Effects of dehydroepiandrosterone supplementation on cognitive function and activities of daily living in older women with mild to moderate cognitive impairment
Effects of dehydroepiandrosterone supplementation on cognitive function and activities of daily living in older women with mild to moderate cognitive impairment
复制标题
DOI：
10.1111/j.1447-0594.2010.00625.x
复制
发表时间：
2010-10-01
影响因子：
3.3
通讯作者：
Ouchi, Yasuyoshi
中科院分区：
文献类型：
--
作者：
Yamada, Shizuru;Akishita, Masahiro;Ouchi, Yasuyoshi
目的：几乎没有证据表明脱氢表雄酮（DHEA）对老年妇女的生理和心理功能有有益的影响。我们研究了DHEA补充剂对老年认知障碍妇女认知功能和ADL的影响。方法：共有27名女性，年龄65-90岁（平均+/-标准差，83 +/- 6），轻度至中度认知障碍（Mini-Mental State Examination， MMSE； 10-28/30分），在日本一家机构接受长期护理。12名妇女被分配接受DHEA 25毫克/天，p.o. 6个月。对照组（n = 15）年龄和认知功能匹配，不进行激素替代。在基线、3、6个月时采用MMSE和Hasegawa痴呆量表（HDS-R）评估认知功能，采用Barthel指数（Barthel Index）评估日常生活基本活动（ADL）。血浆激素水平包括睾酮、脱氢表雄酮、硫酸脱氢表雄酮和雌二醇也进行了随访。结果：6个月后，与基线相比，DHEA治疗显著提高血浆睾酮、DHEA和DHEA-硫酸盐水平2-3倍，但雌二醇水平没有提高。DHEA组认知评分提高，基本ADL评分维持不变，对照组认知评分和基本ADL评分下降（DHEA组6个月变化与对照组比较；MMSE +0.6 +/- 3.2 vs -2.1 +/- 2.2, P < 0.05; HDS-R +2.8 +/- 2.8 vs -0.3 +/- 4.1, P < 0.05； Barthel指数+3.7 +/- 7.1 vs -2.7 +/- 4.6, P = 0.05）。在认知领域，DHEA治疗提高了语言流畅性（P < 0.05）。结论：补充脱氢表雄酮对老年认知障碍妇女的认知功能和ADL可能有有益的影响。Geriatr Gerontol; 2010；10: 280 - 287。
Aim:There is little evidence that dehydroepiandrosterone (DHEA) has beneficial effects on physical and psychological functions in older women. We investigated the effect of DHEA supplementation on cognitive function and ADL in older women with cognitive impairment.Methods:A total of 27 women aged 65-90 years (mean +/- standard deviation, 83 +/- 6) with mild to moderate cognitive impairment (Mini-Mental State Examination, MMSE; 10-28/30 points), receiving long-term care at a facility in Japan were enrolled. Twelve women were assigned to receive DHEA 25 mg/day p.o. for 6 months. The control group (n = 15) matched for age and cognitive function was followed without hormone replacement. Cognitive function was assessed by MMSE and Hasegawa Dementia Scale-Revised (HDS-R), and basic activities of daily living (ADL) by Barthel Index at baseline, 3 and 6 months. Plasma hormone levels including testosterone, DHEA, DHEA-sulfate and estradiol were also followed up.Results:After 6 months, DHEA treatment significantly increased plasma testosterone, DHEA and DHEA-sulfate levels by 2-3-fold but not estradiol level compared to baseline. DHEA administration increased cognitive scores and maintained basic ADL score, while cognition and basic ADL deteriorated in the control group (6-month change in DHEA group vs control group; MMSE, +0.6 +/- 3.2 vs -2.1 +/- 2.2, P < 0.05; HDS-R, +2.8 +/- 2.8 vs -0.3 +/- 4.1, P < 0.05; Barthel Index, +3.7 +/- 7.1 vs -2.7 +/- 4.6, P = 0.05). Among the cognitive domains, DHEA treatment improved verbal fluency (P < 0.05).Conclusion:DHEA supplementation in older women with cognitive impairment may have beneficial effects on cognitive function and ADL. Geriatr Gerontol Int 2010; 10: 280-287.