Increased nocturnal urinary cortisol levels in the elderly patients with depression, coexisting major geriatric syndromes and combined pathogenetic mechanisms.
Aging
Cortisol
Dementia
Depression
Metabolic syndrome
Journal
Aging clinical and experimental research
ISSN: 1720-8319
Titre abrégé: Aging Clin Exp Res
Pays: Germany
ID NLM: 101132995
Informations de publication
Date de publication:
27 Sep 2024
27 Sep 2024
Historique:
received:
08
08
2024
accepted:
09
09
2024
medline:
27
9
2024
pubmed:
27
9
2024
entrez:
27
9
2024
Statut:
epublish
Résumé
The mechanisms at the basis of depression are still matter of debate, but several studies in the literature suggest common pathways with dementia (genetic predispositions, metabolic and inflammatory mechanisms, neuropathological changes) and other geriatric syndromes. To evaluate the role of cortisol (as marker of the HPA, hypothalamus-pituitary-adrenal axis hyperactivity) in elderly subjects with depressive symptoms (by the means of the AGICO, AGIng and COrtisol, study), in relationship to the presence of the major geriatric syndromes. The AGICO study enrolled patients from ten Geriatric Units in Italy. Every subject received a comprehensive geriatric assessment or CGA (including the Mini Mental State Examination or MMSE, Geriatric Depression Scale or GDS and Cornell Scale for Depression in Dementia or CSDD), the neurological examination (with a computed tomography scan or magnetic resonance imaging of the brain), the assessment of the metabolic syndrome (MetS), the evaluation of the cortisol activity by two consecutive urine collections (diurnal and nocturnal), a CGA-derived frailty index (FI) and a modified measure of allostatic load (AL). The MMSE scores were significantly and inversely related to the values of GDS (p < 0.001) and CSDD (p < 0.05), respectively. The patients with depressive symptoms (GDS/CSDD > 8) showed significantly increased disability, MetS, inflammation, FI and AL and significantly reduced MMSE and renal function. The diurnal and nocturnal urinary cortisol levels in the patients with depressive symptoms (GDS/CSDD > 8) were higher with respects to controls (p < 0.05 for nocturnal difference). The AGICO study showed that the stress response is activated in the patients with depression. The depression in elderly patient should be reconsidered as a systemic disease, with coexisting major geriatric syndromes (disability, dementia, frailty) and combined pathogenetic mechanisms (metabolic syndrome, impaired renal function, low-grade inflammation, and allostatic load). Cortisol confirmed its role as principal mediator of the aging process in both dementia and metabolic syndrome.
Sections du résumé
BACKGROUND
BACKGROUND
The mechanisms at the basis of depression are still matter of debate, but several studies in the literature suggest common pathways with dementia (genetic predispositions, metabolic and inflammatory mechanisms, neuropathological changes) and other geriatric syndromes.
AIMS
OBJECTIVE
To evaluate the role of cortisol (as marker of the HPA, hypothalamus-pituitary-adrenal axis hyperactivity) in elderly subjects with depressive symptoms (by the means of the AGICO, AGIng and COrtisol, study), in relationship to the presence of the major geriatric syndromes.
METHODS
METHODS
The AGICO study enrolled patients from ten Geriatric Units in Italy. Every subject received a comprehensive geriatric assessment or CGA (including the Mini Mental State Examination or MMSE, Geriatric Depression Scale or GDS and Cornell Scale for Depression in Dementia or CSDD), the neurological examination (with a computed tomography scan or magnetic resonance imaging of the brain), the assessment of the metabolic syndrome (MetS), the evaluation of the cortisol activity by two consecutive urine collections (diurnal and nocturnal), a CGA-derived frailty index (FI) and a modified measure of allostatic load (AL).
RESULTS
RESULTS
The MMSE scores were significantly and inversely related to the values of GDS (p < 0.001) and CSDD (p < 0.05), respectively. The patients with depressive symptoms (GDS/CSDD > 8) showed significantly increased disability, MetS, inflammation, FI and AL and significantly reduced MMSE and renal function. The diurnal and nocturnal urinary cortisol levels in the patients with depressive symptoms (GDS/CSDD > 8) were higher with respects to controls (p < 0.05 for nocturnal difference).
DISCUSSION
CONCLUSIONS
The AGICO study showed that the stress response is activated in the patients with depression.
CONCLUSION
CONCLUSIONS
The depression in elderly patient should be reconsidered as a systemic disease, with coexisting major geriatric syndromes (disability, dementia, frailty) and combined pathogenetic mechanisms (metabolic syndrome, impaired renal function, low-grade inflammation, and allostatic load). Cortisol confirmed its role as principal mediator of the aging process in both dementia and metabolic syndrome.
Identifiants
pubmed: 39331197
doi: 10.1007/s40520-024-02849-w
pii: 10.1007/s40520-024-02849-w
doi:
Substances chimiques
Hydrocortisone
WI4X0X7BPJ
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
196Investigateurs
Stefano Eleuteri
(S)
Giulia Maria Falaschi
(GM)
Maria Grazia Oddo
(MG)
Cinzia Giuli
(C)
Ilenia Macchiati
(I)
Monica Migale
(M)
Francesca Sorvillo
(F)
Roberto Brunelli
(R)
Monia Francavilla
(M)
Silvia Santini
(S)
Luciano Marini
(L)
Elpidio Santillo
(E)
Luca Fallavollita
(L)
Sara Rotunno
(S)
Michelangela Barbieri
(M)
Edith Angellotti
(E)
Valeria Ludovici
(V)
Paola Cheli
(P)
Rita Del Pinto
(RD)
Ligia J Dominguez
(LJ)
Giovanna Bella
(G)
Valentino Culotta
(V)
Informations de copyright
© 2024. The Author(s).
Références
Leonard BE, Wegener G (2020) Inflammation, insulin resistance and neuroprogression in depression. Acta Neuropsychiatrica 32:1–9
doi: 10.1017/neu.2019.17
pubmed: 31186075
McIntyre RS, Soczynska JK, Konarski JZ et al (2007) Should depressive syndromes be reclassified as “metabolic syndrome type II”? Ann Clin Psychiatry 19:257–264
doi: 10.1080/10401230701653377
pubmed: 18058283
Yasuno F, Kazui H, Morita N et al (2016) High amyloid-β deposition related to depressive symptoms in older individuals with normal cognition: a pilot study. Int J Geriatr Psychiatry 31:920–928
doi: 10.1002/gps.4409
pubmed: 26766490
Jack CR Jr, Knopman DS, Jagust WJ et al (2010) Hypothetical model of dynamic biomarkers of the Alzheimer’s pathological cascade. Lancet Neurol 9:119–128
doi: 10.1016/S1474-4422(09)70299-6
pubmed: 20083042
pmcid: 2819840
Ye Q, Bai F, Zhang Z (2016) Shared genetic risk factors for late-life depression and Alzheimer’s Disease. J Alzheimers Dis 52:1–15
doi: 10.3233/JAD-151129
pubmed: 27060956
Saczynski JS, Beiser A, Seshadri S et al (2010) Depressive symptoms and risk of dementia: the Framingham Heart Study. Neurology 75:35–41
doi: 10.1212/WNL.0b013e3181e62138
pubmed: 20603483
pmcid: 2906404
Jorm AF (2001) History of depression as a risk factor for dementia: an updated review. Aust N Z J Psychiatry 35:776–781
doi: 10.1046/j.1440-1614.2001.00967.x
pubmed: 11990888
Kaup AR, Byers AL, Falvey C et al (2016) Trajectories of depressive symptoms in older adults and risk of dementia. JAMA Psychiat 73:525–531
doi: 10.1001/jamapsychiatry.2016.0004
Du M, Liu M, Liu J (2024) The trajectory of depressive symptoms over time and the presence of depressive symptoms at a single time point with the risk of dementia among US older adults: a national prospective cohort study. Psychiatry Clin Neurosci 78:169–175
doi: 10.1111/pcn.13620
pubmed: 37984429
Byers AL, Covinsky KE, Barnes DE et al (2012) Dysthymia and depression increase risk of dementia and mortality among older veterans. Am J Geriatr Psychiatry 20:664–672
doi: 10.1097/JGP.0b013e31822001c1
pubmed: 21597358
pmcid: 3229643
Richard E, Reitz C, Honig LH et al (2013) Late-life depression, mild cognitive impairment, and dementia. JAMA Neurol 70:374–382
doi: 10.1001/jamaneurol.2013.603
pubmed: 23599941
pmcid: 3694613
Salwierz P, Thapa S, Taghdiri F et al (2024) Investigating the association between a history of depression and biomarkers of Alzheimer’s disease, cerebrovascular disease, and neurodegeneration in patients with dementia. Geroscience 46:783–793
doi: 10.1007/s11357-023-01030-x
pubmed: 38097855
Wragg RE, Jeste DV (1989) Overview of depression and psychosis in Alzheimer’s disease. Am J Psychiatry 146:577–587
doi: 10.1176/ajp.146.5.577
pubmed: 2653053
Beal E (2010) Dementia: depression and dementia. Nat Rev Neurol 6:470
doi: 10.1038/nrneurol.2010.123
pubmed: 20836196
McEwen BS (2003) Mood disorders and allostatic load. Biol Psychiatry 54:200–207
doi: 10.1016/S0006-3223(03)00177-X
pubmed: 12893096
Lara VP, Caramelli P, Teixeira AL et al (2013) High cortisol levels are associated with cognitive impairment no-dementia (CIND) and dementia. Clin Chim Acta 423:18–22
doi: 10.1016/j.cca.2013.04.013
pubmed: 23611893
Twait EL, Basten M, Gerritsen L et al (2023) Late-life depression, allostatic load, and risk of dementia: The AGES-Reykjavik study. Psychoneuroendocrinology 148:105975. https://doi.org/10.1016/j.psyneuen.2022.105975
doi: 10.1016/j.psyneuen.2022.105975
pubmed: 36423561
de Oliveira C, Sabbah W, Bernabé E (2023) Allostatic load and depressive symptoms in older adults: an analysis of 12-year panel data. Psychoneuroendocrinology 152:106100. https://doi.org/10.1016/j.psyneuen.2023.106100
doi: 10.1016/j.psyneuen.2023.106100
pubmed: 36989564
Armstrong R (2019) Risk factors for Alzheimer’s disease. Folia Neuropathol 57:87–105
doi: 10.5114/fn.2019.85929
Adedeji DO, Holleman J, Juster RP et al (2023) Longitudinal study of Alzheimer’s disease biomarkers, allostatic load, and cognition among memory clinic patients. Brain Behav Immun Health 28:100592. https://doi.org/10.1016/j.bbih.2023.100592
doi: 10.1016/j.bbih.2023.100592
pubmed: 36820052
pmcid: 9937889
Martocchia A, Stefanelli M, Falaschi GM et al (2016) Recent advances in the role of cortisol and metabolic syndrome in age related degenerative diseases. Aging Clin Exp Res 28:17–23
doi: 10.1007/s40520-015-0353-0
pubmed: 25813987
Martocchia A, Gallucci M, Noale M et al (2020) The cortisol burden in elderly subjects with metabolic syndrome and its association with low-grade inflammation. Aging Clin Exp Res 32:1309–1315
doi: 10.1007/s40520-019-01322-3
pubmed: 31471891
Martocchia A, Gallucci M, Noale M et al (2022) The increased cortisol levels with preserved rhythmicity in aging and its relationship with dementia and metabolic syndrome. Aging Clin Exp Res 34:2733–2740
doi: 10.1007/s40520-022-02262-1
pubmed: 36190660
Katz S, Ford AB, Moskowitz RW et al (1963) Studies of illness in the aged. The index of ADL: a standardized measure of biological and psychosocial function. JAMA 185:914–919
doi: 10.1001/jama.1963.03060120024016
pubmed: 14044222
Lawton MP, Brody EM (1969) Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 9:179–186
doi: 10.1093/geront/9.3_Part_1.179
pubmed: 5349366
Folstein MF, Folstein SE, McHugh PR (1975) “Mini-mental state”. a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189–198
doi: 10.1016/0022-3956(75)90026-6
pubmed: 1202204
Yesavage JA, Brink TL, Rose TL et al (1982) Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res 17:37–49
doi: 10.1016/0022-3956(82)90033-4
pubmed: 7183759
Alexopoulos GS, Abrams RC, Young RC et al (1988) Cornell scale for depression in dementia. Biol Psychiatr 23:271–284
doi: 10.1016/0006-3223(88)90038-8
Linn BS, Linn MW, Gurel L (1968) Cumulative illness rating scale. J Am Geriatr Soc 16:622–626
doi: 10.1111/j.1532-5415.1968.tb02103.x
pubmed: 5646906
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA, American Psychiatric Association, 2013.
Measso G, Cavarzeran F, Zappalà G et al (1993) The Mini-Mental Score Examination: normative study of an Italian random sample. Dev Neuropsychol 9:77–85
doi: 10.1080/87565649109540545
Barca ML, Eldholm RS, Persson K et al (2019) Cortisol levels among older people with and without depression and dementia. Int Psychogeriatr 31:597–601
doi: 10.1017/S1041610218001199
pubmed: 30556798
Jones D, Song X, Mitnitski A et al (2005) Evaluation of a frailty index based on a comprehensive geriatric assessment in a population based study of elderly Canadians. Aging Clin Exp Res 17:465–471
doi: 10.1007/BF03327413
pubmed: 16485864
Yang Y, Kozloski M (2011) Sex differences in age trajectories of physiological dysregulation: inflammation, metabolic syndrome, and allostatic load. J Gerontol A Biol Sci Med Sci 66:493–500
doi: 10.1093/gerona/glr003
pubmed: 21350248
Delgado C, Baweja M, Crews DC et al (2022) A Unifying Approach for GFR Estimation: Recommendations of the NKF-ASN Task Force on Reassessing the Inclusion of Race in Diagnosing Kidney Disease. Am J Kidney Dis 79:268–288
doi: 10.1053/j.ajkd.2021.08.003
pubmed: 34563581
Ouanes S, Rabl M, Clark C et al (2022) Persisting neuropsychiatric symptoms, Alzheimer’s disease, and cerebrospinal fluid cortisol and dehydroepiandrosterone sulfate. Alzheimers Res Ther 14:190. https://doi.org/10.1186/s13195-022-01139-9
doi: 10.1186/s13195-022-01139-9
pubmed: 36529757
pmcid: 9762003
Dube S, Norby BJ, Pattan V et al (2015) 11β-hydroxysteroid dehydrogenase types 1 and 2 activity in subcutaneous adipose tissue in humans: implications in obesity and diabetes. J Clin Endocrinol Metab 100:E70-76
doi: 10.1210/jc.2014-3017
pubmed: 25303491
Seeman TE, McEwen BS, Rowe JW et al (2001) Allostatic load as a marker of cumulative biological risk: MacArthur studies of successful aging. Proc Natl Acad Sci USA 98:4770–4775
doi: 10.1073/pnas.081072698
pubmed: 11287659
pmcid: 31909
Gruenewald TL, Seeman TE, Karlamangla AS et al (2009) Allostatic load and frailty in older adults. J Am Geriatr Soc 57:1525–1531
doi: 10.1111/j.1532-5415.2009.02389.x
pubmed: 19682116
pmcid: 3650612
Honkalampi K, Virtanen M, Hintsa T et al (2021) Comparison of the level of allostatic load between patients with major depression and the general population. J Psychosom Res 143:110389. https://doi.org/10.1016/j.jpsychores.2021.110389
doi: 10.1016/j.jpsychores.2021.110389
pubmed: 33609985
Han YZ, Zheng HJ, Du BX et al (2023) Role of gut microbiota, immune imbalance, and allostatic load in the occurrence and development of diabetic kidney disease. J Diabetes Res 6:8871677. https://doi.org/10.1155/2023/8871677
doi: 10.1155/2023/8871677
Inker LA, Astor BC, Fox CH et al (2014) KDOQI US commentary on the 2012 KDIGO clinical practice guideline for the evaluation and management of CKD. Am J Kidney Dis 63:713–735
doi: 10.1053/j.ajkd.2014.01.416
pubmed: 24647050
Tsai YC, Chiu YW, Hung CC et al (2012) Association of symptoms of depression with progression of CKD. Am J Kidney Dis 60:54–61
doi: 10.1053/j.ajkd.2012.02.325
pubmed: 22495469
Szymkowicz SM, Gerlach AR, Homiack D et al (2023) Biological factors influencing depression in later life: role of aging processes and treatment implications. Transl Psychiatry 13:160. https://doi.org/10.1038/s41398-023-02464-9
doi: 10.1038/s41398-023-02464-9
pubmed: 37160884
pmcid: 10169845
Meariman JK, Zulli H, Perez A et al (2023) Small vessel disease: connections between the kidney and the heart. Am Heart J Plus 21:100257. https://doi.org/10.1016/j.ahjo.2023.100257
doi: 10.1016/j.ahjo.2023.100257
Dziurkowska E, Wesolowski M (2021) Cortisol as a biomarker of mental disorder severity. J Clin Med 10:5204. https://doi.org/10.3390/jcm10215204
doi: 10.3390/jcm10215204
pubmed: 34768724
pmcid: 8584322
Finlay S, Rudd D, McDermott B et al (2022) Allostatic load and systemic comorbidities in psychiatric disorders. Psychoneuroendocrinology 140:105726. https://doi.org/10.1016/j.psyneuen.2022.105726
doi: 10.1016/j.psyneuen.2022.105726
pubmed: 35339811
Zhan Q, Kong F, Shao S et al (2024) Pathogenesis of depression in Alzheimer’s disease. Neurochem Res 49:548–556
doi: 10.1007/s11064-023-04061-0
pubmed: 38015411
Stewart JC, Patel JS, Polanka BM et al (2023) Effect of modernized collaborative care for depression on depressive symptoms and cardiovascular disease risk biomarkers: eIMPACT randomized controlled trial. Brain Behav Immun 112:18–28
doi: 10.1016/j.bbi.2023.05.007
pubmed: 37209779
pmcid: 10527905
Carney RM, Freedland KE (2017) Depression and coronary heart disease. Nat Rev Cardiol 14:145–155
doi: 10.1038/nrcardio.2016.181
pubmed: 27853162