Associations between blood concentrations of sex hormones and physical function in community-dwelling older women: a prospective cohort study

Background Blood concentrations of testosterone and oestrone tend to increase in women aged >70 years, while concentrations of their precursor hormone dehydroepiandrosterone decline. It is unknown whether these changes influence physical function. We investigated whether concentrations of these hormones were associated with grip strength and self-reported physical function in community-dwelling older women. Methods 9179 Australian women, aged >70 years, were recruited to the ASPREE trial. Sex hormones were measured in SHOW, an ASPREE sub-study, by liquid chromatography-tandem mass spectrometry in 6358 women. The associations between hormone concentrations and physical function [handgrip strength and self-reported physical function assessed by SF-12v2 physical component summary (PCS)] were examined using multiple linear regression. Results The median age of the 5447 participants was 74.0 (IQR 71.7-77.6) years. Testosterone concentrations above the lowest quartile were associated with less decline in grip strength [mean -1.39 (95% CI -1.54 to -1.24) versus -1.75 (-2.00 to -1.50) kg, p=0.02], and dehydroepiandrosterone concentrations above the lowest quartile were associated with less decline in grip strength [-1.39 (-1.54 to -1.25) versus -1.82 (-2.11 to -1.55) kg, p=0.007] and PCS scores [-1.49 (-1.80 to -1.17) versus -2.33 (-2.93 to -1.72), p=0.02] over four years, compared with those in the respective lowest quartile. Conclusions Low endogenous concentrations of testosterone and dehydroepiandrosterone were associated the greatest likelihood of physical function decline in community-based women aged >70 years. Further studies are warranted to determine whether testosterone and dehydroepiandrosterone therapy prevents functional decline in this at-risk group using sensitive measures of muscle strength and performance.