title: Association of plasma sex hormone levels with functional decline in elderly men and women.
abstract: OBJECTIVE
  We aimed to determine whether plasma sex hormone levels are associated with activities of daily living (ADL), cognition, depression and vitality in elderly individuals with functional decline.
  
  
  METHODS
  Two hundred and eight consecutive persons 70 years or older (108 men and 100 women; mean +/- standard deviation, 81 +/- 7 years) with a chronic stable condition, receiving long-term care at a long-term care facilities located in Nagano Prefecture, Japan, were enrolled. Plasma total testosterone, free testosterone (only in men), dehydroepiandrosterone (DHEA), DHEA sulfate (DHEA-S) and estradiol levels were determined in the morning after an overnight fast. Comprehensive geriatric assessment was performed including basic ADL by Barthel Index, instrumental ADL, cognitive function by Hasegawa Dementia Scale--Revised, mood by Geriatric Depression Scale and ADL-related vitality by Vitality Index.
  
  
  RESULTS
  Simple regression analysis showed that, in men, plasma total and free testosterone levels were associated with basic ADL (R = 0.292 and R = 0.282), instrumental ADL (R = 0.261 and R = 0.408), cognitive function (R = 0.393 and R = 0.553) and vitality (R = 0.246 and R = 0.396), while DHEA(-S) was associated with cognitive function, and estradiol with cognitive function as well as vitality. In women, the only significant correlation was between DHEA(-S) and basic ADL. Adjustment for age and nutritional markers did not influence the associations of plasma sex hormone levels with functional scores except for that of free testosterone with Barthel Index.
  
  
  CONCLUSIONS
  These results suggest that sex hormones have sex-specific associations with physical and neuropsychiatric functions in elderly individuals, and that endogenous testosterone is related to global function in elderly men.
authors.affiliation: Department of Geriatric Medicine, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
authors.forename: Shiho
authors.initials: S
authors.lastname: Fukai
authors.forename: Masahiro
authors.initials: M
authors.lastname: Akishita
authors.forename: Shizuru
authors.initials: S
authors.lastname: Yamada
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Hama
authors.forename: Sumito
authors.initials: S
authors.lastname: Ogawa
authors.forename: Katsuya
authors.initials: K
authors.lastname: Iijima
authors.forename: Masato
authors.initials: M
authors.lastname: Eto
authors.forename: Koichi
authors.initials: K
authors.lastname: Kozaki
authors.forename: Kenji
authors.initials: K
authors.lastname: Toba
authors.forename: Yasuyoshi
authors.initials: Y
authors.lastname: Ouchi
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition / Q000502:physiology*; D003430:Cross-Sectional Studies; D003687:Dehydroepiandrosterone / Q000097:blood; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood; D003704:Dementia / Q000097:blood*; D004958:Estradiol / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D013739:Testosterone / Q000097:blood
chemical_list: D013739:Testosterone; D003687:Dehydroepiandrosterone; D004958:Estradiol; D019314:Dehydroepiandrosterone Sulfate