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Unclear evidence for DHEA effects on physical function in elderly

Clinical Question:
Does dehydroepiandrosterone improve strength and function in the elderly?

Bottom Line:
The available literature on the effects of dehydroepiandrosterone (DHEA) on strength and function in the elderly is limited and the findings are conflicting. (LOE = 2a-)

Reference:
Baker WL, Karan S, Kenny AM. Effect of dehydroepiandrosterone on muscle strength and physical function in older adults: a systematic review. J Am Geriatr Soc 2011;59(6):997-1002.  [PMID:21649617]

Study Design:
Systematic review

Funding:
Unknown/not stated

Setting:
Various (meta-analysis)

Synopsis:
These authors searched MEDLINE, Cochrane Central, and abstracts presented at scientific meetings, and manually searched the references of clinical trials and review articles. Two researchers independently evaluated articles for potential inclusion with disagreements resolved by discussion. Additionally, two authors independently extracted data and assessed the quality of the studies. Overall, they included 8 studies with only 661 patients: 2 randomized crossover trials and 6 randomized trials. Two of the included studies were of good quality; the remaining studies were fair. The authors report great variability among the studies in many key areas: age distribution, sex distribution, dosing, duration, co-intervention, and baseline DHEA levels. Because of this variability, the authors appropriately chose not to pool the data. Seven of the studies evaluated muscle strength. Although some studies found improvements in grip strength, chest strength, or leg strength, a similar number of studies found no improvements. Five studies evaluated physical function. Two studies found no improvement in peak oxygen uptake. Two studies used composite scores of functional capacity (eg, get-up-and-go test, walking speed, and so forth) -- one reported benefit, the other did not.

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