The pituitary gland

This chapter reviews the pertinent changes in the pituitary gland that occur with ageing and the diseases that affect this gland that are relevant to the care of the older individual. The pituitary gland is the master endocrine gland as it detects and integrates multiple sources of information to regulate physiologic functions. The blood supply to the anterior pituitary is through a rich vascular network. Hypopituitarism and hyperprolactinaemia are usually present in varying degrees. Nonfunctioning microadenomas have a benign natural history and can be followed with annual visual acuity and visual field testing and neuroimaging in the asymptomatic patient. The predominant cause of acromegaly is growth hormone (GH)-producing tumours and the effects of GH are mediated by insulin growth factor-1. Gamma-knife radiosurgery is a recent option for the management of pituitary tumours. There is no consensus on the effects of ageing on prolactin secretion. In mice, a GH-releasing hormone antagonist improved memory and increased lifespan.