Multiple Hormonal Dysregulation as Determinant of Low Physical Performance and Mobility in Older Persons
Francesca De Vita,
Gian Paolo Ceda.
Mobility-disability is a common condition in older individuals. Many factors, including the age-related hormonal dysregulation,
may concur to the development of disability in the elderly. In fact, during the aging process it is observed an imbalance between
anabolic hormones that decrease (testosterone, dehydroepiandrosterone sulphate (DHEAS), estradiol, insulin like growth factor-1 (IGF-1)
and Vitamin D) and catabolic hormones (cortisol, thyroid hormones) that increase. We start this review focusing on the mechanisms by
which anabolic and catabolic hormones may affect physical performance and mobility. To address the role of the hormonal dysregulation
to mobility-disability, we start to discuss the contribution of the single hormonal derangement. The studies used in this review were selected
according to the period of time of publication, ranging from 2002 to 2013, and the age of the participants (≥65 years). We devoted
particular attention to the effects of anabolic hormones (DHEAS, testosterone, estradiol, Vitamin D and IGF-1) on both skeletal muscle
mass and strength, as well as other objective indicators of physical performance. We also analyzed the reasons beyond the inconclusive
data coming from RCTs using sex hormones, thyroid hormones, and vitamin D (dosage, duration of treatment, baseline hormonal values
and reached hormonal levels). We finally hypothesized that the parallel decline of anabolic hormones has a higher impact than a single
hormonal derangement on adverse mobility outcomes in older population. Given the multifactorial origin of low mobility, we underlined
the need of future synergistic optional treatments (micronutrients and exercise) to improve the effectiveness of hormonal treatment and to
safely ameliorate the anabolic hormonal status and mobility in older individuals.
Keywords: Multiple hormonal derangement, mobility, muscle function, older persons.
Rights & PermissionsPrintExport