Cortisol secretion and Alzheimer's disease progression.
BACKGROUND
Mild hypercortisolemia is a frequent concomitant of Alzheimer's disease (AD). In an effort to ascertain the relationship between serum cortisol concentration (CORT) and disease progression, aging, and survival, we followed 9 persons with AD, ages from 56 to 84 years, from an original cohort of 19 enrollees with serial cognitive testing and CORT determinations.


METHODS
The cognitive instrument was a modification of the Alzheimer's Disease Assessment Scale-Cognitive (mADAS-COG). Serum cortisol determinations were performed at noon, and an Afternoon Cortisol Test (ACT) was used to obtain an estimate of average CORT.


RESULTS
Baseline 12:00 hours CORT but not ACT correlated significantly with the change in mADAS-COG (r = .90, p < .01). ACT levels increased as the mADAS-COG increased over time (p = .037), by 0.156 +/- 0.06 microgram/dL for each one-point increase (indicating greater impairment) in cognitive test score. ACT levels did not increase significantly simply with aging. For the entire cohort of 19 subjects, neither baseline ACT nor 12:00 hours CORT was significantly related to survival.


CONCLUSIONS
Hypercortisolemia in AD appears related to the clinical progression of the disease, but not to aging or length of survival.
Weiner
M F
MF
Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, USA.
Vobach
S
S
Olsson
K
K
Svetlik
D
D
Risser
R C
RC
D000368:Aged; D000375:Aging / Q000097:blood; D000544:Alzheimer Disease / Q000097:blood* / Q000523:psychology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D008297:Male; D008875:Middle Aged; D019954:Neurobehavioral Manifestations; D011569:Psychiatric Status Rating Scales; D013534:Survival
D006854:Hydrocortisone