The association between dehydroepiandosterone and frailty in older men and women

Voznesensky, Maria; Walsh, Stephen J.; Dauser, Deborah; Brindisi, J.; Kenny, Anne M.

doi:10.1093/ageing/afp015

Cited by 73 publications

(54 citation statements)

References 32 publications

(38 reference statements)

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“…Hormonal interventions have typically been explored as a treatment for muscle wasting based on the cross-sectional associations between circulating hormone concentrations and skeletal muscle mass and characteristics of frailty in older men and women [179,180]. However, when hormonal interventions have been implemented, they seldom demonstrate efficacy for improving muscle functioning.…”

Section: Hormonal Interventionsmentioning

confidence: 99%

“…Moreover, studies administering hormonal treatments for treatment of sarcopenia in older adults have seldom reported muscle qualitative outcomes. Thus, although serum levels of the adrenal steroid hormone dehydroepiandrosterone (DHEA) [181] are associated with frailty characteristics in older adults [179], administration of exogenous DHEA supplementation does not appear to benefit measures of physical function or performance [182]. Similarly, while circulating estradiol is associated with skeletal muscle mass in older women [180], estrogen replacement therapy does not appear to protect against the muscle loss of aging [183].…”

Section: Hormonal Interventionsmentioning

confidence: 99%

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Muscle Quality in Aging: a Multi-Dimensional Approach to Muscle Functioning with Applications for Treatment

2015

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Aging is often accompanied by declines in physical functioning which impedes older adults' quality of life, sense of independence, and ability to perform daily tasks. Age-related decreases in skeletal muscle quantity, termed sarcopenia, have traditionally been blamed for these physical decrements. However, recent evidence suggests that the quality of muscle tissue may be more functionally relevant than its quantity. 'Muscle quality' has been emerging as a means to elucidate and describe the intricate intramuscular changes associated with muscle performance in the context of aging and sarcopenia. While muscle quality has most commonly been defined in terms of muscle composition or relative strength, at the core, muscle quality really describes muscle's ability to function. Skeletal muscle displays a strong structure-function relationship by which several architectural characteristics factor into its functional capacity. This review describes the structural, physiological, and functional determinants of muscle quality at the tissue and cellular level, while also introducing other novel parameters such as sarcomere spacing and integrity, circulating biomarkers, and the muscle quality index. Muscle qualitative features are described from the perspective of how physical exercise may improve muscle quality in older adults. This broad, multidimensional perspective of muscle quality in the context of aging and sarcopenia offers comprehensive insights for consideration and integration in developing improved prognostic tools for research and clinical care, while also promoting translational approaches to the design of novel targeted intervention strategies designed to maintain function and mobility into late life.

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Section: Hormonal Interventionsmentioning

confidence: 99%

Section: Hormonal Interventionsmentioning

confidence: 99%

Muscle Quality in Aging: a Multi-Dimensional Approach to Muscle Functioning with Applications for Treatment

2015

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“…Perhaps this is due to the fact that DHEA levels need to be monitored over many years. Obesity appears to attenuate the association or correlation between higher DHEA and lower morbidity [216].…”

Section: First Do No Harm: Potentially Harmful or Ineffective Nutracementioning

confidence: 95%

Nutraceuticals for Fertility and Erectile Health: A Brief Overview of What Works and What Is Worthless

Moyad

2014

Men's Sexual Health and Fertility

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“…Age-related declines in insulin-like growth factor-1 (IGF-1), DHEAS, and gonadal steroids have been implicated in the pathogenesis of frailty and are thought to contribute to changes in anabolic metabolism and leukocyte function [45, 52, 53]. One recent prospective study of community-dwelling seniors demonstrated that higher baseline cortisol to DHEAS ratios (cortisol:DHEAS) and leukocyte counts were predictive of frailty at 10-year follow up (AUC=0.70) [43**].…”

Section: Pathophysiologymentioning

confidence: 99%

The implication of frailty on preoperative risk assessment

Amrock

Deiner²

2014

Current Opinion in Anaesthesiology

102

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Purpose of Review Frailty, a state of decreased homeostatic reserve, is characterized by dysregulation across multiple physiologic and molecular pathways. It is particularly relevant to the perioperative period, during which patients are subject to high levels of stress and inflammation. This review aims to familiarize the anesthesiologist with the most current concepts regarding frailty and its emerging role in preoperative assessment and risk stratification. Recent findings Current literature has established frailty as a significant predictor of operative complications, institutionalization, and death among elderly surgical patients. A variety of scoring systems have been proposed to preoperatively identify and assess frail patients, though they differ in their clinical utility and prognostic ability. Additionally, evidence suggests an evolving potential for preoperative intervention and modification of the frailty syndrome. Summary The elderly are medically complex and heterogeneous with respect to operative risk. Recent advances in the concept of frailty provide an evidence-based framework to guide the anesthesiologist in the perioperative management, evaluation, and risk stratification of older surgical patients.

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The association between dehydroepiandosterone and frailty in older men and women

Cited by 73 publications

References 32 publications

Muscle Quality in Aging: a Multi-Dimensional Approach to Muscle Functioning with Applications for Treatment

Muscle Quality in Aging: a Multi-Dimensional Approach to Muscle Functioning with Applications for Treatment

Nutraceuticals for Fertility and Erectile Health: A Brief Overview of What Works and What Is Worthless

The implication of frailty on preoperative risk assessment

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