DHEA, Depression, and Physical Decline of Old Age

Copyright 1997 by James Michael Howard.

AP, Chicago, June 3. "Depressed older people are much more likely to decline physically, government researchers report, bolstering the notion that mental well-being profoundly influences bodily health. The study, led by scientists at the National Institute on Aging, suggests prevention and treatment of depression could help the elderly live longer, more active lives." This was reported in the Journal of the American Medical Association 1998; 279: 1720. The researchers do not mention the hormone, dehydroepiandrosterone (DHEA). DHEA naturally begins to decline around age twenty-five, reaching very low levels in old age. I suggest that loss of DHEA of old age causes the depression and physical decline. This is why these investigators found that depression eventually resulted in physical decline, while others have reported that physical decline precedes depression. It results from the same loss of DHEA. People react to the loss of DHEA of old age differently.

My work suggests that DHEA is necessary for growth and development of all tissues, and maintenance of adult tissues, thereafter. In 1985 (copyrighted), I suggested that low DHEA results in depression. This was tested and supported in a small study in 1997. "Dehydroepiandrosterone (DHEA) and its sulfate, DHEA-S, are plentiful adrenal steroid hormones that decrease with aging and may have significant neuropsychiatric effects. In this study, six middle-aged and elderly patients with major depression and low basal plasma DHEA and/or DHEA-S levels were openly administered DHEA (30-90 mg/d x 4 weeks) in doses sufficient to achieve circulating plasma levels observed in younger healthy individuals. Depression ratings, as well as aspects of memory performance significantly improved. One treatment-resistant patient received extended treatment with DHEA for 6 months: her depression ratings improved 48-72% and her semantic memory performance improved 63%. These measures returned to baseline after treatment ended. In both studies, improvements in depression ratings and memory performance were directly related to increases in plasma levels of DHEA and DHEA-S and to increase in their ratios with plasma cortisol levels. These preliminary data suggest DHEA may have antidepressant and promemory effects and should encourage double-blind trials in depressed patients." (Biological Psychiatry 1997; 41: 311).

In a study of "DHEA replacement therapy" in aging men and women, DHEA improved many physical characteristics, typically reduced during aging. "DHEA in appropriate replacement doses appears to have remedial effects with respect to its ability to induce an anabolic growth factor, increase muscle strength and lean body mass, activate immune function, and enhance quality of life in aging men and women, with no significant adverse effects." (Ann. N.Y. Acad. Sci. 1995; 774: 128)

I suggest loss of DHEA naturally during old age, or abnormally during younger ages, results in symptoms characteristic of "old age" or "diseases." The expression of the symptoms is characteristic of the individual. The JAMA article concerns itself with two findings, depression and physical decline of old age, that represent the loss of DHEA of old age.