Effects of DHEA and Exercise on Strength and Function in Older, Frail Women
Design
Double-blind, randomized, placebo-controlled trial
Participants
Ninety-nine women (mean age 76.6 +/- 6.0) with low sulfated DHEA (DHEAS) levels, 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 90 minutes twice weekly in an exercise regimen.
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 females (88%) completed 6 months. No significant change in BMD or bone turnover marker was noted. Those who received DHEA supplementation with exercise had gains in lower-extremity strength and improvement in Short Physical Performance Battery Score (composite score focusing on lower-extremity function). DHEA was associated with significant changes in all hormone levels, including DHEAS, estradiol, estrone, and testosterone, as well as decreases in sex-binding globulin levels.
Practice Implications
This study reaffirms that DHEA supplementation does not improve BMD nor bone turnover markers. The authors conclude that DHEA supplementation improves lower-extremity strength and function in older, frail women involved in gentle exercise when in fact it is not demonstrated that the supplementation of DHEA had any material impact on performance. Other studies have demonstrated no effect of DHEA on exercise groups.1 While exercise has been well documented to have beneficial improvements in numerous ways, including measurements of biophysical markers and strength, flexibility, and functionality, this study does not provide clear evidence that DHEA supplementation can account for any improvements alone in performance. In this study, it was found that DHEA supplementation combined with exercise in women selected for low DHEAS levels improved lower-extremity muscle strength, which translated to 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.2,3,4 DHEA supplementation alone for 2 years had no meaningful physiological impact on postmenopausal body composition,5,6 nor did it have any impact on muscle size or strength.7,8 In fact, a study has shown that improvement in strength and physical function only occurred after adding high-resistance training to groups taking supplemental DHEA.9
Further studies need to be completed to evaluate the actual contribution of DHEA supplementation to strength and physical performance over the known benefits of exercise alone.