Plasma cortisol and progression of dementia in subjects with Alzheimer-type dementia.
Plasma cortisol and progression of dementia in subjects with Alzheimer-type dementia.
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DOI：
10.1176/ajp.2006.163.12.2164
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发表时间：
2006-12
期刊：
影响因子：
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通讯作者：
J. Csernansky;Hongxin Dong;A. Fagan;Lei E. Wang;C. Xiong;D. Holtzman;J. Morris
中科院分区：
文献类型：
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作者：
J. Csernansky;Hongxin Dong;A. Fagan;Lei E. Wang;C. Xiong;D. Holtzman;J. Morris
目的：对阿尔茨海默型痴呆患者的研究报告了下丘脑-垂体-肾上腺（HPA）轴活动增加与海马变性之间的相关性。在这项研究中，作者试图确定血浆皮质醇（HPA活性的标志物）的增加是否与阿尔茨海默型痴呆患者疾病进展率的临床和认知指标相关。方法对33例极轻度和轻度阿尔茨海默型痴呆患者和21例无痴呆患者进行为期4年的临床痴呆评定量表和一系列神经心理测试。在一天的上午8点获得血浆并检测皮质醇。临床和认知测量随时间的变化率由生长曲线模型得出。结果：在痴呆患者中，血浆皮质醇水平升高与痴呆症状迅速加重和颞叶功能相关的神经心理测试成绩迅速下降相关。血浆皮质醇水平与在最接近血浆采集时间的单次评估中获得的临床和认知评估之间未观察到关联。结论：血浆皮质醇水平升高所反映的HPA活性升高与阿尔茨海默型痴呆患者更快的疾病进展相关。
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.