RELATIONSHIP BETWEEN MENTAL IMPAIRMENT AND HPA AXIS ACTIVITY IN DEMENTIA DISORDERS

In 40 patients with Alzheimer's disease (AD, <65 years), 56 patients w ith senile dementia of the Alzheimer type (SDAT, greater than or equal to 65 years) and 45 patients with vascular dementia (VAD), basal cort isol levels were estimated and the dexamethasone test (DST) was perfor med. The degree of dementia was assessed according to DSM-III-R and th e GBS scale was used for quantitative measures of functional impairmen t. There were no significant differences in basal cortisol levels. Esp ecially in the VAD group, scores on functional impairment correlated s ignificantly with post-DST cortisol levels. The results indicate hypot halamic overactivity in demented patients which can be correlated to t he degree of dementia. In VAD, and to a certain extent also in SDAT, t here appears to be a disconnection between cortical areas, including t he hippocampus and the hypothalamus.