Cortisol secretion and Alzheimer's disease progression: A preliminary report

      This paper is only available as a PDF. To read, Please Download here.


      We report preliminary findings in a study of the relationship of plasma cortisol concentration (CORT) to the clinical progression of Alzheimer's disease (AD), testing the hypotheses that CORT predicts AD progression and that CORT increases as the disease advances. In 12 subjects with NINCDS/ADRDA probable AD, we performed cognitive testing and plasma cortisol determinations at baseline and again in 12 months. A modified Alzheimer's Disease Assessment Scale-Cognitive (ADAS-COG) measured disease progression. Plasma cortisol concentration CORT was determined at 12 am and 1 pm, and an Afternoon Cortisol Test (ACT) was used to estimate average 24-hr CORT. Baseline 12 am CORT correlated with the change in ADAS-COG from start of study to 12 months. No cortisol measure increased over the study period; estimated average 24-hr CORT and 12 am CORT remained constant, whereas while 1 pm CORT declined. There was no relationship between age or duration of illness and any of the cortisol measures at baseline.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Biological Psychiatry
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Asnis G.M.
        • Sachar E.J.
        • Halbreich U.
        • Nathan R.S.
        • Novacenko H.
        • Ostrow L.C.
        Cortisol secretion in relation to age in major depression.
        Psychosom Med. 1981; 43: 235-242
        • Davis K.L.
        • Davis B.M.
        • Greenwald B.S.
        • et al.
        Cortisol and Alzheimer's disease, I. Basal studies.
        Am J Psychiatry. 1986; 143: 300-305
        • de Leon M.J.
        • McRae T.
        • Tsai J.R.
        • et al.
        Abnormal cortisol response in Alzheimer's disease linked to hippocampal atrophy.
        Lancet. 1988; ii: 391-392
        • Finch C.E.
        The regulation of physiological changes during mammalian aging.
        Quart Rev Biol. 1976; 51: 49-83
        • Fogel B.
        • Satel S.
        • Levy S.
        Occurrence of high concentrations of postdexamethasone cortisol in elderly psychiatric patients.
        Psychiatry Res. 1985; 15: 85-92
        • Hachinski V.C.
        • Lassen N.A.
        • Marshall J.
        Multi-infarct dementia: A cause of mental deterioration in the elderly.
        Lancet. 1974; 2: 207-210
        • Halbreich U.
        • Zumoff B.
        • Kream J.
        • Fukushima D.F.
        The mean 1–4 PM plasma cortisol concentration as a diagnostic test for hypercortisolism.
        J Clin Endocrinol Metab. 1982; 54: 1262-1264
        • Halbreich U.
        • Asnis G.M.
        • Zumoff B.
        • Nathan N.S.
        • Shindledecker R.
        Effect of age and sex on cortisol secretion in depressives and normals.
        Psychiatry Res. 1984; 13: 221-229
        • Hollander E.
        • Mohs R.C.
        • Davis K.L.
        Cholinergic approaches to the treatment of Alzheimer's disease.
        Br Med Bull. 1986; 42: 97-100
        • Landfield P.W.
        An endocrine hypothesis of brain aging and studies on brain-endocrine correlations and monosynaptic neurophysiology during aging.
        in: Parkinson's Disease, Vol. 2. Aging and Neuroendocrine Relationships. Plenum, New York1978: 179-199
        • Lawlor B.A.
        • Tsuboyama G.
        • Ryan T.
        • et al.
        Agitation and postdexamethasone cortisol levels in Alzheimer's disease.
        Am J Psychiatry. 1992; 149: 546-548
        • McEwen B.E.
        Re-examination of the glucocorticoid hypothesis of stress and aging.
        Prog Brain Res. 1992; 33: 365-383
        • McEwen B.E.
        • Weiss J.M.
        • Schwartz L.S.
        Selective retention of corticosterone by limbic structures in rat brain.
        Nature. 1968; 220: 911-912
        • McKhann G.
        • Drachman D.
        • Folstein M.
        • Katzman R.
        • Price D.
        • Stadlan E.M.
        Clinical diagnosis of Alzheimer's disease: Report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease.
        Neurology. 1984; 34: 939-944
        • Maeda K.
        • Tanimoto K.
        • Terada T.
        • Shintani T.
        • Kakigi T.
        Elevated urinary free cortisol in patients with dementia.
        Neurobiol Aging. 1990; 12: 161-163
        • Meaney M.
        • Aitken D.
        • Bhatnagar S.
        • Van Berkel C.
        • Sapolsky R.
        Postnatal handlingattenuates neuroendocrine, anatomical and cognitive impairments related to the aged hippocampus.
        Science. 1988; 238: 766-768
        • Mauri M.
        • Sinforiani E.
        • Bono G.
        • et al.
        Memory impairment in Cushing's disease.
        Acta Neurol Scand. 1993; 87: 52-55
        • Nappi G.
        • Martignoni E.
        • Costa A.
        • et al.
        Aging and dementia: markers of the hypothalamus-pituitary-adrenal axis and sympathetic activities in biological fluids.
        in: Nappi G. Martignoni E. Stress and the Aging Brain. Raven Press, New York1990: 93-106
        • Rosen W.G.
        • Mohs R.C.
        • Davis K.L.
        A new rating scale for Alzheimer's disease.
        Am J Psychiatry. 1984; 141: 1356-1364
        • Sapolsky R.M.
        • Altmann J.
        Increase of hypercortisolism and dexamethasone resistance increases with age among wild baboons.
        Biol Psychiatry. 1991; 30: 1008-1016
        • Sapolsky R.M.
        • McEwen B.S.
        Stress, glucocorticoids and their role in degenerative changes in the aging hippocampus.
        in: Crook T. Bartus R. Ferris S. Treatment Development Strategies for Alzheimer's Disease. Mark Powley Associates, New Canaan, CT1986: 151-172
        • Sapolsky R.M.
        • Uno H.
        • Rebert C.S.
        • et al.
        Hippocampal damage associated with prolonged glucocorticoid exposure in primates.
        J Neurosci. 1990; 10: 2897-2902
        • Starkman M.N.
        • Gebarski S.S.
        • Berent S.
        • Schteingart D.E.
        Hippocampal formation volume, memory dysfunction, and cortisol levels in patients with Cushing's syndrome.
        Biol Psychiatry. 1992; 32: 756-765
        • Weiner M.F.
        Age and cortisol suppression by dexamethasone.
        J Psychiatry Res. 1989; 23: 163-168
        • Weiner M.F.
        • Davis B.M.
        • Mohs R.C.
        • Davis K.L.
        Influence of age and relative weight on cortisol suppression in normal subjects.
        Am J Psychiatry. 1987; 144: 646-649