Study: Effects of DHEA and exercise on strength and function in older, frail women

reference

Kenny AM, Boxer RS, Kleppinger A, Brindisi J, Feinn R, Burleson JA. Dehydroepiandrosterone, when combined with exercise, improves muscle strength and physical function in frail older women.J Am Geriatric Soc. 2010;58:1707-1714.

design

Double-blind, randomized, placebo-controlled study

Participant

Ninety-nine women (mean age 76.6 ± 6.0 years) with low sulfated DHEA (DHEAS), low bone mass, and frailty

intervention

Participants received 50 mg/day DHEA or placebo for 6 months; all received 630 mg/day calcium and 400 IU cholecalciferol. Women participated in an exercise program for 90 minutes twice weekly.

Primary outcome measures

Hormone levels, bone mineral density (BMD), bone turnover markers, body composition, upper and lower extremity strength, and physical performance were measured before and after the study.

Key findings

87 women (88%) completed 6 months. No significant change in BMD or bone turnover marker was noted. Those who received DHEA supplementation along with exercise experienced gains in lower extremity strength and improvement in Short Physical Performance Battery score (composite score that focuses on lower extremity function). DHEA was associated with significant changes in all hormone levels, including DHEAS, estradiol, estrone and testosterone, as well as a decrease in sex-binding globulin levels.

Effects on practice

This study reaffirms that DHEA supplementation does not improve BMD or bone turnover markers. The authors conclude that DHEA supplementation improved lower extremity strength and function in older, frail women engaging in gentle exercise, although in reality it cannot be proven that DHEA supplementation had a significant impact on performance. Other studies have shown no effect of DHEA on exercise groups.¹While it is well documented that exercise leads to positive improvements in many ways, including the measurement of biophysical markers as well as strength, flexibility and functionality. However, this study does not provide clear evidence that DHEA supplementation alone can lead to performance improvements. In this study, DHEA supplementation combined with exercise was found to improve lower extremity muscle strength in women selected for low DHEAS levels, which was translated into an improvement in lower extremity physical performance.

DHEA supplementation does not consistently improve BMD at all skeletal sites or body composition.

DHEA supplementation does not consistently improve BMD at all skeletal sites or body composition.^2,3,4DHEA supplementation alone for two years had no significant physiological impact on postmenopausal body composition.^5.6It also had no effect on muscle size or strength.^7.8In fact, one study showed that improvements in strength and physical function only occurred when groups supplementing with DHEA also completed high-resistance training.⁹

Further studies need to be completed to evaluate the true contribution of DHEA supplementation to strength and physical performance compared to the known benefits of exercise alone.