Salivary Cortisol Awakening Response in Mild Alzheimer Disease, Caregivers, and Noncaregivers

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Salivary Cortisol Awakening Response in Mild Alzheimer Disease, Caregivers, and Noncaregivers

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People with Alzheimer disease (AD) and their caregivers compared with controls might have alterations in hypothalmo-pitutary-adrenal axis function as documented by hypercortisolemia.1–5 The cortisol changes in AD may relate to the underlying pathophysiology of the disorder, whereas in caregivers it may reflect psychologic stress. Some variability in published cortisol results is partly related to differences in methods. For example, cortisol can be measured from different biologic samples: serum, saliva, or cerebrospinal fluid, or during different conditions such as spontaneous measurement or measurement after a low-dose dexamethasone suppression test. Cortisol assays from cerebrospinal fluid and saliva more accurately measure the biologically active free cortisol. Additionally, methods of analyzing cortisol circadian rhythm vary: most studies do not evaluate the transient rise in cortisol after awakening, which is called the cortisol awakening response (CAR)6 and might be related to stress. This study assessed CAR and diurnal cortisol in AD patients, their caregivers, and healthy senior noncaregivers.

Wahbeh H, Kishiyama SS, Zajdel D, Oken BS.
Alzheimer disease and associated disorders. 2008; 22(2):181-3.

Publication Date
Publication Date: 
2008
Length
Length: 
3 pages
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