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Takeshita RS, Edler MK, Meindl RS, Sherwood CC, Hopkins WD, Raghanti MA. Age, adrenal steroids, and cognitive functioning in captive chimpanzees ( Pan troglodytes). PeerJ 2022; 10:e14323. [PMID: 36389417 PMCID: PMC9653054 DOI: 10.7717/peerj.14323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 10/10/2022] [Indexed: 11/11/2022] Open
Abstract
Background Dehydroepiandrosterone-sulfate is the most abundant circulating androgen in humans and other catarrhines. It is involved in several biological functions, such as testosterone production, glucocorticoid antagonist actions, neurogenesis and neuroplasticty. Although the role of dehydroepiandrosterone-sulfate (DHEAS) in cognition remains elusive, the DHEAS/cortisol ratio has been positively associated with a slower cognitive age-decline and improved mood in humans. Whether this relationship is found in nonhuman primates remains unknown. Methods We measured DHEAS and cortisol levels in serum of 107 adult chimpanzees to investigate the relationship between DHEAS levels and age. A subset of 21 chimpanzees was used to test the potential associations between DHEAS, cortisol, and DHEAS/cortisol ratio in cognitive function, taking into account age, sex, and their interactions. We tested for cognitive function using the primate cognitive test battery (PCTB) and principal component analyses to categorize cognition into three components: spatial relationship tasks, tool use and social communication tasks, and auditory-visual sensory perception tasks. Results DHEAS levels, but not the DHEAS/cortisol ratio, declined with age in chimpanzees. Our analyses for spatial relationships tasks revealed a significant, positive correlation with the DHEAS/cortisol ratio. Tool use and social communication had a negative relationship with age. Our data show that the DHEAS/cortisol ratio, but not DHEAS individually, is a promising predictor of spatial cognition in chimpanzees.
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Affiliation(s)
- Rafaela S.C. Takeshita
- Department of Anthropology, Kent State University, Kent, OH, USA,School of Biomedical Sciences, Kent State University, Kent, OH, USA,Brain Health Research Institute, Kent State University, Kent, OH, USA
| | - Melissa K. Edler
- Department of Anthropology, Kent State University, Kent, OH, USA,School of Biomedical Sciences, Kent State University, Kent, OH, USA,Brain Health Research Institute, Kent State University, Kent, OH, USA
| | - Richard S. Meindl
- Department of Anthropology, Kent State University, Kent, OH, USA,School of Biomedical Sciences, Kent State University, Kent, OH, USA
| | - Chet C. Sherwood
- Department of Anthropology, The George Washington University, Washington, DC, USA
| | - William D. Hopkins
- Department of Comparative Medicine, The University of Texas MD Anderson Cancer Center, Bastrop, TX, USA
| | - Mary Ann Raghanti
- Department of Anthropology, Kent State University, Kent, OH, USA,School of Biomedical Sciences, Kent State University, Kent, OH, USA,Brain Health Research Institute, Kent State University, Kent, OH, USA
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2
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Al Meshari SZ, Aldweesh AH. Correlation between salivary dehydroepiandrosterone sulfate (DHEA-S) levels and cervical vertebral maturation in Saudi individuals. Saudi Dent J 2022; 34:355-361. [PMID: 35814844 PMCID: PMC9263755 DOI: 10.1016/j.sdentj.2022.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 05/06/2022] [Accepted: 05/07/2022] [Indexed: 11/30/2022] Open
Affiliation(s)
- Sarah Z. Al Meshari
- Corresponding author at: Graduate Studies and Scientific Research, Orthodontics Department, College of Dentistry, King Saud University, P.O. Box 60169-15, Riyadh 11545, Saudi Arabia
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Pierce SR, Germann AL, Steinbach JH, Akk G. The Sulfated Steroids Pregnenolone Sulfate and Dehydroepiandrosterone Sulfate Inhibit the α1 β3 γ2L GABA A Receptor by Stabilizing a Novel Nonconducting State. Mol Pharmacol 2022; 101:68-77. [PMID: 34853153 PMCID: PMC8969134 DOI: 10.1124/molpharm.121.000385] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 11/21/2021] [Indexed: 02/03/2023] Open
Abstract
The GABAA receptor is inhibited by the endogenous sulfated steroids pregnenolone sulfate (PS) and dehydroepiandrosterone sulfate (DHEAS). It has been proposed in previous work that these steroids act by enhancing desensitization of the receptor. Here, we have investigated the modulatory effects of the steroids on the human α1β3γ2L GABAA receptor. Using electrophysiology and quantitative model-based data analysis, we show that exposure to the steroid promotes occupancy of a nonconducting state that retains high affinity to the transmitter but whose properties differ from those of the classic, transmitter-induced desensitized state. From the analysis of the inhibitory actions of two combined steroids, we infer that PS and DHEAS act through shared or overlapping binding sites. SIGNIFICANCE STATEMENT: Previous work has proposed that sulfated neurosteroids inhibit the GABAA receptor by enhancing the rate of entry into the desensitized state. This study shows that the inhibitory steroids pregnenolone sulfate and dehydroepiandrosterone sulfate act through a common interaction site by stabilizing a distinct nonconducting state.
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Affiliation(s)
- Spencer R Pierce
- Department of Anesthesiology (S.R.P., A.L.G., J.H.S., G.A.) and the Taylor Family Institute for Innovative Psychiatric Research (J.H.S., G.A.), Washington University School of Medicine, St. Louis, Missouri
| | - Allison L Germann
- Department of Anesthesiology (S.R.P., A.L.G., J.H.S., G.A.) and the Taylor Family Institute for Innovative Psychiatric Research (J.H.S., G.A.), Washington University School of Medicine, St. Louis, Missouri
| | - Joe Henry Steinbach
- Department of Anesthesiology (S.R.P., A.L.G., J.H.S., G.A.) and the Taylor Family Institute for Innovative Psychiatric Research (J.H.S., G.A.), Washington University School of Medicine, St. Louis, Missouri
| | - Gustav Akk
- Department of Anesthesiology (S.R.P., A.L.G., J.H.S., G.A.) and the Taylor Family Institute for Innovative Psychiatric Research (J.H.S., G.A.), Washington University School of Medicine, St. Louis, Missouri
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4
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Jang S, Choi SW, Son SJ, Oh J, Ha J, Kim WJ, Roh HW, Kim KY, Lee S, Jung E, Cha W, Chae H, Kang S, Kwon JH, Kim IY, Lee JY, Shin HK, Ryu JS, Ahn R, Hong CH, Seok JH. Virtual reality-based monitoring test for MCI: A multicenter feasibility study. Front Psychiatry 2022; 13:1057513. [PMID: 36741575 PMCID: PMC9891464 DOI: 10.3389/fpsyt.2022.1057513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 12/19/2022] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVES As the significance of the early diagnosis of mild cognitive impairment (MCI) has emerged, it is necessary to develop corresponding screening tools with high ecological validity and feasible biomarkers. Virtual reality (VR)-based cognitive assessment program, which is close to the daily life of the older adults, can be suitable screening tools for MCI with ecological validity and accessibility. Meanwhile, dehydroepiandrosterone (DHEA) has been observed at a low concentration in the older adults with dementia or cognitive decline, indicating its potential as a biomarker of MCI. This study aimed to determine the efficacy and usability of a VR cognitive assessment program and salivary DHEA for screening MCI. METHODS The VR cognitive assessment program and the traditional Montreal Cognitive Assessment (MOCA) test were performed on 12 patients with MCI and 108 healthy older adults. The VR program operates in a situation of caring for a grandchild, and evaluates the memory, attention, visuospatial, and executive functions. An analysis of covariance (ANCOVA), a partial correlation analysis, and receiving operating characteristic (ROC) curve analysis were conducted for statistical analysis. RESULTS According to the ANCOVA, no significant difference in MOCA scores was found between the normal and MCI groups (F = 2.36, p = 0.127). However, the VR total score of the MCI group was significantly lower than that of the normal group (F = 8.674, p = 0.004). There was a significant correlation between the MOCA and VR scores in the total and matched subdomain scores. The ROC curve analysis also showed a larger area under the curve (AUC) for the VR test (0.765) than for the MOCA test (0.598), and the sensitivity and specificity of the VR program were 0.833 and 0.722, respectively. Salivary DHEA was correlated with VR total (R 2 = 0.082, p = 0.01) and attention scores (R 2 = 0.086, p = 0.009). CONCLUSION The VR cognitive test was as effective as the traditional MOCA test in the MCI classification and safe enough for older adults to perform, indicating its potential as a diagnostic tool. It has also been shown that salivary DHEA can be used as a biomarker for MCI.
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Affiliation(s)
- Sooah Jang
- Research Institute of Minds.AI, Co., Ltd., Seoul, Republic of Korea
| | - Sun-Woo Choi
- Research Institute of Minds.AI, Co., Ltd., Seoul, Republic of Korea
| | - Sang Joon Son
- Department of Psychiatry, Ajou University, Suwon, Gyeonggi-do, Republic of Korea
| | - Jooyoung Oh
- Department of Psychiatry, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.,Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Junghee Ha
- Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.,Department of Psychiatry, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Woo Jung Kim
- Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.,Department of Psychiatry, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Gyeonggi-do, Republic of Korea
| | - Hyun Woong Roh
- Department of Psychiatry, Ajou University, Suwon, Gyeonggi-do, Republic of Korea
| | - Keun You Kim
- Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.,Department of Psychiatry, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - San Lee
- Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.,Department of Psychiatry, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Gyeonggi-do, Republic of Korea
| | - Eunjin Jung
- Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Woojin Cha
- Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Heonjoo Chae
- FNIKorea Co., Ltd., Gwacheon, Gyeonggi-do, Republic of Korea
| | - Suzi Kang
- FNIKorea Co., Ltd., Gwacheon, Gyeonggi-do, Republic of Korea
| | - Ji Hye Kwon
- Research Institute of Minds.AI, Co., Ltd., Seoul, Republic of Korea
| | - In-Young Kim
- Research Institute of Minds.AI, Co., Ltd., Seoul, Republic of Korea
| | - Ju-Yeal Lee
- Research Institute of Minds.AI, Co., Ltd., Seoul, Republic of Korea
| | - Hyun Kyung Shin
- Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jin Sun Ryu
- Research Institute of Minds.AI, Co., Ltd., Seoul, Republic of Korea.,Department of Psychiatry, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ryunsup Ahn
- Research Institute of Minds.AI, Co., Ltd., Seoul, Republic of Korea
| | - Chang Hyung Hong
- Department of Psychiatry, Ajou University, Suwon, Gyeonggi-do, Republic of Korea
| | - Jeong-Ho Seok
- Research Institute of Minds.AI, Co., Ltd., Seoul, Republic of Korea.,Department of Psychiatry, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.,Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
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5
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Correlation of age and sex with urine dehydroepiandrosterone sulfate level in healthy Thai volunteers. Pract Lab Med 2021; 24:e00204. [PMID: 33553553 PMCID: PMC7848761 DOI: 10.1016/j.plabm.2021.e00204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 01/13/2021] [Indexed: 11/22/2022] Open
Abstract
Objective Dehydroepiandrosterone sulfate (DHEAs), a prohormone secreted by the adrenal gland, plays a role in the synthesis of sex hormones, namely, androgen and estrogen. It has been found that the amount of DHEAs is correlated with age, although most studies have focused on the correlation of serum DHEAs levels with age and sex. Thus, this noninvasive, cross-sectional study aimed to investigate the correlation of urine DHEAs levels with age and sex in healthy Thai volunteers aged 20–80 years. Methods DHEAs levels were measured in 178 healthy volunteers using electrochemiluminescence immunoassay and then normalized by creatinine. Multiple regression was performed to determine the correlation of urine DHEAs levels normalized by creatinine with age and sex. Results The normalized DHEAs levels are correlated with age group for both sexes. Moreover, an increasing trend in DHEAs levels was found in the age group 20–29 years, and the DHEAs level peaked at the age group 30–39 years before declining with advancing age. Based on the multiple regression analyses, the significance of the interaction term (P < 0.05) indicates that both age and sex significantly contribute to the prediction of ln (DHEAs/Creatinine). Our fitted model implies the following: as age increases by 1 year, DHEAs/Creatinine is expected to decrease by 3.63% in females and by 2.18% in males. Conclusion This study reports more data on clinical reference value of urine DHEAs levels in healthy volunteers. Our result demonstrates urine DHEAs levels are associated with age and sex and decline by 2–3% a year. There is no data on the correlation of urine DHEAs with age and sex in a wide age range. First report of urine DHEAs levels in healthy Thai volunteers aged 20–80 years. The fitted model is proposed to determine the correlation of urine DHEAs levels normalized by creatinine with age and sex.
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Eiser AR, Fulop T. Extra-cranial factors in the development of Alzheimer's disease. Brain Res 2020; 1748:147076. [PMID: 32853641 DOI: 10.1016/j.brainres.2020.147076] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 07/29/2020] [Accepted: 08/19/2020] [Indexed: 12/30/2022]
Abstract
The development of Alzheimer's Disease (AD) likely involves dysfunction in more than one extra-cranial organ system. AD appears to depend on several functional organ impairments that develops frequently during aging: lack of normal hepatic synthesis, defective detoxification of ammonia, gut microbiome dysbiosis, the development of insulin resistance, diminished adrenal production of dehydroepiandrosterone, nutrient depletion, impaired immune processes with persistent chronic neuro-inflammation, and persistent infectious processes are important components of this system-wide disorder. By reviewing these abnormalities in different organ systems, this review intends to suggest that clinical research into the prevention of dementia needs to take this interplay of organ system dysfunction into account. The design of therapeutic interventions needs to address dysfunction in more than one system at a time. We have singled out one aberrant signaling pathway, NF-kB, that seems common to several of the dysfunctional organ systems and suggest some potential interventions that may be effective when combined with others. Clinical research may need to shift from single factor interventions to studies that include multiple simultaneous interventions that restore health in multiple impaired organ systems in the aging human in order to avert future epidemics of AD.
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Affiliation(s)
- Arnold R Eiser
- Adjunct Senior Fellow, Leonard Davis Institute, University of Pennsylvania, 3641 Locust Walk, Philadelphia, PA 19104, United States.
| | - Tamas Fulop
- Professor of Medicine and Geriatrics, Research Center on Aging, University of Sherbrooke, Quebec, Canada
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7
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Associations between dehydroepiandrosterone sulphate (DHEAS) and cognitive function in 5,061 older men and women in the English Longitudinal Study of Ageing. Psychoneuroendocrinology 2020; 117:104702. [PMID: 32388228 DOI: 10.1016/j.psyneuen.2020.104702] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 04/21/2020] [Accepted: 04/23/2020] [Indexed: 11/22/2022]
Abstract
Despite extensive observational and intervention research, the association between concentrations of dehydroepiandrosterone sulfate (DHEAS) and cognition at older ages remains unclear. This study investigated cross-sectional and longitudinal relationships between plasma DHEAS and cognitive function in a large nationally-representative cohort of men and women aged 50 and older. Data were analysed from 5061 participants (mean age 65.1, standard deviation 8.61) who completed memory, verbal fluency and processing speed tests at baseline and two years later. Age, education, marital status, paid employment, depressive symptoms, mobility impairment, coronary heart disease and diabetes were included as covariates, and analyses were stratified by gender. We found positive associations at baseline between DHEAS concentration and aggregate cognition after adjustment for covariates in men (β = 0.049, standard error (s.e.) 0.020, p = 0.015). Longitudinally, DHEAS at baseline predicted cognition two years later in men (β = 0.052, s.e. 0.020, p = 0.010), but not after baseline cognition was taken into account (β = 0.022, s.e. 0.016, p = 0.17), indicating that DHEAS was not associated with rate of cognitive decline. Similar associations were recorded at 6 year follow-up. No significant relationships between DHEAS and cognition were observed among women. We conclude that greater DHEAS concentrations are associated with cognition level at older ages in men, but are unlikely to play a functional role in cognitive decline.
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Toh YL, Shariq Mujtaba J, Bansal S, Yeo A, Shwe M, Lau AJ, Chan A. Prechemotherapy Levels of Plasma Dehydroepiandrosterone and Its Sulfated Form as Predictors of Cancer-Related Cognitive Impairment in Patients with Breast Cancer Receiving Chemotherapy. Pharmacotherapy 2019; 39:553-563. [PMID: 30892712 PMCID: PMC6635742 DOI: 10.1002/phar.2259] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Study Objective Dehydroepiandrosterone (DHEA) and its sulfated form (DHEAS)—jointly referred to as DHEA(S)—are neurosteroids known to regulate brain development and function that have been found to be positively correlated with cognitive function. It is unknown whether prechemotherapy plasma DHEA(S) levels are associated with the onset of cancer‐related cognitive impairment (CRCI). The objective of this study was to evaluate whether an association exists between prechemotherapy plasma DHEA(S) levels and onset of CRCI in patients with breast cancer receiving chemotherapy. Design Multicenter, prospective cohort study. Setting Two specialized cancer centers in Singapore. Patients Eighty‐one patients with early‐stage breast cancer (stages I–III) who had no prior exposure to chemotherapy and/or radiotherapy and were scheduled to receive anthracycline‐based or taxane‐based chemotherapy treatment with curative intent. Measurements and Main Results Patients completed assessments for self‐perceived and objective cognitive function at three time points: prechemotherapy (T1), during chemotherapy (T2), and after chemotherapy (T3). Plasma samples were collected prior to chemotherapy, and DHEA(S) levels were quantified by using ultra–high‐performance liquid chromatography–tandem mass spectrometry. Multivariable logistic regression was used to adjust for clinically important factors and to evaluate the association between prechemotherapy plasma DHEA(S) levels and CRCI. Mean ± SD age was 48.9 ± 9.3 years, with 27.8% of patients experiencing clinically significant cognitive impairment based on global Functional Assessment of Cancer Therapy–Cognitive Function scores. The mean ± SD prechemotherapy plasma DHEAS and DHEA levels were 1.61 ± 0.91 μmol/L and 19.21 ± 13.13 nmol/L, respectively. Prechemotherapy DHEAS levels were found to be associated with impairment in the self‐perceived cognitive domains of verbal fluency (adjusted odds ratio [OR] 0.27, 95% confidence interval [CI] 0.08–0.96) and mental acuity (adjusted OR 0.25, 95% CI 0.08–0.74). Conversely, DHEA levels were not associated with impairment in any cognitive subdomains. Conclusion Our findings suggest that patients with higher prechemotherapy DHEAS levels had lower odds of developing self‐perceived cognitive impairment. Future studies are required to further investigate the effect of DHEA(S) on specific cognitive domains and to validate our findings in independent cohorts.
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Affiliation(s)
- Yi Long Toh
- Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore
| | | | - Sumit Bansal
- Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore
| | - Angie Yeo
- Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore
| | - Maung Shwe
- Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore.,Department of Pharmacy, National Cancer Centre Singapore, Singapore
| | - Aik Jiang Lau
- Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore.,Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Alexandre Chan
- Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore.,Department of Pharmacy, National Cancer Centre Singapore, Singapore.,Oncology Academic Clinical Program, Duke-National University of Singapore Medical School, Singapore
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Pan X, Wu X, Kaminga AC, Wen SW, Liu A. Dehydroepiandrosterone and Dehydroepiandrosterone Sulfate in Alzheimer's Disease: A Systematic Review and Meta-Analysis. Front Aging Neurosci 2019; 11:61. [PMID: 30983988 PMCID: PMC6449476 DOI: 10.3389/fnagi.2019.00061] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 03/05/2019] [Indexed: 12/27/2022] Open
Abstract
Background and Purpose: Previous studies found inconsistent results for the relationship between Alzheimer's disease and the levels of dehydroepiandrosterone and dehydroepiandrosterone sulfate. This study performed a systematic review and meta-analysis to evaluate previous studies' results on this relationship. Method: Studies related to this outcome were obtained using a systematic search from the electronic databases of PubMed, Embase, Web of Science, and Psyc-ARTICLES in March 2018. The random-effects model was used to measure the strength of the association between Alzheimer's disease and the levels of dehydroepiandrosterone and dehydroepiandrosterone sulfate, using the standardized mean difference. Results: Thirty-one eligible studies were included in the final analysis. There was no statistically significant association between the level of dehydroepiandrosterone and Alzheimer's disease (standardized mean difference: 0.51, 95% confidence interval: -0.44 to 1.45, Z = 1.06, p = 0.29). On the other hand, lower level dehydroepiandrosterone sulfate was observed in patients with Alzheimer's disease than in controls (standardized mean difference: -0.69, 95% confidence interval: -1.17 to -0.22, Z = -2.84, p < 0.01). Conclusion: Decreased dehydroepiandrosterone sulfate concentrations may be an important indicator for Alzheimer's disease, although whether dehydroepiandrosterone sulfate could be used as a diagnostic tool requires further research.
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Affiliation(s)
- Xiongfeng Pan
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Xinyin Wu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Atipatsa C Kaminga
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China.,Department of Mathematics and Statistics, Mzuzu University, Mzuzu, Malawi
| | - Shi Wu Wen
- Department of Obstetrics and Gynaecology, University of Ottawa, Ottawa, ON, Canada.,Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Aizhong Liu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
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Cheung YT, Chemaitilly W, Mulrooney DA, Brinkman TM, Liu W, Banerjee P, Srivastava D, Pui CH, Robison LL, Hudson MM, Krull KR. Association between dehydroepiandrosterone-sulfate and attention in long-term survivors of childhood acute lymphoblastic leukemia treated with only chemotherapy. Psychoneuroendocrinology 2017; 76:114-118. [PMID: 27907849 PMCID: PMC5272831 DOI: 10.1016/j.psyneuen.2016.11.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 11/09/2016] [Indexed: 12/24/2022]
Abstract
Long-term survivors of childhood acute lymphoblastic leukemia (ALL) are at risk for neurocognitive impairment, as well as compromised hypothalamic-pituitary-adrenal (HPA) function. Dehydroepiandrosterone-sulfate (DHEAS) is an adrenal androgen commonly used as a marker of HPA function. In the general population, a low level of DHEAS has been associated with poorer cognition. At ≥2years post-treatment, we examined the association of DHEAS with attention outcomes in 35 male and 34 female long-term survivors of childhood ALL (mean[standard deviation] age at evaluation 14.5[4.7] years; 7.5[1.9] years post-diagnosis) who were treated with only chemotherapy and without prophylactic cranial irradiation. Male survivors with low-normal levels of DHEAS had worse performance than male survivors with high levels of DHEAS on multiple measures of attention (all P's<0.05). However, association between DHEAS and attention measures were not found in female survivors. Our results suggest that survivors of ALL who suffer from partial but persistent adrenal insufficiency may be at risk for neurocognitive deficits. This finding should be validated in a larger prospective study, with attention to sex differences in the potential impact of adrenal insufficiency on neurocognitive outcomes.
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Affiliation(s)
- Yin Ting Cheung
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, USA
| | - Wassim Chemaitilly
- Department of Endocrinology, St Jude Children's Research Hospital, Memphis, USA
| | - Daniel A Mulrooney
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, USA; Department of Oncology, St Jude Children's Research Hospital, Memphis, USA
| | - Tara M Brinkman
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, USA; Department of Psychology, St Jude Children's Research Hospital, Memphis, USA
| | - Wei Liu
- Department of Biostatistics, St Jude Children's Research Hospital, Memphis, USA
| | - Pia Banerjee
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, USA
| | - Deokumar Srivastava
- Department of Biostatistics, St Jude Children's Research Hospital, Memphis, USA
| | - Ching-Hon Pui
- Department of Oncology, St Jude Children's Research Hospital, Memphis, USA
| | - Leslie L Robison
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, USA
| | - Melissa M Hudson
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, USA; Department of Oncology, St Jude Children's Research Hospital, Memphis, USA
| | - Kevin R Krull
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, USA; Department of Psychology, St Jude Children's Research Hospital, Memphis, USA.
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Laudisio A, Fontana DO, Rivera C, Ruggiero C, Bandinelli S, Gemma A, Ferrucci L, Antonelli Incalzi R. Bone Mineral Density and Cognitive Decline in Elderly Women: Results from the InCHIANTI Study. Calcif Tissue Int 2016; 98:479-88. [PMID: 26713334 PMCID: PMC6117833 DOI: 10.1007/s00223-015-0102-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 12/13/2015] [Indexed: 10/22/2022]
Abstract
Osteoporosis and cognitive impairment, which are highly prevalent conditions in elderly populations, share several risk factors. This study aims at evaluating the association of bone mineral density (BMD) with prevalent and incident cognitive impairment after a 3-year follow-up. We studied 655 community-dwelling women aged 65+ participating in the InCHIANTI study, who had been followed for 3 years. Total, trabecular, and cortical BMD were estimated by peripheral quantitative computed tomography using standard transverse scans at 4 and 38 % of the tibial length. Cognitive performance was evaluated using the Mini-Mental State Examination and the Trail Making Tests (TMT) A and B; a MMSE score <24 was adopted to define cognitive impairment. The TMT A-B score was calculated as the difference between TMT-A and TMT-B times (ΔTMT). The association of cognitive performance after 3 years with baseline indices of BMD was assessed by logistic and linear regression analyses. Cortical, but not trabecular, BMD was independently associated with incident cognitive impairment (OR 0.93, 95 % CI 0.88-0.98; P = 0.012), worsening cognitive performance (OR 0.96, 95 % CI 0.92-0.98; P = 0.039), and worsening performance in ΔTMT (OR 0.96, 95 % CI 0.92-0.99; P = 0.047). Increasing cortical BMD tertiles was associated with decreasing probability of incident cognitive impairment (P for linear trend =0.001), worsening cognitive performance (P = 0.013), and a worsening performance below the median value (P for linear trend <0.0001). In older women, low BMD might represent an independent and early marker of subsequent cognitive impairment. Physicians should assess and monitor cognitive performance in the routine management of elderly women with osteoporosis.
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Affiliation(s)
- Alice Laudisio
- Unit of Geriatrics, Department of Medicine, Campus Bio-Medico di Roma University, via Álvaro del Portillo 21, 00128, Rome, Italy.
| | - Davide Onofrio Fontana
- Unit of Geriatrics, Department of Medicine, Campus Bio-Medico di Roma University, via Álvaro del Portillo 21, 00128, Rome, Italy
| | - Chiara Rivera
- Unit of Geriatrics, Department of Medicine, Campus Bio-Medico di Roma University, via Álvaro del Portillo 21, 00128, Rome, Italy
| | - Carmelinda Ruggiero
- Department of Medicine Institute of Gerontology and Geriatrics, Ospedale S. Maria della Misericordia, Perugia, Italy
| | - Stefania Bandinelli
- Geriatric Rehabilitation Unit, Azienda Sanitaria di Firenze, Florence, Italy
| | - Antonella Gemma
- Department of Homecare Service, Azienda Sanitaria Locale Roma E, Rome, Italy
| | - Luigi Ferrucci
- Longitudinal Studies Section, Clinical Research Branch, National Institute on Aging, Baltimore, MD, USA
| | - Raffaele Antonelli Incalzi
- Unit of Geriatrics, Department of Medicine, Campus Bio-Medico di Roma University, via Álvaro del Portillo 21, 00128, Rome, Italy
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Tay L, Lim WS, Chan M, Ye RJ, Chong MS. The Independent Role of Inflammation in Physical Frailty among Older Adults with Mild Cognitive Impairment and Mild-to-Moderate Alzheimer's Disease. J Nutr Health Aging 2016; 20:288-99. [PMID: 26892578 DOI: 10.1007/s12603-015-0617-6] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To examine the independent and combined effects of inflammation and endocrine dysregulation on (i) baseline frailty status and (ii) frailty progression at one year, among cognitively impaired community dwelling older adults. DESIGN Prospective cohort study. SETTING Tertiary Memory Clinic. METHODS We recruited patients with mild cognitive impairment and mild-moderate Alzheimer's disease. Physical frailty status was assessed at baseline and 1-year. Blood biomarkers of systemic inflammation [interleukin-6 (IL-6), tumour necrosis factor-α (TNF-α)] and anabolic hormones [insulin-like growth factor-1 (IGF-1), dehydroepiandrosterone sulphate (DHEAS)] were measured at baseline and examined in relation to physical frailty status at baseline and progression at 1-year. Each subject was categorized as (i) neither pro-inflammatory nor endocrine deficient, (ii) pro-inflammatory (IL-6 or TNF-α, or both, being in highest quartile) but not endocrine deficient, (iii) endocrine deficient (IGF-1 or DHEAS, or both, being in lowest quartile) but not pro-inflammatory and (iv) both pro-inflammatory and endocrine deficient. RESULTS Twenty (20.2%) of 99 subjects were physically frail at baseline. There was no association between severity of cognitive impairment and baseline frailty status, but the frail group had significantly greater hippocampal atrophy (median MTA: 2 (2-3) vs 1 (1-2), p=0.010). TNF-α was significantly higher in subjects who were physically frail at baseline (median TNF-α: 1.30 (0.60-1.40) vs 0.60 (0.50-1.30) pg/mL, p=0.035). In multiple logistic regression adjusted for age and gender, a pro-inflammatory state in the absence of concomitant endocrine deficiency was significantly associated with physical frailty at baseline (OR=4.99, 95% C.I 1.25-19.88, p=0.023); this was no longer significant when MTA score was included in the model. Isolated pro-inflammatory state (without endocrine deficiency) significantly increased the odds of frailty progression (OR=4.06, 95% CI 1.09-15.10, p=0.037) at 1-year. The combination pro-inflammatory and endocrine deficient state was not significantly associated with either baseline or progressive physical frailty. CONCLUSION A pro-inflammatory state exerts differential effects on physical frailty, contributing to the increased risk of baseline and progressive frailty only in the absence of a concomitant endocrine deficient state, with potential mediation via neurodegeneration.
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Affiliation(s)
- L Tay
- Dr Laura Tay, Department of Geriatric Medicine, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433. Phone: 65-6359 6474, Fax: 65-6359 6294, E-Mail:
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Keane KN, Hinchliffe PM, Namdar N, Conceicao JL, Newsholme P, Yovich JL. Novel dehydroepiandrosterone troche supplementation improves the serum androgen profile of women undergoing in vitro fertilization. DRUG DESIGN DEVELOPMENT AND THERAPY 2015; 9:5569-78. [PMID: 26487801 PMCID: PMC4607057 DOI: 10.2147/dddt.s92467] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Dehydroepiandrosterone (DHEA) is the most abundant steroid hormone in the circulation and has potent multifunctional activity. Epidemiological evidence suggests that levels of serum DHEA decrease with advancing age, and this has been associated with onset or progression of various age-related ailments, including cognitive decline and dementia, cardiovascular disease, and obesity. Consequently, these findings have sparked intense research interest in DHEA supplementation as an "antiaging" therapy. Currently, DHEA is being used by 25% of in vitro fertilization (IVF) clinicians as an adjuvant in assisted reproductive programs, yet the therapeutic benefit of DHEA is unclear. Here, we examined the use of novel DHEA-containing oral troches in patients undertaking IVF and investigated the impact of these troches on their serum androgen profile. This retrospective study determined the androgen profile of 31 IVF patients before (baseline) and after DHEA supplementation (with DHEA). Baseline serum measurements of testosterone (total and free), DHEA sulfate (DHEAS), sex hormone-binding globulin (SHBG), and androstenedione were made before and after supplementation. Each patient received DHEA troches containing 25 mg of micronized DHEA, and troches were administered sublingually twice daily for a period of no greater than 4 months. Adjuvant treatment with DHEA boosted the serum concentration of a number of androgen-related analytes, including total and free testosterone, androstenedione, and DHEAS, while serum SHBG remained unchanged. Supplementation also significantly increased the free-androgen index in IVF patients. Interestingly, the increase in serum analyte concentration following DHEA supplementation was found to be dependent on body mass index (BMI), but not individual age. Patients with the lowest BMI (<20.0 kg/m(2)) tended to have lower testosterone and DHEAS, but higher SHBG and androstenedione levels in comparison with other BMI groups postsupplementation. However, patients in the highest BMI group (>30.0 kg/m(2)) tended to have lower androgen responses following DHEA supplementation, but these were not statistically different from the corresponding baseline level. This method of DHEA administration results in a similar enhancement of testosterone, DHEAS, and androstenedione levels in comparison with other methods of administration. Furthermore, we showed that BMI significantly influences DHEA uptake and metabolism, and that BMI should be carefully considered during dosage calculation to ensure a significant and robust androgen-profile boost.
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Affiliation(s)
- Kevin N Keane
- School of Biomedical Sciences, Curtin Health Innovation Research Institute - Biosciences, Curtin University, Perth, Australia ; PIVET Medical Centre, Perth, Australia
| | | | | | | | - Philip Newsholme
- School of Biomedical Sciences, Curtin Health Innovation Research Institute - Biosciences, Curtin University, Perth, Australia
| | - John L Yovich
- School of Biomedical Sciences, Curtin Health Innovation Research Institute - Biosciences, Curtin University, Perth, Australia ; PIVET Medical Centre, Perth, Australia
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Abstract
BACKGROUND This cross-sectional study examined the associations of hormones and age with short-term memory and perceptual capacity in 472 healthy Asian men. METHODS The symbol digit and digit span tests from the Swedish Performance Evaluation System were used to assess perceptual capacity and memory. Linear regression analyses with the stepwise method were carried out with the SPSS 21.0 package. RESULTS Age was associated with lower dehydorepiandrosterone sulphate (DHEA/S), insulin growth factor-1 (IGF-1), thyroxine (T4), testosterone (T), bioavailable T (BioT) and error rate (Err) but higher glucose (GLU), sex hormone binding globulin (SHBG), estradiol (E2) and retention time (RT). High GLU was associated with higher error rate, longer RT of the perceptual capacity domain and shorter digit span (DSpan) of the short-term memory domain. Higher insulin-like growth factor binding protein-3 (BP3) was associated with longer DSpan. High cortisol (Cor) was associated with higher Err, while high DHEA/S was associated with shorter RT. All other hormones from the adrenal, somatotrophic and gonadal were not significantly associated with cognition. CONCLUSION The findings suggest (1) a role for tighter control of blood glucose levels in cognitive decline with aging in men, (2) different hormones may be related to different parameters of cognition and "cognition" is not a unitary phenomenon and (3) further investigation of the potential for exogenous DHEA/S to slow cognitive decline in aging, especially as it relates to reaction time.
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Affiliation(s)
- Victor H-H Goh
- Department of Medical Education, Faculty of Health Sciences, Curtin University , Bentley, WA , Australia
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Pluchino N, Drakopoulos P, Bianchi-Demicheli F, Wenger JM, Petignat P, Genazzani AR. Neurobiology of DHEA and effects on sexuality, mood and cognition. J Steroid Biochem Mol Biol 2015; 145:273-80. [PMID: 24892797 DOI: 10.1016/j.jsbmb.2014.04.012] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Revised: 04/14/2014] [Accepted: 04/20/2014] [Indexed: 10/25/2022]
Abstract
Dehydroepiandrosterone (DHEA) and its sulfate ester, DHEAS, are the most abundant steroid hormones in the humans. However, their physiological significance, their mechanisms of action and their possible roles as treatment are not fully clarified. Biological actions of DHEA(S) in the brain involve neuroprotection, neurite growth, neurogenesis and neuronal survival, apoptosis, catecholamine synthesis and secretion, as well as anti-oxidant, anti-inflammatory and antiglucocorticoid effects. In addition, DHEA affects neurosteroidogenis and endorphin synthesis/release. We also demonstrated in a model of ovariectomized rats that DHEA therapy increases proceptive behaviors, already after 1 week of treatment, affecting central function of sexual drive. In women, the analyses of clinical outcomes are far from being conclusive and many issues should still be addressed. Although DHEA preparations have been available in the market since the 1990s, there are very few definitive reports on the biological functions of this steroid. We demonstrate that 1 year DHEA administration at the dose of 10mg provided a significant improvement in comparison with vitamin D in sexual function and in frequency of sexual intercourse in early postmenopausal women. Among symptomatic women, the spectrum of symptoms responding to DHEA requires further investigation, to define the type of sexual symptoms (e.g. decreased sexual function or hypoactive sexual desire disorder) and the degree of mood/cognitive symptoms that could be responsive to hormonal treatment. In this regard, our findings are promising, although they need further exploration with a larger and more representative sample size. This article is part of a Special Issue entitled: Essential role of DHEA.
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Affiliation(s)
- N Pluchino
- Division of Gynecology and Obstetrics, University Hospital of Geneva, Geneva, Switzerland.
| | - P Drakopoulos
- Division of Gynecology and Obstetrics, University Hospital of Geneva, Geneva, Switzerland
| | - F Bianchi-Demicheli
- Division of Gynecology and Obstetrics, University Hospital of Geneva, Geneva, Switzerland
| | - J M Wenger
- Division of Gynecology and Obstetrics, University Hospital of Geneva, Geneva, Switzerland
| | - P Petignat
- Division of Gynecology and Obstetrics, University Hospital of Geneva, Geneva, Switzerland
| | - A R Genazzani
- Division of Gynecology and Obstetrics, University of Pisa, Pisa, Italy
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Maggio M, De Vita F, Fisichella A, Colizzi E, Provenzano S, Lauretani F, Luci M, Ceresini G, Dall'Aglio E, Caffarra P, Valenti G, Ceda GP. DHEA and cognitive function in the elderly. J Steroid Biochem Mol Biol 2015; 145:281-92. [PMID: 24794824 DOI: 10.1016/j.jsbmb.2014.03.014] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Revised: 03/20/2014] [Accepted: 03/27/2014] [Indexed: 11/28/2022]
Abstract
The adrenal prohormone dehydroepiandrosterone (DHEA) and its sulphate conjugate (DHEAS) steadily decrease with age by 10% per decade reaching a nadir after the age of 80. Both DHEA and DHEAS (DHEA/S) exert many biological activities in different tissues and organs. In particular, DHEA and DHEAS are produced de novo in the brain, hence their classification as neurosteroids. In humans, the brain-to-plasma ratios for DHEA and DHEAS are 4-6.5 and 8.5, respectively, indicating a specific neuroendocrine role for these hormones. DHEA/S stimulates neurite growth, neurogenesis and neuronal survival, apoptosis, catecholamine synthesis and secretion. Together with antioxidant, anti-inflammatory and anti-glucocorticoid properties, it has been hypothesized a neuroprotective effect for DHEA/S. We conducted an accurate research of the literature using PubMed. In the period of time between 1994 and 2013, we selected the observational human studies testing the relationship between DHEA/S and cognitive function in both sexes. The studies are presented according to the cross-sectional and longitudinal design and to the positive or neutral effects on different domains of cognitive function. We also analysed the Clinical Trials, available in the literature, having cognitive domains as the main or secondary outcome. Although the cross-sectional evidence of a positive association between DHEA/S and cognitive function, longitudinal studies and RCTs using DHEA oral treatment (50mg/day) in normal or demented adult-older subjects, have produced conflicting and inconsistent results. In summary, the current data do not provide clear evidence for the usefulness of DHEA treatment to improve cognitive function in adult-older subjects. This article is part of a Special Issue entitled 'Essential role of DHEA'.
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Affiliation(s)
- Marcello Maggio
- Geriatric Rehabilitation Department, University Hospital of Parma, Via Gramsci, 14, 43126 Parma (PR), Italy; Department of Clinical and Experimental Medicine, Section of Geriatrics, Food Sciences Unit and Endocrinology of Aging Unit, University of Parma, Via Gramsci, 14, 43126 Parma (PR), Italy.
| | - Francesca De Vita
- Geriatric Rehabilitation Department, University Hospital of Parma, Via Gramsci, 14, 43126 Parma (PR), Italy
| | - Alberto Fisichella
- Geriatric Rehabilitation Department, University Hospital of Parma, Via Gramsci, 14, 43126 Parma (PR), Italy
| | - Elena Colizzi
- Geriatric Rehabilitation Department, University Hospital of Parma, Via Gramsci, 14, 43126 Parma (PR), Italy
| | - Sandra Provenzano
- Geriatric Rehabilitation Department, University Hospital of Parma, Via Gramsci, 14, 43126 Parma (PR), Italy
| | - Fulvio Lauretani
- Geriatric Rehabilitation Department, University Hospital of Parma, Via Gramsci, 14, 43126 Parma (PR), Italy
| | - Michele Luci
- Geriatric Rehabilitation Department, University Hospital of Parma, Via Gramsci, 14, 43126 Parma (PR), Italy
| | - Graziano Ceresini
- Geriatric Rehabilitation Department, University Hospital of Parma, Via Gramsci, 14, 43126 Parma (PR), Italy; Department of Clinical and Experimental Medicine, Section of Geriatrics, Food Sciences Unit and Endocrinology of Aging Unit, University of Parma, Via Gramsci, 14, 43126 Parma (PR), Italy
| | - Elisabetta Dall'Aglio
- Department of Clinical and Experimental Medicine, Section of Geriatrics, Food Sciences Unit and Endocrinology of Aging Unit, University of Parma, Via Gramsci, 14, 43126 Parma (PR), Italy
| | - Paolo Caffarra
- Department of Neuroscience, University of Parma, Parma (PR), Italy; Outpatient Clinic for the Diagnosis and Therapy of Cognitive Disorders, AUSL, Parma (PR), Italy
| | - Giorgio Valenti
- Department of Clinical and Experimental Medicine, Section of Geriatrics, Food Sciences Unit and Endocrinology of Aging Unit, University of Parma, Via Gramsci, 14, 43126 Parma (PR), Italy
| | - Gian Paolo Ceda
- Geriatric Rehabilitation Department, University Hospital of Parma, Via Gramsci, 14, 43126 Parma (PR), Italy; Department of Clinical and Experimental Medicine, Section of Geriatrics, Food Sciences Unit and Endocrinology of Aging Unit, University of Parma, Via Gramsci, 14, 43126 Parma (PR), Italy
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Chua CK, Henderson VW, Dennerstein L, Ames D, Szoeke C. Dehydroepiandrosterone sulfate and cognition in midlife, post-menopausal women. Neurobiol Aging 2014; 35:1654-5. [DOI: 10.1016/j.neurobiolaging.2014.01.140] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Revised: 01/21/2014] [Accepted: 01/27/2014] [Indexed: 11/28/2022]
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Samaras N, Samaras D, Frangos E, Forster A, Philippe J. A review of age-related dehydroepiandrosterone decline and its association with well-known geriatric syndromes: is treatment beneficial? Rejuvenation Res 2014; 16:285-94. [PMID: 23647054 DOI: 10.1089/rej.2013.1425] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Dehydroepiandrosterone (DHEA) and its sulfate ester are the most abundant steroids in humans. DHEA levels fall with age in men and women, reaching values sometimes as low as 10%-20% of those encountered in young individuals. This age-related decrease suggests an "adrenopause" phenomenon. Studies point toward several potential roles of DHEA, mainly through its hormonal end products, making this decline clinically relevant. Unfortunately, even if positive effects of DHEA on muscle, bone, cardiovascular disease, and sexual function seem rather robust, extremely few studies are large enough and/or long enough for conclusions regarding its effects on aging. Moreover, because it has been publically presented as a "fountain of youth" equivalent, over-the-counter preparations lacking pharmacokinetic and pharmacodynamic data are widely used worldwide. Conceptually, supplementing a pre-hormone is extremely interesting, because it would permit the human organism to adequately use it throughout long periods, increasing or decreasing end products according to his needs. Nevertheless, data on the safety profile of long-term DHEA supplementation are still lacking. In this article, we examine the potential relation between low DHEA levels and well-known age-related diseases, such as sarcopenia, osteoporosis, dementia, sexual disorders, and cardiovascular disease. We also review risks and benefits of existing protocols of DHEA supplementation.
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Affiliation(s)
- Nikolaos Samaras
- Department of Internal Medicine, Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland.
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Hildreth KL, Gozansky WS, Jankowski CM, Grigsby J, Wolfe P, Kohrt WM. Association of serum dehydroepiandrosterone sulfate and cognition in older adults: sex steroid, inflammatory, and metabolic mechanisms. Neuropsychology 2013; 27:356-363. [PMID: 23688217 DOI: 10.1037/a0032230] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE Dehydroepiandrosterone sulfate (DHEAS) levels and cognitive function decline with age, and a role for DHEAS in supporting cognition has been proposed. Higher DHEAS levels may be associated with better cognitive performance, although potential mechanisms for this relationship are not well established. METHOD We performed a cross-sectional study of the relationship between serum DHEAS and three aspects of cognition--executive function, working memory, and processing speed--in 49 men and 54 women, aged 60-88 years, with low serum DHEAS levels. We examined three potential mechanisms of DHEAS action--sex hormone sufficiency, inflammatory status, and glucose regulation. RESULTS After adjustment for multiple covariates, higher serum DHEAS levels were associated with better working memory (standardized beta coefficient 0.50, p < .05), with a trend toward better executive function (standardized beta coefficient 0.37, p < .10) in men only. There was a nonsignificant trend toward a negative association between levels of tumor necrosis factor α (TNFα) and working memory in the combined population (standardized beta coefficient -0.22, p < .10). None of the glucoregulatory measures was associated with cognitive function. CONCLUSIONS The relationship between DHEAS and cognition is complex and differs by sex and cognitive domain. This study supports the need for further investigations of the sex-specific effects of DHEAS on cognition and its underlying mechanisms of action.
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Affiliation(s)
- Kerry L Hildreth
- Department of Medicine, University of Colorado School of Medicine
| | | | | | - Jim Grigsby
- Department of Medicine, University of Colorado School of Medicine
| | - Pamela Wolfe
- Colorado Biostatistical Consortium, University of Colorado School of Public Health
| | - Wendy M Kohrt
- Department of Medicine, University of Colorado School of Medicine
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Maggio M, Colizzi E, Fisichella A, Valenti G, Ceresini G, Dall’Aglio E, Ruffini L, Lauretani F, Parrino L, Ceda GP. Stress hormones, sleep deprivation and cognition in older adults. Maturitas 2013; 76:22-44. [DOI: 10.1016/j.maturitas.2013.06.006] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Accepted: 06/05/2013] [Indexed: 12/20/2022]
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Bradley M, McElhiney M, Rabkin J. DHEA and cognition in HIV-positive patients with non-major depression. PSYCHOSOMATICS 2012; 53:244-9. [PMID: 22296865 DOI: 10.1016/j.psym.2011.08.005] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2010] [Revised: 08/04/2011] [Accepted: 08/08/2011] [Indexed: 11/18/2022]
Abstract
BACKGROUND Dihydroepiandrosterone (DHEA) has been investigated for its potential role in improving cognition in a number of patient populations. Treatment options are limited for HIV-associated neurocognitive disorders. OBJECTIVE The authors tested the effect of DHEA administration on the cognitive functioning of HIV-positive subjects with non-major depression. METHOD The neuropsychological testing data for 60 HIV-positive patients enrolled in a clinical trial for non-major depression were analyzed to determine if DHEA-treated patients demonstrated improved cognitive functioning versus placebo. RESULTS At baseline, 80% of the sample met criteria for asymptomatic cognitive impairment. No benefit in cognitive performance was found on 16 of 17 neuropsychological measures evaluated. One measure showed a modest benefit for placebo-treated patients over DHEA. CONCLUSION DHEA treatment was not associated with improved cognitive performance in HIV-positive patients with non-major depression.
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Affiliation(s)
- Mark Bradley
- New York University/Veterans Affairs New York Harbor Healthcare System, New York, NY 10036, USA.
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Maggio M, Dall'Aglio E, Lauretani F, Cattabiani C, Ceresini G, Caffarra P, Valenti G, Volpi R, Vignali A, Schiavi G, Ceda GP. The hormonal pathway to cognitive impairment in older men. J Nutr Health Aging 2012; 16:40-54. [PMID: 22238001 DOI: 10.1007/s12603-012-0002-7] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
In older men there is a multiple hormonal dysregulation with a relative prevalence of catabolic hormones such as thyroid hormones and cortisol and a decline in anabolic hormones such as dehydroepiandrosterone sulphate, testosterone and insulin like growth factor 1 levels. Many studies suggest that this catabolic milieu is an important predictor of frailty and mortality in older persons. There is a close relationship between frailty and cognitive impairment with studies suggesting that development of frailty is consequence of cognitive impairment and others pointing out that physical frailty is a determinant of cognitive decline. Decline in cognitive function, typically memory, is a major symptom of dementia. The "preclinical phase" of cognitive impairment occurs many years before the onset of dementia. The identification of relevant modifiable factors, including the hormonal dysregulation, may lead to therapeutic strategies for preventing the cognitive dysfunction. There are several mechanisms by which anabolic hormones play a role in neuroprotection and neuromodulation. These hormones facilitate recovery after brain injury and attenuate the neuronal loss. In contrast, elevated thyroid hormones may increase oxidative stress and apoptosis, leading to neuronal damage or death. In this mini review we will address the relationship between low levels of anabolic hormones, changes in thyroid hormones and cognitive function in older men. Then, giving the contradictory data of the literature and the multi-factorial origin of dementia, we will introduce the hypothesis of multiple hormonal derangement as a better determinant of cognitive decline in older men.
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Affiliation(s)
- M Maggio
- Department of Internal Medicine and Biomedical Sciences, Section of Geriatrics, University of Parma, Parma, Italy.
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Ritsner M. The clinical and therapeutic potentials of dehydroepiandrosterone and pregnenolone in schizophrenia. Neuroscience 2011; 191:91-100. [DOI: 10.1016/j.neuroscience.2011.04.017] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2010] [Revised: 04/04/2011] [Accepted: 04/05/2011] [Indexed: 01/08/2023]
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