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Hyperactivity in the hypothalamic-pituitary-adrenal axis in demented patients with delirium.

Artikel i vetenskaplig tidskrift
Författare Barbro Robertsson
Kaj Blennow
G Bråne
Åke Edman
I Karlsson
Anders Wallin
Carl-Gerhard Gottfries
Publicerad i International clinical psychopharmacology
Volym 16
Nummer/häfte 1
Sidor 39-47
ISSN 0268-1315
Publiceringsår 2001
Publicerad vid Institutionen för omvårdnad
Institutionen för klinisk neurovetenskap
Institutionen för klinisk neurovetenskap, Sektionen för laborativ neurovetenskap
Sidor 39-47
Språk en
Länkar www.ncbi.nlm.nih.gov/entrez/query.f...
Ämnesord Aged, Alzheimer Disease, diagnosis, physiopathology, Arousal, physiology, Delirium, diagnosis, physiopathology, Dementia, diagnosis, physiopathology, Dexamethasone, diagnostic use, Female, Humans, Hydrocortisone, blood, Hypothalamo-Hypophyseal System, physiopathology, Male, Middle Aged, Pituitary-Adrenal System, physiopathology
Ämneskategorier Psykiatri, Äldre och åldrande

Sammanfattning

Occurrence of delirium is known to be related to, among other things, organic brain disorder, somatic disease and old age. It has been hypothesized that delirium is also associated with stress. Disturbances of the hypothalamic-pituitary-adrenal (HPA) system have been found in delirious patients in various studies. The aim of the present study was to determine the activity in the HPA axis in demented patients to ascertain whether the stress regulating system was more disturbed in patients with delirium than in those without delirium. Demented inpatients with no acute medical illness were included in the study. Basal cortisol levels in serum were measured and dexamethasone suppression test (DST) was performed. The most important finding of the study was a strong relationship between delirium and DST pathology irrespective of age and severity of dementia. It is suggested that certain demented individuals have an impaired HPA system and a low delirium threshold and respond to stress with delirium.

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