Letter re: Long-term cortisol measures predict Alzheimer disease risk

We read with interest the article by Ennis et al.,1 which found cortisol dysregulation to be related to an increased risk for Alzheimer disease (AD), and built on the unresolved question of whether systemic homeostasis primarily contributes to AD expression or represents an epiphenomenon of the underlying brain pathology. Additional considerations might provide useful insights toward a better and more comprehensive understanding of this issue. Within their pleiotropic effects, corticosteroids can greatly influence metabolic functions as well as blood pressure levels and fluctuations, all of which play key roles in dementia onset and course.2 In the CNS, corticosteroid receptors are not uniformly localized and abnormal glucocorticoid signaling can result in cell type and site-specific differences.3 Accordingly, it would be of great interest to address the interrelationships among cortisol dysregulation, insulin resistance, and blood pressure variability,4 and to investigate the associations between cortisol exposure and the risk of non-AD dementias.5
Source: Neurology - Category: Neurology Authors: Tags: WRITECLICK & amp;reg; EDITOR ' S CHOICE Source Type: research