title: Changes in reproductive hormone concentrations predict the prevalence and progression of the frailty syndrome in older men: the concord health and ageing in men project.
abstract: BACKGROUND
  Frailty, a syndrome of multiple morbidity, weakness, and immobility in aging, is an increasingly urgent threat to public health. Single measures of low serum androgen have been associated with frailty in men, but the contributory role of hormonal changes with time is unassessed.
  
  
  OBJECTIVE
  The objective of the study was to examine, using longitudinal measurements, the relations of serum androgens, estrogens, gonadotropins, and SHBG to the prevalence and progression of frailty in older men.
  
  
  METHODS
  Concord Health and Ageing in Men Project is an observational cohort study of 1705 men (aged 70 yr or older) living in the suburb of Concord, Sydney, Australia. Measurements were obtained at baseline (2005-2007) and 2-yr follow-up (2007-2009). Testosterone (T), dihydrotestosterone, estradiol, and estrone were obtained by liquid chromatography-tandem mass spectrometry, whereas SHBG, LH, and FSH were measured by immunoassay.
  
  
  METHODS
  Subjects from the general community were sampled.
  
  
  METHODS
  A total of 1645 subjects constituting a representative sample of community-dwelling men aged 70 yr old or older participated in the study.
  
  
  METHODS
  The frailty syndrome was measured according to the Cardiovascular Health Study (CHS) and Study of Osteoporotic Fractures (SOF) indices.
  
  
  RESULTS
  Androgens and estrogens showed significant age-adjusted associations with concurrent frailty. Subjects in the lowest T quintile had 2.2-fold odds of exhibiting greater CHS frailty as compared with the highest T quintile (P < 0.001); results for dihydrotestosterone, estradiol, estrone, and calculated free T were similar, and were unchanged when the SOF frailty index was substituted for the CHS frailty index. A 1 sd, 2-yr decrease in T, calculated free T, or LH was associated with a 1.2- to 1.3-fold increase in the odds of progression (increase in severity) of frailty. The control for comorbid medical conditions did not affect results.
  
  
  CONCLUSIONS
  Age-related changes in blood androgens and estrogens may contribute to the development or progression of frailty in men.
authors.affiliation: Section of Endocrinology, Diabetes, and Nutrition, Boston University School of Medicine, Boston, Massachusetts 02118, USA. tgt@bu.edu
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Travison
authors.forename: Anh-Hoa
authors.initials: AH
authors.lastname: Nguyen
authors.forename: Vasi
authors.initials: V
authors.lastname: Naganathan
authors.forename: Fiona F
authors.initials: FF
authors.lastname: Stanaway
authors.forename: Fiona M
authors.initials: FM
authors.lastname: Blyth
authors.forename: Robert G
authors.initials: RG
authors.lastname: Cumming
authors.forename: David G
authors.initials: DG
authors.lastname: Le Couteur
authors.forename: Philip N
authors.initials: PN
authors.lastname: Sambrook
authors.forename: David J
authors.initials: DJ
authors.lastname: Handelsman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000378:metabolism*; D000728:Androgens / Q000097:blood; D018450:Disease Progression; D004967:Estrogens / Q000097:blood; D005640:Follicle Stimulating Hormone / Q000097:blood; D016330:Frail Elderly / Q000706:statistics & numerical data*; D015577:Geriatric Assessment; D012739:Gonadal Steroid Hormones / Q000097:blood*; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D011237:Predictive Value of Tests; D015995:Prevalence; D012044:Regression Analysis; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism; D013739:Testosterone / Q000097:blood
chemical_list: D000728:Androgens; D004967:Estrogens; D012739:Gonadal Steroid Hormones; D012738:Sex Hormone-Binding Globulin; D013739:Testosterone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone