Bang Zheng1, Roy Tal1, Zhirong Yang2, Lefkos Middleton3, Chinedu Udeh-Momoh4. 1. Ageing Epidemiology Research Unit, School of Public Health, Faculty of Medicine, Imperial College London, London, W6 8RP, UK. 2. Primary Care Unit, Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge, CB1 8RN, UK. 3. Ageing Epidemiology Research Unit, School of Public Health, Faculty of Medicine, Imperial College London, London, W6 8RP, UK; Public Health Directorate, Imperial College NHS Healthcare Trust, London, W6 8RP, UK. 4. Ageing Epidemiology Research Unit, School of Public Health, Faculty of Medicine, Imperial College London, London, W6 8RP, UK; Translational Health Sciences, Faculty of Medicine, University of Bristol, Bristol, BS1 3NY, UK. Electronic address: c.udeh@imperial.ac.uk.
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. Crown
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. Crown
Authors: Sami Ouanes; Christopher Clark; Jonas Richiardi; Bénédicte Maréchal; Piotr Lewczuk; Johannes Kornhuber; Clemens Kirschbaum; Julius Popp Journal: Front Aging Neurosci Date: 2022-07-07 Impact factor: 5.702