Androgen Deficiency in Aging Males: Translation and Validation Study of the Iranian Version

Mansoureh Ashghali-Farahani, Alice Khachian, Parya Vakilian, Mokhtar Mahmoudi


Background: Considering the importance of psychometric evaluation of the male sex hormone deficiency questionnaire by Iranian nurses, this study aimed to determine the translation and validation of the Iranian version of the Androgen Deficiency in Aging Males (ADAM) questionnaire.

Materials and Methods: This study was cross‑sectional. After obtaining permission from the instrument maker, translating it into Farsi, retranslated it into English, and determining validity and reliability. The study population was 200 Iranian men who admitted to hospitals affiliated with Iran University of medical science and were older than 50 years and selected by convenience sampling method. They were evaluated and monitored based on the Iranian version of the ADAM questionnaire. Sensitivity and specificity were assessed and analyzed by Rock Chart analysis. Descriptive and analytical statistical tests were used at a significant level of 0.05.

Results: Findings showed that the Iranian version of the ADAM questionnaire had good face validity. Results showed that Cronbach’s alpha in this questionnaire was 0.93, which indicates high reliability, and all the valid questionnaires were reported for the Scale‑Content Validity Index (SCVI) calculation. Hence, the questionnaire has good content validity. The Iranian version of the ADAM questionnaire has a sensitivity of 93.85% and a specificity of 77.14% at the cut‑off point of 2.2, indicating high sensitivity and specificity.

Conclusions: The Iranian version of the ADAM questionnaire is valid and reliable and has high sensitivity and specificity. Nurses can also use it as an adjunctive scale to screen andropause men over 50 years of age.


Aging, androgens, Iran, nurses, translations, validation study

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Emaminaeini M, Bakhtiyari M, Hatami H, Khodakarim S, Sahaf R. Depression and perceived social support in the elderly. Iranian Journal of Ageing 2017;12:191 9.

Lunenfeld B, Mskhalaya G, Zitzmann M, Arver S, Kalinchenko S, Tishova Y, et al. Recommendations on the diagnosis, treatment and monitoring of hypogonadism in men. Aging Male 2015;18:5 15.

Yan YY. Awareness and knowledge of andropause among Chinese males in Hong Kong. Am J Mens Health 2010;4:231 6.

Živanović J, Jarić I, Ajdžanović V, Mojić M, Miler M, Šošić Jurjević B, et al. Daidzein upregulates anti aging protein Klotho and NaPi 2a cotransporter in a rat model of the andropause. Ann Anat 2019;221:27 37.

Narukawa T, Soh J, Kanemitsu N, Harikai S, Ukimura O. Efficacy of combined treatment of intramuscular testosterone injection and testosterone ointment application for late onset hypogonadism: An open labeled, randomized, crossover study. Aging Male 2019:18;1 7.

Eurostat Statistical Books[Internet]. Active ageing and solidarity between generations. A statistical portrait of the European Union.C 2019 [cited 2012 Apr 01]. Available from: https:// EP 11 001 EN.

Jafari E, Kamali S, Mazloomzadeh S, Sharifi F. Clinical symptoms of androgen deficiency and sex hormone levels in men referring to Zanjan Blood Transfusion Organization. J Arak Univ Med Sci 2013;15:41 50.

Puri S, Adam SA. Ams scale for assessing andropause among aging Indian men. Int J Pharm Pharm Sci 2015;7:453 8.

Morley J, Charlton E, Patrick P, Kaiser F, Cadeau P. Validation of a screening questionnaire for androgen deficiency in aging males. Metabolism 2000;49:1239 42.

Martı'nez Jabaloyas JM, Queipo Zaragoza A, Rodríguez Navarro R, Quiepo Zaragoza JA, Gil Salom M, Chuan Nuez P. Relationship between the Saint Louis University ADAM Questionnaire and sexual hormonal levels in a male outpatient population over 50 years of age. Eur Urol 2007;52:1760 7.

Ugwu TE, Ikem RT. Performance of the androgen deficiency in aging male questionnaire for the clinical detection of androgen deficiency in black sub Saharan African men with Type 2 diabetes mellitus. Journal of Endocrinology, Metabolism and Diabetes of South Africa 2017;22:1 4.

Erenpreiss J, Fodina V, Pozarska R, Zubkova K, Dudorova A, Pozarskis A. Prevalence of testosterone deficiency among aging men with and without morbidities. Aging Male 2019:1 5. /10.1080/13685538.2019.1621832

Rabah DM, Arafa MA. Validation of an Arabic ADAM questionnaire for androgen deficiency screening in the Arab community. Aging Male 2009;12:95 9.

Chu LW, Tam S, Kung AW, Lam TP, Lee A, Wong RL, et al. A short version of the ADAM questionnaire for androgen deficiency in Chinese men. J Gerontol A Biol Sci Med Sci 2008;63:426 31.

Surbone A, Vaucher L, Primi MP, Leyvraz C, Pitteloud N, Ballabeni P, et al. Clomiphene citrate effect on testosterone level and semen parameters in 18 infertile men with low testosterone level and normal/low gonadotropines level. Eur J Obstet Gynecol Reprod Biol 2019;238:104 9.


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