Changes in adrenocortical function with aging and therapeutic implications

Throughout life, the adrenal cortex exhibits dramatic morphogenic and stero idogenic changes. While there is subtle senescent decline in aldosterone, a nd a similarly subtle increase in cortisol, the adrenal androgens dehydroep iandrosterone (DHEA) and dehydroepiandrosterone sulfate (DHEAS) decline wit h age in a situation similar to menopause, and this decline is considered b y some to aggravate some age-related diseases. This decline is associated w ith an almost complete loss of the inner zone of the adrenal cortex, known as the zona reticularis. This review addresses these adrenal cortical chang es, and explores their clinical significance. In particular, the clinical d ata on DHEA replacement in aging is addressed.