Barrett-Connor E, Edelstein S L
Department of Family and Preventive Medicine, University of California, San Diego, La Jolla 92093-0607.
J Am Geriatr Soc. 1994 Apr;42(4):420-3. doi: 10.1111/j.1532-5415.1994.tb07491.x.
To determine whether low plasma dehydroepiandrosterone sulfate (DHEAS) levels predict poor cognitive function in the elderly.
A prospective, population-based study with periodic clinical evaluations and 100% follow-up for vital status.
Rancho Bernardo, California
270 men and 167 women (80% of surviving, local, age-eligible subjects) from the Rancho Bernardo cohort who had plasma obtained for DHEAS assays in 1972 to 1974 and screening for dementia in 1988 to 1991.
DHEAS levels were measured by radioimmunoassay. There were five interviewer-administered standard screening tests of cognitive function: Mini-Mental Status Examination, Buschke selective reminding test, Trails B, category fluency, and Heaton Visual Reproduction test.
DHEAS levels were higher in men than women and decreased with age in both sexes. There were no significant differences in age-adjusted DHEAS levels in the percent of men or women with categorically impaired performance on any test. When analyzed as a continuous variable, DHEAS levels were significantly correlated with only one test, the Bushke, and only in women. Low baseline DHEAS levels were not associated with any mention of dementia on death certificates or with non-participation of survivors. Low levels of DHEAS predicted mortality in men more than in women such that men were more likely to have died before cognitive function testing than women.
The single DHEAS-memory association, restricted to women, is most likely to be spurious, consequent to multiple comparisons. We cannot exclude a true effect of low DHEAS, restricted to women and reflecting their better survival than men.
确定血浆硫酸脱氢表雄酮（DHEAS）水平低是否可预测老年人认知功能差。
一项基于人群的前瞻性研究，进行定期临床评估并对生命状态进行100%随访。
加利福尼亚州兰乔贝纳多
来自兰乔贝纳多队列的270名男性和167名女性（占存活的、当地符合年龄条件受试者的80%），他们在1972年至1974年期间采集血浆进行DHEAS检测，并于1988年至1991年期间进行痴呆筛查。
采用放射免疫分析法测量DHEAS水平。有五项由访员实施的认知功能标准筛查测试：简易精神状态检查表、布施克选择性提醒测试、B线试验、类别流畅性测试和希顿视觉再现测试。
男性的DHEAS水平高于女性，且两性的DHEAS水平均随年龄增长而降低。在任何测试中表现明显受损的男性或女性百分比中，年龄调整后的DHEAS水平无显著差异。当作为连续变量进行分析时，DHEAS水平仅与一项测试（布施克测试）显著相关，且仅在女性中如此。低基线DHEAS水平与死亡证明上提及的任何痴呆症或幸存者未参与情况均无关联。低水平的DHEAS对男性死亡率的预测作用大于女性，以至于男性比女性更有可能在认知功能测试前死亡。
单一的DHEAS与记忆的关联仅限于女性，很可能是由于多次比较而产生的假关联。我们不能排除低DHEAS的真实作用，这种作用仅限于女性，并反映出她们比男性有更好的生存率。
