title: DHEAS levels and mortality in disabled older women: the Women's Health and Aging Study I.
abstract: BACKGROUND
  Dehydroepiandrosterone sulfate (DHEAS) is an endogenously produced sex steroid that has been hypothesized to have anti-aging effects. Low DHEAS levels are associated with mortality in older men, but the relationship between DHEAS levels and mortality in women is not clearly defined.
  
  
  METHODS
  The relationship between serum DHEAS level and 5-year mortality was analyzed in a cohort of 539 disabled women aged 65-100 years enrolled in the Women's Health and Aging Study I (WHAS I). Using Cox proportional hazard models, we calculated multivariate-adjusted mortality risks by DHEAS quartiles and by DHEAS continuously, allowing for a nonlinear relationship. We also examined cause-specific mortality.
  
  
  RESULTS
  We found a U-shaped relationship between DHEAS level and mortality. After adjusting for multiple covariates, women in the top and bottom DHEAS quartiles had a more than 2-fold higher 5-year mortality than did those in the middle quartiles (hazard ratio, 2.15; 95% confidence interval [CI], 1.17-3.98 for the top quartile and 2.05; 95% CI, 1.27-3.32 for the bottom quartile, each compared to the third quartile). Women with higher DHEAS levels tended to have greater cancer mortality, whereas those with lower DHEAS tended to have greater cardiovascular mortality.
  
  
  CONCLUSIONS
  Disabled older women with either low or high levels of DHEAS are at greater risk for death than are those with intermediate levels. More research is needed to determine if targeted dehydroepiandrosterone supplementation would provide clinical benefit to disabled older women.
authors.affiliation: Division of Endocrinology, Diabetes, and Metabolism, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, PA 19104-6021, USA. acappola@cceb.med.upenn.edu
authors.forename: Anne R
authors.initials: AR
authors.lastname: Cappola
authors.forename: Qian-Li
authors.initials: QL
authors.lastname: Xue
authors.forename: Jeremy D
authors.initials: JD
authors.lastname: Walston
authors.forename: Sean X
authors.initials: SX
authors.lastname: Leng
authors.forename: Luigi
authors.initials: L
authors.lastname: Ferrucci
authors.forename: Jack
authors.initials: J
authors.lastname: Guralnik
authors.forename: Linda P
authors.initials: LP
authors.lastname: Fried
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000097:blood / Q000401:mortality*; D015331:Cohort Studies; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood*; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015999:Multivariate Analysis; D009369:Neoplasms / Q000097:blood / Q000401:mortality*; D016016:Proportional Hazards Models; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
chemical_list: D019314:Dehydroepiandrosterone Sulfate