries and among immigrants in hosting countries. Two hundred and seventy-three Arab undergraduates (178 women and 95 men; age M = 22.17, SD = 4.09) from Morocco completed a questionnaire adapted to their culture following the back translation method. To determine construct validity, data were analysed by means of confirmatory factor analysis. The final scale resulted in a second-order factorial model with four first-order factors compounded by 16 items. This structure supports the original for Moroccan Arabic and other countries in which Arabic is spoken. Likewise, the results confirm an adequate criterion validity of the instrument.     

'Du hast jar keene Ahnung': African American English dubbed into German

This paper explores the translation of sociolinguistic variation by examining the ways that African American English (AAE) is dubbed into German. In discussing this ubiquitous yet poorly studied area of language use, I show that ideas about language as an index to social groupings are transferable to the degree that the ideas overlap in the cultures in question. In the case of German, if the character being dubbed is young, male and tied to the street cultures of the urban inner city, then AAE is dubbed using a form of German that has links to the urban youth cultures of north‐central Germany. The transferability of sociolinguistic variation is important to issues related to cross‐cultural communication and the ideologies that may play a role in the outcomes of that communication as well as to linguistic creativity and language style more generally.     

“Aging males” symptoms and general health of adult males: a cross-sectional study

A cross-sectional study was conducted to explore the prevalence and severity of health-related complaints perceived by adult males of Hong Kong by using the Hong Kong Traditional Chinese versions of the Aging males’ symptoms (AMS) scale and the 5-dimensional and 3-level European Quality of life (EQ-5D-3L) questionnaire. A total of 825 adult males aged 40 years or above were surveyed, and observed that 80% of the population was living with little-to-mild levels of aging symptoms with mean total scores ranged between 26.02?±?7.91 and 32.99?±?7.91 in different age groups. Such symptoms were correlated with age, especially for the somato-vegetative and sexual symptoms. The most severe AMS symptoms were observed in the oldest age group at 70 years or above, with 76%, 34% and 70% living with moderate-to-severe levels of somato-vegetative, psychological and sexual symptoms, respectively. The result was highly correlated with the EQ-5D-3L questionnaire. Secondly, the Hong Kong Aging males’ symptoms (AMS) scale was shown to have good reliability with test–retest coefficient at 0.79 (ranged 0.66–0.87) and Cronbach’s alpha coefficient at 0.88 (ranged 0.70–0.84). In summary, the population of Hong Kong male adults was commonly living with little-to-mild levels of aging symptoms, whereas their severity was correlated with age.     

A reliability generalization meta-analysis of coefficient alpha and test–retest coefficient for the aging males’ symptoms (AMS) scale

Purpose: The aging males’ symptoms (AMS) scale is an instrument used to determine the health-related quality of life in adult and elderly men. The purpose of this study was to synthesize internal consistency (Cronbach’s alpha) and test–retest reliability for the AMS scale and its three subscales.

Methods: Of the 123 studies reviewed, 12 provided alpha coefficients which were then used in the meta-analyses of internal consistency. Seven of the 12 included studies provided test–retest coefficients, and these were used in the meta-analyses of test–retest reliability.

Results: The AMS scale had excellent internal consistency [α?=?0.89 (95% CI 0.88–0.90)]; the mean alpha estimates across the AMS subscales ranged from 0.79 to 0.82. The AMS scale also had good test–retest reliability [r?=?0.85 (95% CI 0.82–0.88]; the test–retest reliability coefficients of the AMS subscales ranged from 0.76 to 0.83. There was significant heterogeneity among the included studies.

Conclusions: The AMS scale and the three subscales had fairly good internal consistency and test–retest reliability. Future psychometric studies of the AMS scale should report important characteristics of the participants, details of item scores, and test–retest reliability.     

Faculty abstracts

Background. The Aging Males' Symptoms scale (AMS) is an internationally used scale to analyse health related quality of life (HRQoL). The aim of this paper is to provide evidence that the Nigerian AMS scale measures HRQoL with similar accuracy as in other language versions. We also intended to show the severity of complaints of aging in males in advanced old age. More generally, we aim to demonstrate that the Nigerian AMS scale is an applicable, validated, sensitive instrument to measure HRQoL in Nigeria.

Material. We performed a representative survey in Nigeria to get data of the AMS scale in a group of males in old age. The survey was a household-based population sample conducted in March 2006. The Nigerian data were compared with existing data from other European countries. Only community-based data were used for this comparison.

Results and discussion. The internal structure of the AMS (factorial analysis) was sufficiently similar with the comparison group of other countries in Europe to conclude that the scale really measures the same phenomenon. The sub-scores and total score correlations were high (0.8–0.9) but lower among the sub-scales (0.4–0.8). This suggests that the domains are not fully independent. The reliability (consistency) was found to be good and almost identical with European countries.

Mean scores of the Nigerian AMS did systematically differ from data of other European studies. There were much higher because of older age. The same applies for the population reference values obtained in Nigeria. It is the first time that population norm values are available for very old age.

Conclusion. The Nigerian AMS scale is a standardized HRQoL scale that showed good psychometric characteristics (reliability, validity) similar to other international versions. We suggest that the results obtained with the Nigerian AMS scale should be used preliminarily as reference for ‘norm values’ for highest age, i.e. in absence of other data. Confirmation in future studies is needed.     

The “Aging Males’ Symptoms” (AMS) Scale assesses depression and anxiety

Abstract

Objective: Emotional distress may be associated with severe aging symptoms. This study aimed to investigate aging symptoms in male psychiatric outpatients and their relationship with anxiety and depression.

Method: About 176 male psychiatric outpatients aged 40–80?years were enrolled into this single-center cross-sectional study, and completed self-reported questionnaires including “Aging Males’ Symptoms” (AMS) scale and the Hospital Anxiety and Depression Scale (HADS).

Result: Age was correlated with less anxiety (r?=??0.23), less psychological (r?=??0.16) and more sexual symptoms (r?=?0.31). After controlling demographic variables, the partial correlation coefficients of HADS and AMS scores ranged from 0.30 to 0.73. Four groups were defined by HADS: control (C; n?=?103), depression (D; n?=?18), anxiety (A; n?=?26) and mixed anxiety and depression (M; n?=?29). The M group had the most severe aging symptoms, and the C group the least. The A group had more psychological and less sexual symptoms than the D group. “Impaired sexual potency” was the only aging symptom in males not significantly different among the four groups.

Conclusions: Anxiety and depression was associated with more severe aging symptoms in male psychiatric outpatients. Sexual dysfunction could be regarded as the core manifestation to differentiate aging symptoms from syndromal emotional distress.     

Aging male symptomatology and eating behavior

Objective: The literature on eating disorders in older males is still very limited. We assessed the relationship between aging male symptomatology and eating behavior in middle-aged and older men.

Method: We distributed anonymous questionnaires to men aged 40–75?years living in or near Innsbruck, Austria, covering demographic items, current eating disorder symptoms (as defined by DSM-5), and associated measures of eating pathology, body image, and sports activity (including exercise addiction). We also administered the Aging Males’ Symptoms scale (AMS), and classified respondents as “high-AMS” (AMS score ≥37; N?=?82) or “low-AMS” (AMS score <37; N?=?386).

Results: High-AMS men reported a significantly higher mean current BMI, a greater prevalence of eating disorder symptoms, higher scores on the Eating Disorder Examination Questionnaire, greater risk of exercise addiction, and more negative body image than low-AMS men.

Discussion: We found a marked association between aging-male symptomatology and eating-disorder symptomatology in aging men. Our findings suggest that clinicians should carefully inquire about eating disorder symptoms in men aged 40 and above reporting aging-male symptomatology. Importantly, several men in the study reported “purging” via excessive exercise (as opposed to the more common methods of vomiting or use of laxatives or diuretics), and therefore this should be a subject of inquiry in clinical evaluations. To pursue these findings, subsequent studies of eating disorders in older men should consider assessing endocrinological measures, particularly testosterone levels, and should use longitudinal designs.     

生态翻译学视角下的中国英语研究

中国英语是有中国特色,产生于中国本土的英语中国英语。在文化交际过程中如何使用恰当的中国英语,涉及到中国英语的英语翻译问题,而生态翻译学,基于翻译选择适应论探讨中国英语的英译,为中国英语的英译提供了全新的视角。     

Sleep disturbance as a clinical sign for severe hypogonadism: efficacy of testosterone replacement therapy on sleep disturbance among hypogonadal men without obstructive sleep apnea

Objective: The present subanalysis of the EARTH study investigates the effects of one year testosterone replacement therapy (TRT) on sleep disturbance among hypogonadal men without obstructive sleep apnea.

Methods: Sleep disturbance was defined as three or more points in question 4 of the aging males symptoms (AMS) questionnaire. All participants completed the AMS scale, International Prostatic Symptoms Score (IPSS), Sexual Health Inventory for Men (SHIM) and Short Form 36 (SF-36) health survey at baseline and after 12?months. Sexual symptoms were also evaluated based on three AMS subscores (Q15, 16 and 17).

Results: We identified 100 patients with sleep disturbance, of whom 48 (24 each in the TRT and control groups) were ultimately included for analysis. All SF-36 categories , AMS scale, IPSS and SHIM score subdomains were significantly worse in patients with sleep disturbance than in those without disturbance. Statistically significant differences in sleep disturbance, erectile symptoms, sexual desire and some domains of the SF-36 were observed between the TRT and control groups after 12?months.

Conclusion: Sleep disturbance may be one of the clinical signs for severe hypogonadism. Moreover, TRT improved sleep conditions, sexual function and quality of life among hypogonadal men with sleep disturbance.