Zheng, Bang; Tal, Roy; Yang, Zhirong; Middleton, Lefkos; Udeh-Momoh, Chinedu; (2020) Cortisol hypersecretion and the risk of Alzheimer's disease: A systematic review and meta-analysis. Ageing research reviews, 64. 101171-. ISSN 1568-1637 DOI: https://doi.org/10.1016/j.arr.2020.101171
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Abstract
BACKGROUND: Morning cortisol levels have been reported to be elevated among patients with Alzheimer's disease (AD); yet no meta-analysis has been conducted to confirm the existence and magnitude of this association. It also remains unclear whether hypercortisolism is a risk factor for AD. METHODS: PubMed, EMBASE, and PsycINFO were systematically searched for eligible studies. Cross-sectional data were pooled using random-effects meta-analyses; the differences in morning cortisol levels between patients and cognitively normal controls were quantified. Longitudinal studies were qualitatively synthesised due to methodological heterogeneity. RESULTS: 17,245 participants from 57 cross-sectional studies and 19 prospective cohort studies were included. Compared with cognitively normal controls, AD patients had moderately increased morning cortisol in blood (g = 0.422, P < 0.001; I2 = 48.5 %), saliva (g = 0.540, P < 0.001; I2 = 13.6 %), and cerebrospinal fluids (g = 0.565, P = 0.003; I2 = 75.3 %). A moderate elevation of morning cortisol was also detected in cerebrospinal fluids from patients with mild cognitive impairment (MCI) versus controls (g = 0.309, P = 0.001; I2 = 0.0 %). Cohort studies suggested that higher morning cortisol may accelerate cognitive decline in MCI or mild AD patients, but the results in cognitively healthy adults were inconsistent. CONCLUSIONS: Morning cortisol was confirmed to be moderately elevated in AD patients and may have diagnostic and prognostic values for AD.
Item Type | Article |
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Faculty and Department | Faculty of Epidemiology and Population Health > Dept of Non-Communicable Disease Epidemiology |
PubMed ID | 32971258 |
Elements ID | 169806 |
Official URL | http://dx.doi.org/10.1016/j.arr.2020.101171 |
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