We performed thyrotropin-releasing hormone (TRH) stimulation testing in 18 nondepressed patients with primary degenerative dementia (10 M, 8F; average age +/- SD = 68 +/- 7) and 12 elderly controls (7M, 5F; average age +/- SD = 61 +/- 6). Six patients were retested approximately 2 years later. Initial Mini-Mental State Examination scores for patients ranged from 2 to 28 (average +/- SD = 18 +/- 6) and the scores for the control subjects were all equal to 30. Protirelin (500 micrograms) was injected iv and blood was sampled at 0, 15, 30, 45, 60, and 90 min for thyrotropin-stimulating hormone (TSH) and prolactin (PRL). There were no significant differences between patients and controls in baseline T4, T3 uptake, TSH, or PRL. No significant differences were found between patients and controls for either TRH-stimulated TSH or PRL at all time points. Duration of illness, severity of dementia, and severity of depressive symptoms did not correlate significantly with stimulation test results. There were, however, significantly greater responses in stimulated TSH and PRL for women compared with men in both patients and controls. Upon repeat testing (n = 6), TRH-stimulated TSH and PRL were not significantly different from the initial results.
To examine the utility of the dexamethasone suppression test (DST) in the differential diagnosis of depression in elderly demented patients, we reviewed the literature and focused on four components of this question: (1) cortisol nonsuppression rates in dementia; (2) cortisol nonsuppression and dementia severity; (3) cortisol nonsuppression in demented versus depressed patients; and (4) cortisol nonsuppression following antidepressant treatment. A combined analysis of 27 articles showed cortisol nonsuppression in 60% of patients with concurrent dementia and depression, in 47% of patients with depression only, in 41% of patients with dementia only, in 46% of patients with multi-infarct dementia, in 36% of patients with primary degenerative dementia, and in 10% of controls. The abnormal DST rate in demented patients was not significantly different from the abnormal DST rate in depressed patients. Eight of 12 studies (67%) did not find a significant relationship between DST results and dementia severity dementia patients without depression. Twelve of 13 studies (92%) did not find a relationship between age and DST outcome. The data we reviewed do not support the use of the DST in discriminating between depression and dementia or between dementia subtypes.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.