Relationships of sex hormone levels to dependence in activities of daily living in the frail elderly

Objectives: We undertook this nursing home study in order to determine the relationships between dependency in activities of daily living (ADL) and bl ood levels of estrone, testosterone, androstenedione, and dehydroepiandrost erone (DHEA). Little is known about this issue. Methods: cross-sectional st udy of 370 nursing home residents. Hormone levels in blood specimens drawn in 1997 and 1998 were correlated with degree of ADL dependency recorded in medical charts. Results: Because of multiple comparisons associations were deemed significant for P-values less than or equal to0.017 for mates and le ss than or equal to0.0125 for females. In males, the following were inverse ly related: testosterone levels with dependency in transferring and eating; estrone with eating and a summary ADL index; and androstenedione with toil eting and a summary ADL index (in all cases, r = -0.4; P = 0.007-0.015). In verse trends existed between testosterone levels and dependency in mobility and a summary ADL index. and androstenedione and eating (in all cases r = -0.3; P = 0.030-0.055). Among females the following were directly related: estrone levels with dependence in mobility, toileting, transferring, and a summary ADL index; and DHEA with transferring and a summary ADL index (r = 0.2 - 0.3, P = 0.0001 - 0.01). Trends existed between estrone and eating, a nd DHEA and toileting (r = 0.1 - 0.2, P = 0.04). Conclusion: In male reside nts, higher sex hormone levels are associated with better ADL performance. Among females the opposite is true. While further studies are needed to elu cidate these relationships, our results and recent findings of others sugge st sex hormone actions in older women differ from those in younger populati ons. A possible stress-related mechanism is also presented. (C) 2001 Elsevi er Science Ireland Ltd. All rights reserved.