Introduction: Frailty, a common cause of disability and dependency in the elderly is a multifactorial condition; ageing-associated endocrine dyregulations may play an important role. It is not known if testosterone (T) deficiency contributes to frailty, through its effects on muscle (sarcopenia) and physical function.
Objective: To investigate the relationship between T and frailty in elderly men in a cross-sectional observational study in community-dwelling men.
Methods: One thousand six hundred and sixty one men, median age 72 yr, (range 6595) were screened for frailty using Frieds criteria1 (weight loss of 10 lbs or more in the past year, self-reported exhaustion, decreased grip strength, slow walking speed and reduced physical activity). Frail (F) men were characterized by the presence of ≥3 criteria, prefrail (PF) men by 1-2 criteria and non-frail (NF) men by the absence of any criteria. Total testosterone (TT), sex hormone binding globulin (SHBG), follicle stimulating hormone (FSH), and luteinizing hormone (LH) were measured. The local research ethics committee approved the study.
Results: The prevalence of F and PF was 7% and 45% respectively. Mean (95%CI) TT was lower in F and PF; 11.9 (10.9,12.9) and 13.6 (13.5,14) nmol/L respectively vs. 14.3 (13.9,14.7) nmol/L in NF (P<0.001). Logistic regression analysis including TT, LH, age, body mass index (BMI), number of co-morbidities and prescribed medication as predictor variables revealed that TT ≤12 nmol/L was associated with an odds ratio (OR) (95% CI) of 1.86 (1.07, 3.23) (P<0.05) for being F compared to NF. Among PF, unadjusted logistic regression analysis revealed that a TT ≤10 nmol/L was associated with an OR (95% CI) of 1.39 (1.08,1.79) (P<0.01), when compared with NF. However, hormone measures were not predictive of PF when age and other covariates were included.
Conclusions: Although a causal relationship cannot be attributed to testosterone in the aetiology of frailty, low T levels are significantly associated with frailty.