title: Additive benefit of higher testosterone levels and vitamin D plus calcium supplementation in regard to fall risk reduction among older men and women.
abstract: Higher physiologic testosterone levels among community dwelling older men and women may protect against falls, and this benefit may be further increased among those taking additional vitamin D plus calcium.
  
  
  BACKGROUND
  The aim of this study is to investigate sex hormone levels and fall risk in older men and women.
  
  
  METHODS
  One hundred and ninety-nine men and 246 women age 65+ living at home were followed for 3 years after baseline assessment of sex hormones. Analyses controlled for several covariates, including baseline 25-hydroxyvitamin D, sex hormone binding globulin, and vitamin D plus calcium treatment (vitD+cal).
  
  
  RESULTS
  Compared to the lowest quartile, men and women in the highest quartile of total testosterone had a decreased odds of falling (men: OR = 0.22; 95% CI [0.07,0.72]/ women: OR = 0.34; 95% CI [0.14,0.83]); if those individuals also took vitD+cal, the fall reduction was enhanced (men: OR = 0.16; 95% CI [0.03,0.90] / women: OR = 0.15; 95% CI [0.04,0.57]). Similarly, women in the top quartile of dihydroepiandrosterone sulfate (DHEA-S) had a lower risk of falling (OR = 0.39; 95% CI [0.16,0.93]). Other sex hormones and SHBG did not predict falling in men or women.
  
  
  CONCLUSIONS
  Higher testosterone levels in both genders and higher DHEA-S levels in women predicted a more than 60% lower risk of falling. With vitD+cal, the anti-fall benefit of higher physiologic testosterone levels is enhanced from 78% to 84% among men and from 66% to 85% among women.
authors: Department of Rheumatology and Institute for Physical Medicine, University Hospital Zurich, Gloriastrasse, 258091, Zurich, Switzerland. hbischof@hsph.harvard.edu
authors: H A
authors: HA
authors: Bischoff-Ferrari
authors: E J
authors: EJ
authors: Orav
authors: B
authors: B
authors: Dawson-Hughes
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D002118:Calcium / Q000627:therapeutic use*; D002762:Cholecalciferol / Q000627:therapeutic use*; D003153:Community Health Services / Q000379:methods; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood; D019587:Dietary Supplements; D004359:Drug Therapy, Combination; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D012737:Sex Factors; D013739:Testosterone / Q000097:blood*
chemical_list: D015415:Biomarkers; D002762:Cholecalciferol; D013739:Testosterone; D019314:Dehydroepiandrosterone Sulfate; D002118:Calcium