Low serum testosterone and frailty in older men and women

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.

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.

Median (range) TT and FT were lower in frail than in pre-frail and robust men (TT: (frail) 15.7 [2.4-26.9] vs. (pre-frail) 19.4 [7.2-39.9] and (robust) 25.9 [13.2-35.2] nmol/L, P=0.03; FT: 230.0 [35.9-299.0] vs. 272.0 [86.7-411.0] and 303.0 [267.0-396.0] pmol/L, P=0.02) and women (TT: 0.31 [0.10-0.51] vs. 0.47 [0.14-1.55] and 0.45 [0.36-1.25] nmol/L, P=0.02; FT: 4.59 [0.46-6.63] vs. 4.66 [1.57-15.10] and 6.65 [3.91-21.00] 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 TT and FT levels were in the lowest tertile compared to the highest tertile in men (TT: odds ratio [OR] 3.29, 95% confidence interval [CI] 1.14-9.50; FT: OR 3.44, 95% CI 1.05-11.22) and in women (TT: OR 6.69, 95% CI 1.84-24.31; FT: OR 4.86, 95% CI 1.31-18.08).

Low serum testosterone levels were independently associated with frailty in the elderly Taiwanese.