title: Dehydroepiandrosterone sulfate and psychiatric measures in a frail, elderly residential care population.
abstract: BACKGROUND
  Previous reports have found low levels of dehydroepiandrosterone sulfate (DHEA-S) in association with physical illness, and with frailty in the elderly. In a preliminary study, we also found low DHEA-S associated with increased disability and number of pain sites. However, we found the opposite relationship between DHEA-S and cognitive impairment. Therefore, we conducted a study of a second sample to confirm this unexpected finding and the expected inverse correlations between DHEA-S levels and increased disability and number of pain sites.
  
  
  METHODS
  Psychiatric symptoms and disorders were correlated with DHEA-S and related steroid levels in a second convenience sample in the nursing home population.
  
  
  RESULTS
  This sample confirmed the previous finding of a positive association of cognitive impairment with higher DHEA-S levels but the inverse association of DHEA-S levels with the numbers of pain sensations did not reach statistical significance. Cognitive impairment was also positively associated with higher dehydroepiandrosterone (DHEA) and estradiol levels (women only). Cortisol levels were inversely associated with depressive symptoms.
  
  
  CONCLUSIONS
  The anomalous positive correlation between cognitive dysfunction and DHEA-S levels, and the inverse correlation between cortisol levels and depressive symptoms, suggests that the relationships between psychiatric symptomatology and levels of steroids that are part of the hypothalamic-pituitary adrenal axis are different in the frail elderly population from that of younger and heartier populations.
authors.affiliation: Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia 19104-4283, USA.
authors.forename: M F
authors.initials: MF
authors.lastname: Morrison
authors.forename: E
authors.initials: E
authors.lastname: Redei
authors.forename: T
authors.initials: T
authors.lastname: TenHave
authors.forename: P
authors.initials: P
authors.lastname: Parmelee
authors.forename: A A
authors.initials: AA
authors.lastname: Boyce
authors.forename: P S
authors.initials: PS
authors.lastname: Sinha
authors.forename: I R
authors.initials: IR
authors.lastname: Katz
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000097:blood / Q000175:diagnosis; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood*; D003866:Depressive Disorder / Q000097:blood; D005260:Female; D016330:Frail Elderly / Q000523:psychology*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008297:Male; D009735:Nursing Homes; D012189:Retrospective Studies; D012727:Sex Characteristics
chemical_list: D019314:Dehydroepiandrosterone Sulfate; D006854:Hydrocortisone