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Plasma Cortisol and Progression of Dementia in Subjects With Alzheimer-Type Dementia
Open accessAbstract
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.
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Metadata
- Authors
- Csernansky, J. G., Dong, H., Fagan, A. M., Wang, L., Xiong, C., Holtzman, D. M., & Morris, J. C.
- Affiliations
- Washington University in St. Louis (US)
- Venue
- American Journal of Psychiatry
- Published
- 2006-12
- Volume
- 163
- Issue
- 12
- Pages
- 2164-2169
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- PMC
- PMC1780275
- OpenAlex
- W2079409065
- Cited by
- 426
- References
- 54
- Citations by year
- 2026: 8 · 2025: 11 · 2024: 15 · 2023: 20 · 2022: 19 · 2021: 28 · 2020: 28 · 2019: 27 · 2018: 30 · 2017: 19 · 2016: 27 · 2015: 30 · 2014: 22 · 2013: 16 · 2012: 21
- FWCI
- 9.79
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Aging (AG 025824, AG20794, AG03991, AG 05681, R01AG025824, P50AG005681, P01AG003991)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Alzheimer's disease research and treatments
- Keywords
- Alzheimer-type dementia, plasma cortisol, hypothalamic-pituitary-adrenal axis, disease progression, hippocampal neurodegeneration, cognitive decline, Clinical Dementia Rating, growth curve models
- MeSH terms
- Age Factors, Aged, Alzheimer Disease, Cognition Disorders, Female, Humans, Hydrocortisone, Longitudinal Studies, Male, Psychiatric Status Rating Scales, Severity of Illness Index, Disease Progression
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