Reproductive hormone levels predict changes in frailty status in community-dwelling older men: European male ageing study prospective data

Research output: Contribution to journalArticle


Context: Clinical sequelae of androgen deficiency share common features with frailty. Evidence supporting the role of androgens in the development of frailty is limited and conflicting. Objective: To determine associations between male reproductive hormones and prospective changes in frailty status. Design/Setting: A 4.3-year prospective cohort study of community-dwelling men participating in the European Male Ageing Study. Participants: A total of 3369 men aged 40 to 79 from eight European centers. Intervention: None. Main Outcome Measure: Frailty status was determined using frailty index (FI; n = 2278) and frailty phenotype (FP; n = 1980). Results: After adjusting for baseline frailty, age, center, and smoking, the risk ofworsening FI decreased with higher testosterone (T), free T, and dihydrotestosterone (DHT) [percentage change (95% confidence interval) in FI associated with 1 standard deviation higher hormone level: -3.0 (-5.9, -1.0) for total T; -3.9 (-6.8, -2.0) for free T; and -3.9 (-6.8, -2.0) forDHT]. After further adjustment for bodymass index, only free T remained a significant predictor of FI change. In fully adjusted models, higher luteinizing hormone and follicle-stimulating hormone were positively related to worsening FI only in men ,60 years, and higher estradiol predicted lower likelihood of improving FP [odds ratio: 0.68 (0.52, 0.88)]. Conclusions: These prospective data support the hypothesis that higher androgen levels may protect elderly men from worsening frailty. However, the causal nature of these relationships requires further investigation.Whereas raised gonadotropins inmen,60 yearsmight be an earlymarker of frailty, the role of estradiol in frailty needs further clarification.


  • Agnieszka Swiecicka
  • Robert J.A.H. Eendebak
  • Mark Lunt
  • Terence W. O'Neill
  • György Bartfai
  • Felipe F. Casanueva
  • Gianni Forti
  • Aleksander Giwercman
  • Thang S. Han
  • Jolanta Slowikowska-Hilczer
  • Michael E.J. Lean
  • Neil Pendleton
  • Margus Punab
  • Dirk Vanderschueren
  • Ilpo T. Huhtaniemi
  • Frederick C.W. Wu
  • Martin K. Rutter
External organisations
  • University of Manchester
  • Christie NHS Foundation Trust
  • University of Szeged
  • Complejo Hospitalario Universitario de Santiago
  • University of Florence
  • Skåne University Hospital
  • Royal Holloway University of London
  • Great Ormond Street Hospital
  • Medical University of Lodz
  • University of Glasgow
  • Tartu University Hospital
  • Catholic University of Leuven
  • Imperial College London
  • University of Turku
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Endocrinology and Diabetes
Original languageEnglish
Pages (from-to)701-709
Number of pages9
JournalJournal of Clinical Endocrinology and Metabolism
Issue number2
Publication statusPublished - 2018 Feb 1
Publication categoryResearch