Cited by 426Dementia and Cognitive Impairment ResearchStress Responses and CortisolAlzheimer's disease research and treatments

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Plasma Cortisol and Progression of Dementia in Subjects With Alzheimer-Type Dementia

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Csernansky, John G., Dong, Hongxin, Fagan, Anne M., Wang, Lei, Xiong, Chengjie, Holtzman, David M., Morris, John C.·2006·American Journal of Psychiatry

DOI 10.1176/appi.ajp.163.12.2164PMC PMC1780275

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Abstract

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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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)
ORCID: Dong, Hongxin
Fagan, Anne M.
Wang, Lei
Xiong, Chengjie
Holtzman, David M.
Morris, John C.
Venue: American Journal of Psychiatry
Publisher: American Psychiatric Association Publishing
Published: 2006-12
Volume: 163
Issue: 12
Pages: 2164-2169
ISSN: 0002-953X (ISSN-L)
1535-7228
DOI: 10.1176/appi.ajp.163.12.2164
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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Plasma Cortisol and Progression of Dementia in Subjects With Alzheimer-Type Dementia

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