| Most studies involving hormone deficiency and aging have focused on the relationship between individual hormones and specific age-associated disease. In a recently released study, scientists at the University of Pennsylvania School of Medicine investigated the possibility that frailty would mostly likely manifest in the presence of deficits in multiple hormones. They studied the relationships of serum levels of insulin-like growth factor-1 (IGF-1), DHEAS, and unbound testosterone with frailty status in aging women. The study used 494 women aged 70 to 79 years who were enrolled in the Women's Health and Aging Studies I or II. Scientists calculated the odds of frailty for deficiency of each hormone, which they defined as the bottom quartile of hormone level. They found that for each hormone, those with a deficiency were more likely to be frail than those without a deficiency. Compared with women who showed no hormonal deficiencies, those with one deficiency were somewhat more likely to be frail. However, those women with two or three deficiencies had a very high likelihood of being frail. The odds ratio for frailty for these women was 2.79, meaning that women who were deficient in more than one hormone had almost a 3 times greater risk of being frail than women who were not hormonally deficient. The scientists concluded that the absolute burden of hormonal deficiencies in the bodies of aging women was a stronger predictor of frailty status than the type of hormonal deficiency. They found the relationship to be exponential, and suggestive of generalized endocrine dysfunction in the frailty syndrome. This study may be found in the January 31 edition of Journals of Gerontology Series A Biological Sciences and Medical Sciences. People diagnosed as frail lose the ability to care for themselves and live independently Frailty is characterized by unexplained weight loss, exhaustion, weak grip, slow walking speed, and generalized low energy levels. Women who are frail are the most vulnerable, most at risk for disability or death, and are the highest users of medical care. In a nationwide study of 5,000 older adults, those who were frail were found to be six times more likely to die than those who were not over a three-year period, and more than three times more likely to die over a seven-year period. After seven years, 43 percent of those who were frail had died, compared to 23 percent of those who were classified as intermediate, and 12 percent of those who were robust. A diagnosis of frailty is made based on symptoms such as shrinking (unintentional weight loss of at least 10 pounds or 5 percent of body weight compared to a year ago), weakness (grip strength in the lowest 20th percentile), poor endurance and energy (self-reported exhaustion), slowness (the most time it takes to walk 15 feet), and low physical activity level (the lowest 20 percent in physical activity compared to others). Frail women have a very high incidence of osteoporosis. They are the most likely group to suffer falls that result in broken bones, and may even suffer broken bones without a fall. Frail women and men are the highest users of disease establishment services and are the most likely to be admitted to nursing homes. Men with multiple hormonal deficiencies are more than twice as likely to die Aging in men is also characterized by progressive decline in levels of hormones such as testosterone, IGF-1, and DHEAS. In a study at the National Institute on Aging, scientists investigated whether deficiencies in these hormones were associated with higher mortality. Testosterone, IGF-1, DHEAS, and demographic factors were evaluated in 410 men age 65 and older enrolled in the Aging in the Chianti Area Study. The men were divided into four groups: no hormone in the lowest reference quartile, and 1, 2, and 3 hormones in the lowest quartiles. Compared with men having levels of all 3 hormones above the lowest quartiles, having 1, 2, and 3 deficient hormones was associated with hazard ratios for mortality of 1.47, 1.85, and 2.29. This means that men deficient in 3 hormones were more than two and one-quarter times more likely to die. The scientists concluded that age associated decline in hormone levels is a strong independent predictor of mortality in older men. Having multiple hormone deficiencies is a reliable biomarker of health status in older men. This study is from the November, 2007 Archives of Internal Medicine. Hormonally deficient men with chronic heart failure have the poorest prognosis In men with chronic heart failure, hormone depletion is common. A deficiency of each hormone is an independent marker of poor prognosis according to a study at the Military Hospital of Wroclaw, Poland. Serum levels of total testosterone, DHEAS, and IGF-1 were obtained from 208 men with chronic heart failure who were hospitalized or treated as outpatients, and from a reference population of 366 men free of chronic disease. Deficiencies in DHEAS, total and unbound testosterone, and IGF-1, defined as serum levels at or below the 10th percentile of healthy peers, were seen across all age categories of men with chronic heart failure. DHEAS deficiency correlated positively with left ventricular disturbance. Testosterone measures and IGF-1 levels were prognostic biomarkers. Men with chronic heart failure and normal levels of all hormones had the best 3 year survival rate (83 percent) compared to those with 1 hormone deficiency (74 percent survival rate), 2 hormone deficiencies (55 percent survival rate), and 3 hormone deficiencies (27 percent) survival rate. This study is from the October 24, 2006 edition of Circulation. |
Hormonal Deficiencies
