Free Testosterone Levels Are Associated with Mobility Limitation and Physical Performance in Community-Dwelling Men: The Framingham Offspring Study
Open accessAbstract
Context: Mobility limitation is associated with increased morbidity and mortality. The relationship between circulating testosterone and mobility limitation and physical performance is incompletely understood. Objective: Our objective was to examine cross-sectional and prospective relations between baseline sex hormones and mobility limitations and physical performance in community-dwelling older men. Design, Setting, and Participants: We conducted cross-sectional and longitudinal analyses of 1445 men (mean age 61.0 ± 9.5 yr) who attended Framingham Offspring Study examinations 7 and 8 (mean 6.6 yr apart). Total testosterone (TT) was measured by liquid chromatography tandem mass spectrometry at examination 7. Cross-sectional and longitudinal analyses of mobility limitation and physical performance were performed with continuous (per sd) and dichotomized [low TT and free testosterone (FT) and high SHBG vs. normal] hormone levels. Main Outcome Measures: Self-reported mobility limitation, subjective health, usual walking speed, and grip strength were assessed at examinations 7 and 8. Short physical performance battery was performed at examination 7. Results: Higher continuous FT was positively associated with short physical performance battery score (β = 0.13; P = 0.008), usual walking speed (β = 0.02; P = 0.048), and lower risk of poor subjective health [odds ratio (OR) = 0.72; P = 0.01]. In prospective analysis, 1 sd increase in baseline FT was associated with lower risk of developing mobility limitation (OR = 0.78; 95% confidence interval = 0.62–0.97) and progression of mobility limitation (OR = 0.75; 95% confidence interval = 0.60–0.93). Men with low baseline FT had 57% higher odds of reporting incident mobility limitation (P = 0.03) and 68% higher odds of worsening of mobility limitation (P = 0.007). Conclusions: Lower levels of baseline FT are associated with a greater risk of incident or worsening mobility limitation in community-dwelling older men. Whether this risk can be reduced with testosterone therapy needs to be determined by randomized trials.
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In select older men over 60 years with testosterone deficiency and frailty, body composition and quality of life improved after testosterone supplementation.
“In select older men over the age of 60 years with testosterone deficiency and frailty, body composition and quality of life improved following supplementation with testosterone409–411.”
From Sarcopenic obesity in older adults: aetiology, epidemiology and treatment strategies (2018) · cites this paper as [411]
The Discussion (page unavailable in our copy) says testosterone administration is associated with increased skeletal muscle mass, supporting the body-composition part of the claim. It does not report improved quality of life after supplementation in men over 60 with both testosterone deficiency and frailty; it notes that most earlier trials enrolled healthy older men without functional limitations. (LLM, conf=0.86)
Experimental — accuracy not yet measuredLow free testosterone concentrations are associated with limited mobility in older men.
“Findings from studies have shown an association of low free testosterone concentrations with limited mobility in older men.81”
From Age-related and disease-related muscle loss: The effect of diabetes, obesity, and other diseases (2014) · cites this paper as [81]
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References 59 · Cited by 152
- Authors
- Krasnoff, J. B., Basaria, S., Pencina, M. J., Jasuja, G. K., Vasan, R. S., Ulloor, J., Zhang, A., Coviello, A., Kelly-Hayes, M., D'Agostino, R. B., Wolf, P. A., Bhasin, S., & Murabito, J. M.
- Affiliations
- Boston University (US)
- Department of Neurology (M.K.-H., P.A.W.), Boston University, Boston, Massachusetts 02118
- Department of Mathematics, Statistics and Consulting Unit (M.J.P., G.K.J., R.B.D.), Boston University, Boston, Massachusetts 02215
- Corresponding author
- Bhasin, Shalender
- ORCID
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2010-06-01
- Volume
- 95
- Issue
- 6
- Pages
- 2790-2799
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- PMC
- PMC2902069
- OpenAlex
- W2155100960
- Cited by
- 152
- References
- 59
- Citations by year
- 2026: 8 · 2025: 6 · 2024: 3 · 2023: 8 · 2022: 12 · 2021: 8 · 2020: 6 · 2019: 7 · 2018: 5 · 2017: 9 · 2016: 6 · 2015: 9 · 2014: 11 · 2013: 13 · 2012: 18
- FWCI
- 12.59
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- School of Medicine, Boston University (N01-HC25195)
- National Institutes of Health (n01hc25195-41-0-1, N01-HC 25195, 5p30ag031679-15)
- Centers for Disease Control and Prevention
- National Institute on Aging (5P30 AG31679, R01AG031206, R01AG029451, AG029451-01A2, 2 R01 AG16495, P30-AG031679, 1R01-AG-31206, R01AG016495, R56AG029451)
- National Heart, Lung, and Blood Institute (N01‐HC25195, N01-HC-025195, AG16495)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Keywords
- free testosterone, mobility limitations, physical performance, sex hormones, older men, community-dwelling men, walking speed, grip strength, Short Physical Performance Battery, self-rated health, sex hormone-binding globulin, testosterone replacement therapy, Framingham Offspring Study
- MeSH terms
- Adolescent, Adult, Aged, Chromatography, High Pressure Liquid, Cross-Sectional Studies, Postural Balance, Health, Humans, Longitudinal Studies, Male, Middle Aged, Prospective Studies, Sex Hormone-Binding Globulin, Testosterone, Odds Ratio, Walking, Hand Strength, Mobility Limitation, Muscle Strength, Tandem Mass Spectrometry
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