Salivary cortisol and DHEA: association with measures of cognition and well-being in normal older men, and effects of three months of DHEA supplementation

Dehydroepiandrosterone (DHEA) is a steroid that shows a marked age-related decline in humans. Previous research suggests potential for DHEA replacemen t in old age to enhance cognition and well-being. We conducted a clinical t rial to test these hypotheses in a nonclinical sample of 46 men aged 62-76. Participants received either 50 mg DHEA daily for 13 weeks, followed by pl acebo for 13 weeks, or the reverse, in a randomised double-blind crossover trial design. Levels of salivary cortisol and DHEA were measured at 0800 h and 2000 h prior to each assessment session. Cognition was assessed with te sts of speed, attention and episodic memory. Well-being was measured with q uestionnaires of mood and perceived health. Mood questionnaires were comple ted at the assessment session as well as concurrently with saliva sampling. A correlational analysis of baseline behavioural data with hormonal data, c ontrolling for age, revealed that higher morning DHEA was assocated with lo wer confusion (r=-0.33; P=0.04), while higher evening DHEA was associated w ith lower anxiety (r=-0.35; P=0.03) and lower current negative mood in the morning (r=-0.37; P=0.03). Conversely, higher morning cortisol and a mornin g cortisol/DHEA ratio were assocated with higher anxiety (r=0.35; P=0.03), (r=0.46; P=0.004), general mood disturbance (r=0.32; P=0.046), (r=0.32; P=0 .04) and higher current negative mood in the evening (r=0.37; P=0.03), (r=0 .38; P=0.03). A higher morning cortisol/DHEA ratio was also associated with higher confusion (r=20.39; P=0.01) and lower visuo-spatial memory performa nce (r=-0.39: P=0.01). Unexpectedly, higher evening cortisol was associated with faster choice reaction time (r=-0.33: P=0.04). These findings are con sistent with an impairing effect of high cortisol on episodic memory and mo od in older men, which may be attenuated by DHEA. When treatment effects we re analysed, no significant effects of DHEA were observed on any of the tri al outcomes, providing no support for benefits of DHEA supplementation for cognition or well-being in normal older men in the shorter-term. (C) 2001 E lsevier Science Ltd. All rights reserved.