title: Mild dementia is associated with increased adrenal secretion of cortisol and precursor sex steroids in women.
abstract: BACKGROUND
  Sex steroid levels decrease with increasing age, but little is known whether this is of importance for the age-related decline in cognitive function.
  
  
  METHODS
  A cross-sectional study of 50 (26 men) consecutive patients under primary evaluation of cognitive impairment (D group) and 18 (9 men) matched healthy controls (C group).
  
  
  METHODS
  Sex steroid and precursor levels were determined in serum and, when measurable, in cerebrospinal fluid (CSF) using gas chromatography/mass spectroscopy (GC-MS) or liquid chromatography/mass spectroscopy (LC-MS). Sex hormone binding globulin (SHBG) and cortisol concentrations were measured using conventional assays.
  
  
  RESULTS
  Patients in the D group had higher 24-h urine cortisol levels and increased serum levels of dehydroepiandrosterone (DHEA) and its sulphate ester dihydroepiandrosterone sulphate (DHEAS), androsterone (ADT), and oestrone (E1) and its sulphate ester E1S, compared with the controls. When men and women were analysed separately, increased serum concentrations of E1 and E1S were observed in both D men and D women, whereas increased levels of other sex steroids and cortisol were seen only in D women.
  
  
  CONCLUSIONS
  In both D men and women, serum E1 and E1S levels were increased, whereas other changes were gender specific and only seen in D women. Further studies are needed to determine whether these changes are a cause of, or merely a consequence of, cognitive impairment in elderly subjects.
authors.affiliation: Department of Neuropsychiatry, Skaraborg Hospital, Falköping, Sweden.johan.svensson@medic.gu.se
authors.forename: Per
authors.initials: P
authors.lastname: Johansson
authors.forename: Jan-Ove
authors.initials: JO
authors.lastname: Johansson
authors.forename: Fernand
authors.initials: F
authors.lastname: Labrie
authors.forename: Niklas
authors.initials: N
authors.lastname: Mattsson
authors.forename: Oskar
authors.initials: O
authors.lastname: Hansson
authors.forename: Kaj
authors.initials: K
authors.lastname: Blennow
authors.forename: Henrik
authors.initials: H
authors.lastname: Zetterberg
authors.forename: Anders
authors.initials: A
authors.lastname: Wallin
authors.forename: Claes
authors.initials: C
authors.lastname: Ohlsson
authors.forename: Johan
authors.initials: J
authors.lastname: Svensson
mesh_terms: D000311:Adrenal Glands / Q000378:metabolism*; D000368:Aged; D000369:Aged, 80 and over; D000738:Androsterone / Q000097:blood; D002853:Chromatography, Liquid; D003072:Cognition Disorders / Q000378:metabolism / Q000473:pathology; D003430:Cross-Sectional Studies; D003687:Dehydroepiandrosterone / Q000097:blood; D003704:Dementia / Q000378:metabolism* / Q000473:pathology; D004970:Estrone / Q000031:analogs & derivatives / Q000097:blood; D005260:Female; D008401:Gas Chromatography-Mass Spectrometry; D012739:Gonadal Steroid Hormones / Q000097:blood* / Q000134:cerebrospinal fluid; D006801:Humans; D006854:Hydrocortisone / Q000097:blood / Q000378:metabolism* / Q000652:urine; D008297:Male; D013058:Mass Spectrometry; D012737:Sex Factors; D012738:Sex Hormone-Binding Globulin / Q000032:analysis
chemical_list: D012739:Gonadal Steroid Hormones; D012738:Sex Hormone-Binding Globulin; D004970:Estrone; D003687:Dehydroepiandrosterone; D000738:Androsterone; C017296:estrone sulfate; D006854:Hydrocortisone