Evaluation of sex-specific association of serum testosterone and estradiol levels with frailty in elderly Egyptian men and women

Background
Frailty is an age-associated syndrome characterized by a reduced functional reserve and impaired adaptive capacity. Age-ass ociated decline in sex-hormone levels represent one of the potential mechanisms involved in the development of frailty. We aimed at studying the association of serum testosterone and serum estradiol levels with frailty in elderly Egyptian men and women, and evaluating sex-specific differences in the association between testosterone and estradiol levels with frailty.
Materials and methods
A total of 94 elderly participants (55 men and 39 women), aged 65 years and older, were included in the present study. Participants were divided into three groups according to their frailty status, which was determined according to the Fried criteria. Total testosterone (TT), free testosterone (FT), and total estradiol (E2) were determined.
Results
For men, frailty was significantly correlated with TT and FT but not with E2, whereas, for women, frailty was significantly correlated with FT and E2 but not with TT. In addition, BMI was significantly correlated with frailty for both men and women.
Conclusion
We concluded that lower levels of FT are associated with frailty for both men and women, whereas lower levels of TT are associated with frailty in men but not in women. Estradiol (E2) is correlated with frailty in women but not in men. In light of these findings, men with low levels of testosterone are at an increased risk for physical frailty and could thus benefit from testosterone therapy. In addition, postmenopausal women might also benefit from testosterone administration and estrogen supplementation in the context of a wider hormonal care.