TY - JOUR
T1 - Plasma cortisol and progression of dementia in subjects with Alzheimer-type dementia
AU - Csernansky, John G.
AU - Dong, Hongxin
AU - Fagan, Anne M.
AU - Wang, Lei
AU - Xiong, Chengjie
AU - Holtzman, David M.
AU - Morris, John C.
PY - 2006/12
Y1 - 2006/12
N2 - Objective: Studies of subjects with dementia of the Alzheimer type have reported correlations between increases in activity of the hypothalamic- pituitary-adrenal (HPA) axis and hippocampal degeneration. In this study, the authors sought to determine whether increases in plasma cortisol, a marker of HPA activity, were associated with clinical and cognitive measures of the rate of disease progression in subjects with Alzheimer-type dementia. Method: Thirty-three subjects with very mild and mild Alzheimer-type dementia and 21 subjects without dementia were assessed annually for up to 4 years with the Clinical Dementia Rating scale and a battery of neuropsychological tests. Plasma was obtained at 8 a.m. on a single day and assayed for cortisol. Rates of change over time in the clinical and cognitive measures were derived from growth curve models. Results: In the subjects with dementia, but not in those without dementia, higher plasma cortisol levels were associated with more rapidly increasing symptoms of dementia and more rapidly decreasing performance on neuropsychological tests associated with temporal lobe function. No associations were observed between plasma cortisol levels and clinical and cognitive assessments obtained at the single assessment closest in time to the plasma collection. Conclusions: Higher HPA activity, as reflected by increased plasma cortisol levels, is associated with more rapid disease progression in subjects with Alzheimer-type dementia.
AB - Objective: Studies of subjects with dementia of the Alzheimer type have reported correlations between increases in activity of the hypothalamic- pituitary-adrenal (HPA) axis and hippocampal degeneration. In this study, the authors sought to determine whether increases in plasma cortisol, a marker of HPA activity, were associated with clinical and cognitive measures of the rate of disease progression in subjects with Alzheimer-type dementia. Method: Thirty-three subjects with very mild and mild Alzheimer-type dementia and 21 subjects without dementia were assessed annually for up to 4 years with the Clinical Dementia Rating scale and a battery of neuropsychological tests. Plasma was obtained at 8 a.m. on a single day and assayed for cortisol. Rates of change over time in the clinical and cognitive measures were derived from growth curve models. Results: In the subjects with dementia, but not in those without dementia, higher plasma cortisol levels were associated with more rapidly increasing symptoms of dementia and more rapidly decreasing performance on neuropsychological tests associated with temporal lobe function. No associations were observed between plasma cortisol levels and clinical and cognitive assessments obtained at the single assessment closest in time to the plasma collection. Conclusions: Higher HPA activity, as reflected by increased plasma cortisol levels, is associated with more rapid disease progression in subjects with Alzheimer-type dementia.
UR - http://www.scopus.com/inward/record.url?scp=33846316003&partnerID=8YFLogxK
U2 - 10.1176/ajp.2006.163.12.2164
DO - 10.1176/ajp.2006.163.12.2164
M3 - Article
C2 - 17151169
AN - SCOPUS:33846316003
SN - 0002-953X
VL - 163
SP - 2164
EP - 2169
JO - American Journal of Psychiatry
JF - American Journal of Psychiatry
IS - 12
ER -