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@ARTICLE{White:259918,
      author       = {White, Silke and Mauer, René and Lange, Catharina and
                      Klimecki, Olga and Huijbers, Willem and Wirth, Miranka},
      collaboration = {Initiative, Alzheimer's Disease Neuroimaging},
      title        = {{T}he effect of plasma cortisol on hippocampal atrophy and
                      clinical progression in mild cognitive impairment.},
      journal      = {Alzheimer's $\&$ dementia / Diagnosis, assessment $\&$
                      disease monitoring},
      volume       = {15},
      number       = {3},
      issn         = {2352-8729},
      address      = {Hoboken, NJ},
      publisher    = {Wiley},
      reportid     = {DZNE-2023-00803},
      pages        = {e12463},
      year         = {2023},
      abstract     = {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).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.},
      keywords     = {hypothalamic‐pituitary‐adrenal axis (Other) /
                      hypothalamic‐pituitary‐adrenal axis (Other) / ADNI
                      (Other) / MCI (Other) / cortisol (Other) / hippocampus
                      (Other) / hypothalamic‐pituitary‐adrenal axis (Other) /
                      neurodegeneration (Other) / risk factor (Other) / stress
                      (Other)},
      cin          = {AG Wirth / AG White},
      ddc          = {610},
      cid          = {I:(DE-2719)1710011 / I:(DE-2719)1740002},
      pnm          = {353 - Clinical and Health Care Research (POF4-353)},
      pid          = {G:(DE-HGF)POF4-353},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:37583892},
      pmc          = {pmc:PMC10423926},
      doi          = {10.1002/dad2.12463},
      url          = {https://pub.dzne.de/record/259918},
}