Dehydroepiandrosterone sulfate and fall risk in older people: Sex differences in the Pro.V.A. longitudinal study

Background:The effect of dehydroepiandrosterone sulfate (DHEA-S) on fall risk in older age is still unclear, as isthe effect of sex on any relationship between the two. Our aim was to evaluate the association between DHEA-Sand the risk of falls and risk of recurrent falls in community-dwelling older men and women.Methods:We included 1949 (781 M, 1168 F) older adults enrolled in the Progetto Veneto Anziani study. Baselineserum DHEA-S levels were analyzed by immunoassay. The number of falls reported in the year preceding the 4.4-year follow-up assessment was collected. The association between DHEA-S and falls was analyzed by multi-nomial logistic regression, adjusting for potential confounders and considering death as alternative outcome.Results:After the follow-up, 548 (36.8%) individuals reported at least one fall in the previous year, and 214(14.4%) reported>=2 falls (recurrent falls). Each 1-standard deviation (SD) increase in log-transformed DHEA-Slevel reduced the odds of experiencing at least one fall by 9% (95%CI:0.88-0.95), and the risk of recurrent fallsby 16% (95%CI:0.79-0.89). The highest DHEA-S tertile was 27% (95%CI:0.65-0.83) less likely to experiencerecurrent falls than the lowest tertile. The analyses, stratified by sex, suggested a strong association betweenDHEA-S and the fall risk for women (OR = 0.91; 95%CI:0.87-0.95 for at least one fall; OR = 0.83, 95%CI:0.78-0.89 for recurrent falls per each 1-SD increase in log-transformed DHEA-S); non-significant results were observedamong men.Conclusions:Higher levels of DHEA-S are associated with a lower risk of falls and recurrent falls in older people,especially women