The Journals of Gerontology Series A: Biological Sciences and Medical Sciences Advance Access originally published online on January 31, 2009
The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 2009 64A(2):243-248; doi:10.1093/gerona/gln026
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Multiple Hormonal Deficiencies in Anabolic Hormones Are Found in Frail Older Women: The Women's Health and Aging Studies
1 Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia
2 Division of Geriatric Medicine and Gerontology, Department of Medicine, and Center on Aging and Health, Johns Hopkins Medical Institutions, Baltimore, Maryland
3 Department of Epidemiology, Mailman School of Public Health, Columbia University, New York
Address correspondence to Anne R. Cappola, MD, ScM, Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University of Pennsylvania School of Medicine, CRB 764, 415 Curie Blvd, Philadelphia, PA 19104. Email: acappola{at}mail.med.upenn.edu
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Abstract |
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Background: Alterations in anabolic hormones are theorized to contribute to aging and frailty, with most studies focusing on the relationship between individual hormones and specific age-associated diseases. We hypothesized that associations with frailty would most likely manifest in the presence of deficits in multiple anabolic hormones.
Methods: The relationships of serum levels of total IGF-1, DHEAS, and free testosterone (T) with frailty status (nonfrail, prefrail, or frail) were analyzed in 494 women aged 70–79 years enrolled in the Women's Health and Aging Studies I or II. Using multivariate polytomous regression, we calculated the odds of frailty for deficiency in each hormone (defined as the bottom quartile of the hormone) individually, as well as for a count of the hormones.
Results: For each hormone, in adjusted analyses, those with the deficiency were more likely to be frail than those without the deficiency, although this did not achieve statistical significance (IGF-1: odds ratio [OR] 1.82, confidence interval [CI] 0.81–4.08; DHEAS: OR 1.68, CI 0.77–3.69; free T: OR 2.03, CI 0.89–4.64). Compared with those with no hormonal deficiencies, those with one deficiency were not more likely to be frail (OR 1.15, CI 0.49–2.68), whereas those with two or three deficiencies had a very high likelihood of being frail (OR 2.79, CI 1.06–7.32), in adjusted models.
Conclusions: The absolute burden of anabolic hormonal deficiencies is a stronger predictor of frailty status than the type of hormonal deficiency, and the relationship is nonlinear. These analyses suggest generalized endocrine dysfunction in the frailty syndrome.
Keywords Hormones; Aging; Elderly; Women; Frailty; IGF-1; DHEAS; Testosterone
Received: April 7, 2008; Accepted: July 24, 2008