title: Cardiovascular disease is associated with greater incident dehydroepiandrosterone sulfate decline in the oldest old: the cardiovascular health study all stars study.
abstract: OBJECTIVE
  To describe cross-sectional and longitudinal associations with dehydroepiandrosterone sulfate (DHEAS) and change in DHEAS with age.
  
  
  METHODS
  Longitudinal cohort study.
  
  
  METHODS
  Pittsburgh, Pennsylvania.
  
  
  METHODS
  Cardiovascular Health Study All Stars study participants assessed in 2005/06 (N=989, mean age 85.2, 63.5% women, 16.5% African American).
  
  
  METHODS
  Health characteristics were assessed in 2005/06 according to DHEAS level, mean DHEAS and DHEAS change across age categories were tested, and linear and logistic regression was used to identify factors present in 1996/97 associated with continuous and categorical DHEAS change.
  
  
  RESULTS
  Mean +/- standard deviation DHEAS was 0.555 +/- 0.414 microg/mL in 1996/97 and 0.482 +/- 0.449 microg/mL in 2005/06 for women and 0.845 +/- 0.520 microg/mL in 1996/97 and 0.658 +/- 0.516 microg/mL in 2005/06 for men. In 2005/06, DHEAS was lower in women and subjects with cardiovascular disease (CVD) and chronic pulmonary disease and higher for African Americans and subjects with hypertension and high cholesterol. Mean DHEAS change was greater in men (-0.200 microg/mL) than in women (-0.078 microg/mL) (P<.001). Each 1-year increase in age attenuated the effect of male sex by 0.01 microg/mL (P=.009), abolishing the sex difference in DHEAS change by age 79. Presence of CVD before the study period was associated with greater absolute DHEAS change (beta=-0.04 microg/mL, P=.04) and with the fourth quartile of DHEAS change versus the first to third quartiles (odds ratio=1.46, 95% confidence interval=1.03-2.05).
  
  
  CONCLUSIONS
  DHEAS change continues into very old age, is not homogenous, is affected by sex, and is associated with prevalent CVD. Future studies should investigate factors that might accelerate DHEAS decline.
authors.affiliation: Department of Medicine, School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA. sanders.jason@medstudent.pitt.edu
authors.forename: Jason L
authors.initials: JL
authors.lastname: Sanders
authors.forename: Robert M
authors.initials: RM
authors.lastname: Boudreau
authors.forename: Anne R
authors.initials: AR
authors.lastname: Cappola
authors.forename: Alice M
authors.initials: AM
authors.lastname: Arnold
authors.forename: John
authors.initials: J
authors.lastname: Robbins
authors.forename: Mary
authors.initials: M
authors.lastname: Cushman
authors.forename: Anne B
authors.initials: AB
authors.lastname: Newman
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood* / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D015999:Multivariate Analysis; D012044:Regression Analysis; D017678:Sex Distribution; D014481:United States / Q000453:epidemiology
chemical_list: D015415:Biomarkers; D019314:Dehydroepiandrosterone Sulfate