Adrenopause: an imbalance between dehydroepiandrosterone (DHEA) and cortisol secretion

Several clinical signs might be related to the decline of DHEA secretion in aged people: sarcopenia, osteopenia, atherosclerosis progression, impairment of cognitive and affective performances, deterioration of immunocompetence are the most significant evidences. In addition, in aged people this clinical condition might be worsened by the concomitant relative glucocorticoid excess which develops in an age related manner. All together, these clinical signs construct the corpus of a syndrome named adrenopause. DHEA replacement therapy might find its indication besides the obvious condition of primary and secondary corticoadrenal insufficiency in those aged patients with typical signs of adrenopause accompanied by magnified decline of DHEA and relative excess of cortisol. Two further indications for aged patients might be represented by those with chronic inflammatory diseases, especially when long term treated with glucocorticoids and those who undergo surgical procedures.