THE CONTRIBUTION OF HYPERCORTISOLAEMIA TO THE COGNITIVE DECLINE OF GERIATRIC DEPRESSION.
- Resource Type
- Article
- Authors
- Mitchell, Alexander J.
- Source
- International Journal of Geriatric Psychiatry. May1995, Vol. 10 Issue 5, p401-409. 9p.
- Subject
- *DEPRESSION in old age
*COGNITION disorders
*GERIATRIC psychiatry
*PATHOLOGICAL psychology
*HYPOTHALAMIC-pituitary-adrenal axis
*LONGITUDINAL method
*NEUROENDOCRINOLOGY
- Language
- ISSN
- 0885-6230
Cognitive impairment in depression is well recognized but poorly understood. A subset of depressed patients exhibit a syndrome of severe neuropshychological 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 hypothalamopituitary-adrenal (HPA) axis. The homeostatic regulation of the HPS 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. [ABSTRACT FROM AUTHOR]