Low serum testosterone and frailty in older men and women

Background Frail older persons are at high risk of morbidity and mortality and are characterized by body composition alterations Serum testosterone which regulates body composition declines with age We investigated the relation between serum testosterone level and physiological frailty in both older men and women Methods This was a cross-sectional study of 108 adults 65 years old or older Frailty status was determined by hand-grip strength weight change walking speed exhaustion and activity levels and was classified as frail (3 or more deficits) pre-frail (1 or 2 deficits) or robust (no deficit) according to the Fried criteria Serum total testosterone (TT) and sex-hormone-binding globulin were measured while free testosterone (FT) was estimated Results Median (range) TT and FT were lower in frail than in pre-frail and robust men (TT (frail) 157 [2 4-26 9] vs (pre-frail) 19 4 [7 2-39 9] and (robust) 25 9 [13 2-35 2] nmol/L P=003 FT 230 0 [35 9-299 0] vs 272 0 [86 7-411 0] and 303 0 [267 0-396 0] pmol/L P=002) and women (IT 031 [0 10-0 51] vs 047 (014-1 551 and 045 1036-1 251 nmol/L P=002 FT 459 [0 46-6 63] vs 466 [1 57-15 10] and 665 1391-21 001 pmol/L P=0 03) After adjusting for age comorbidities body mass index and serum albumin in ordinal logistic regression model odds ratios of being frail were significantly higher for those participants whose IT and FT levels were in the lowest fertile compared to the highest tertile in men (TT odds ratio [OR] 3 29 95% confidence interval]Cl] 1 14-950 FT OR 344 95% CI 1 05-11 22) and in women (Tf OR 6 69 95% CI 1 84-24 31 FT OR 4 86 95% CI 1 31-18 08) Conclusions Low serum testosterone levels were independently associated with frailty in the elderly Taiwanese (C) 2010 Elsevier Ireland Ltd All rights reserved