학술논문

The effect of plasma cortisol on hippocampal atrophy and clinical progression in mild cognitive impairment
Document Type
article
Source
Alzheimer’s & Dementia: Diagnosis, Assessment & Disease Monitoring, Vol 15, Iss 3, Pp n/a-n/a (2023)
Subject
ADNI
cortisol
hippocampus
hypothalamic‐pituitary‐adrenal axis
MCI
neurodegeneration
Neurology. Diseases of the nervous system
RC346-429
Geriatrics
RC952-954.6
Language
English
ISSN
2352-8729
19966024
Abstract
Abstract Introduction Both elevated cortisol and hippocampal volume have been linked to an increased risk for the development of Alzheimer's disease (AD). This longitudinal study assessed the effects of plasma cortisol on hippocampal atrophy and clinical progression rates in patients with mild cognitive impairment (MCI). Methods Patients with amnestic MCI (n = 304) were selected from the Alzheimer's Disease Neuroimaging Initiative (ADNI) based on availability of baseline plasma cortisol and hippocampal volume measures, assessed at baseline and during follow‐ups. We investigated associations between plasma cortisol, hippocampal volume, and risk of clinical progression to AD over a study period of up to 100 months (mean follow‐up time 36.8 months) using linear mixed models, Cox proportional hazards models, and Kaplan‐Meier estimators. Results Plasma cortisol predicted greater hippocampal atrophy, such that participants with higher cortisol showed faster decline in hippocampal volume over time (interaction: β = ‐0.15, p = 0.004). Small hippocampal volume predicted a higher risk of clinical progression to AD (haard ratio [HR] = 2.15; confidence in terval [CI], 1.64–2.80; p