The contribution of hypercortisolemia to the cognitive decline of geriatric depression
A.J. Mitchell
Bok Engelsk 1995
| Utgitt | AJ Mitchell Fulbourne Hosp Psychiat Serv Elder , 1995
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| Opplysninger | Cognitive impairment in depression is well recognized but poorly understood. A subset of depressed patients exhibit a syndrome of severe neuropsychological deficits which may be partially reversible upon episode resolution. This has been called depressive pseudodementia, the dementia syndrome of depression and depression induced cognitive impairment. The epidemiology, clinical features, natural history and prognosis of this condition support the notion of an underlying organic aetiology. The most plausible neurobiological candidate involved in the pathogenesis is hyperactivity of the hypothalamo-pituitary-adrenal (HPA) axis. The homeostatic regulation of the HPA axis becomes increasingly vulnerable to disruption in geriatric depression and perhaps particularly in depressive dementia. Hypercortisolaemia has been correlated with cognitive impairment in depression as well as in other related psychiatric conditions. The mechanism of this abnormality may involve hippocampal dysfunction. Further longitudinal studies are needed to clarify the role of the HPA axis in the cognitive decline of depressive illness.
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