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000259918 1001_ $$0P:(DE-2719)2810508$$aWhite, Silke$$b0$$eFirst author$$udzne
000259918 245__ $$aThe effect of plasma cortisol on hippocampal atrophy and clinical progression in mild cognitive impairment.
000259918 260__ $$aHoboken, NJ$$bWiley$$c2023
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000259918 520__ $$aBoth 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).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.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 < 0.001). A similar effect was not found for cortisol (HR = 1.206; CI, 0.82-1.37; p = 0.670) and there was no statistical evidence for an interaction between hippocampal volume and cortisol on clinical progression (HR = 0.81; CI, 0.57-0.17; p = 0.260).Our findings suggest that higher cortisol predicts higher hippocampal atrophy, which in turn is a risk factor for progression to AD. Regulation of the hypothalamic-pituitary-adrenal axis through stress-reducing lifestyle interventions might be a protective factor against hippocampal degeneration at the prodromal stage of AD.
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000259918 650_7 $$2Other$$ahypothalamic‐pituitary‐adrenal axis
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000259918 650_7 $$2Other$$aADNI
000259918 650_7 $$2Other$$aMCI
000259918 650_7 $$2Other$$acortisol
000259918 650_7 $$2Other$$ahippocampus
000259918 650_7 $$2Other$$ahypothalamic‐pituitary‐adrenal axis
000259918 650_7 $$2Other$$aneurodegeneration
000259918 650_7 $$2Other$$arisk factor
000259918 650_7 $$2Other$$astress
000259918 7001_ $$aMauer, René$$b1
000259918 7001_ $$0P:(DE-2719)9000635$$aLange, Catharina$$b2$$udzne
000259918 7001_ $$0P:(DE-2719)9002456$$aKlimecki, Olga$$b3$$udzne
000259918 7001_ $$aHuijbers, Willem$$b4
000259918 7001_ $$0P:(DE-2719)2814122$$aWirth, Miranka$$b5$$eLast author$$udzne
000259918 7001_ $$aInitiative, Alzheimer's Disease Neuroimaging$$b6$$eCollaboration Author
000259918 773__ $$0PERI:(DE-600)2832898-X$$a10.1002/dad2.12463$$gVol. 15, no. 3, p. e12463$$n3$$pe12463$$tAlzheimer's & dementia / Diagnosis, assessment & disease monitoring$$v15$$x2352-8729$$y2023
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