Additive benefit of higher testosterone levels and vitamin D plus calcium supplementation in regard to fall risk reduction among older men and women.
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.
Bischoff-Ferrari
H A
HA
Department of Rheumatology and Institute for Physical Medicine, University Hospital Zurich, Gloriastrasse, 258091, Zurich, Switzerland. hbischof@hsph.harvard.edu
Orav
E J
EJ
Dawson-Hughes
B
B
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*
D015415:Biomarkers; D002762:Cholecalciferol; D013739:Testosterone; D019314:Dehydroepiandrosterone Sulfate; D002118:Calcium