@article {1200, title = {Concurrent change in dehydroepiandrosterone sulfate and functional performance in the oldest old: results from the Cardiovascular Health Study All Stars study.}, journal = {J Gerontol A Biol Sci Med Sci}, volume = {65}, year = {2010}, month = {2010 Sep}, pages = {976-81}, abstract = {

INTRODUCTION: The correlation between dehydroepiandrosterone sulfate (DHEAS) decline and age led to the hypothesis that DHEAS might be a marker of primary aging, though conflicting data from observational studies of mortality do not support this. We evaluated concurrent DHEAS and functional decline in a very old cohort to test if DHEAS change tracks with functional change during aging.

METHODS: DHEAS and functional performance (gait speed, grip strength, Modified Mini-Mental State Examination [3MSE] score, and digit symbol substitution test [DSST] score) were measured in 1996-1997 and 2005-2006 in 989 participants in the Cardiovascular Health Study All Stars study (mean age 85.2 years in 2005-2006, 63.5\% women and 16.5\% African American). We used multivariable linear regression to test the association of DHEAS decline with functional decline.

RESULTS: After adjustment, each standard deviation decrease in DHEAS was associated with greater declines in gait speed (0.12 m/s, p = .01), grip strength (0.09 kg, p = .03), 3MSE score (0.13 points, p < .001), and DSST score (0.14 points, p = .001) in women only. Additional adjustment for baseline DHEAS attenuated the association with grip strength but did not alter other estimates appreciably, and baseline DHEAS was unassociated with functional decline.

CONCLUSIONS: In this cohort of very old individuals, DHEAS decline tracked with declines in gait speed, 3MSE score, and DSST score, but not grip strength, in women independent of baseline DHEAS level. DHEAS decline might be a marker for age-associated performance decline, but its relevance is specific to women.

}, keywords = {Aged, 80 and over, Biomarkers, Cognition, Cohort Studies, Dehydroepiandrosterone Sulfate, Female, Gait, Geriatric Assessment, Hand Strength, Health Surveys, Humans, Longitudinal Studies, Male, Neuropsychological Tests, Sex Factors, United States}, issn = {1758-535X}, doi = {10.1093/gerona/glq072}, author = {Sanders, J L and Cappola, A R and Arnold, A M and Boudreau, R M and Chaves, P H and Robbins, J and Cushman, M and Newman, A B} } @article {7585, title = {Association between subclinical thyroid dysfunction and change in bone mineral density in prospective cohorts.}, journal = {J Intern Med}, volume = {283}, year = {2018}, month = {2018 Jan}, pages = {56-72}, abstract = {

BACKGROUND: Subclinical hyperthyroidism (SHyper) has been associated with increased risk of hip and other fractures, but the linking mechanisms remain unclear.

OBJECTIVE: To investigate the association between subclinical thyroid dysfunction and bone loss.

METHODS: Individual participant data analysis was performed after a systematic literature search in MEDLINE/EMBASE (1946-2016). Two reviewers independently screened and selected prospective cohorts providing baseline thyroid status and serial bone mineral density (BMD) measurements. We classified thyroid status as euthyroidism (thyroid-stimulating hormone [TSH] 0.45-4.49 mIU/L), SHyper (TSH < 0.45 mIU/L) and subclinical hypothyroidism (SHypo, TSH >= 4.50-19.99 mIU/L) both with normal free thyroxine levels. Our primary outcome was annualized percentage BMD change (\%ΔBMD) from serial dual X-ray absorptiometry scans of the femoral neck, total hip and lumbar spine, obtained from multivariable regression in a random-effects two-step approach.

RESULTS: Amongst 5458 individuals (median age 72 years, 49.1\% women) from six prospective cohorts, 451 (8.3\%) had SHypo and 284 (5.2\%) had SHyper. During 36 569 person-years of follow-up, those with SHyper had a greater annual bone loss at the femoral neck versus euthyroidism: \%ΔBMD = -0.18 (95\% CI: -0.34, -0.02; I2 = 0\%), with a nonstatistically significant pattern at the total hip: \%ΔBMD = -0.14 (95\% CI: -0.38, 0.10; I2 = 53\%), but not at the lumbar spine: \%ΔBMD = 0.03 (95\% CI: -0.30, 0.36; I2 = 25\%); especially participants with TSH < 0.10 mIU/L showed an increased bone loss in the femoral neck (\%Δ BMD = -0.59; [95\% CI: -0.99, -0.19]) and total hip region (\%ΔBMD = -0.46 [95\% CI: -1.05, -0.13]). In contrast, SHypo was not associated with bone loss at any site.

CONCLUSION: Amongst adults, SHyper was associated with increased femoral neck bone loss, potentially contributing to the increased fracture risk.

}, keywords = {Aged, Asymptomatic Diseases, Bone Density, Female, Fractures, Bone, Humans, Hyperthyroidism, Hypothyroidism, Male, Risk Factors}, issn = {1365-2796}, doi = {10.1111/joim.12688}, author = {Segna, D and Bauer, D C and Feller, M and Schneider, C and Fink, H A and Aubert, C E and Collet, T-H and da Costa, B R and Fischer, K and Peeters, R P and Cappola, A R and Blum, M R and van Dorland, H A and Robbins, J and Naylor, K and Eastell, R and Uitterlinden, A G and Rivadeneira Ramirez, F and Gogakos, A and Gussekloo, J and Williams, G R and Schwartz, A and Cauley, J A and Aujesky, D A and Bischoff-Ferrari, H A and Rodondi, N} }