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

• 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.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Psykiatri (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Psychiatry (hsv//eng)

SAMHÄLLSVETENSKAP  -- Annan samhällsvetenskap -- Övrig annan samhällsvetenskap (hsv//swe)

SOCIAL SCIENCES  -- Other Social Sciences -- Other Social Sciences not elsewhere specified (hsv//eng)

Nyckelord

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

Publikations- och innehållstyp

ref (ämneskategori)

art (ämneskategori)