Language
English
Publication Date
11-27-2024
Journal
European Journal of Endocrinology
DOI
10.1093/ejendo/lvae157
PMID
39671564
PMCID
PMC11662234
PubMedCentral® Posted Date
12-13-2024
PubMedCentral® Full Text Version
Post-print
Abstract
Objectives: The impact of mild autonomous cortisol secretion (MACS) on cognition is incompletely characterized. We aimed to assess cognition in patients with MACS, identify factors associated with lower cognition, and determine the impact of adrenalectomy on cognition.
Methods: We conducted a cross-sectional study (4/2019 to 10/2022) and a longitudinal cohort study (10/2021 to 9/2023) of adults with MACS and referent subjects. Cognition was assessed with National Institute of Health Toolbox Cognition Battery and reported as standardized T scores (adjusted for age, sex, race/ethnicity, and education) for fluid, crystallized, and total composite cognition. Participants were assessed with urine steroid profiling (liquid chromatography-tandem mass spectrometry), frailty index, Beck's Depression Inventory (BDI), and Short Form-36 (SF-36).
Results: A total of 84 patients (median age 57 years, 67% women) and 201 referent subjects (median age 63 years, 58% women) were included. Patients with MACS demonstrated lower mean (SD) total composite (50.9 [9.3] vs 55.4 [8.9], P < .001) and fluid composite T score (49.3 [10.6] vs 55.2 [10.2], P < .001), but not crystallized composite T score (52.3 [8.4] vs 54.0 [8.4], P = .130) when compared with referent subjects. Multivariable analysis adjusted for age, sex, BDI, SF-36, frailty index, total glucocorticoids, and androgens demonstrated that MACS status was associated with lower cognition. When cognition was reassessed in 37 patients post-adrenalectomy and 31 referent subjects, adjusted group differences of cognition change were similar except for a higher comparative increase in attention and executive functioning in patients with MACS.
Conclusion: Patients with MACS demonstrate lower cognition than referent subjects. Adrenalectomy for MACS had a minor positive impact on cognition.
Keywords
Humans, Female, Male, Middle Aged, Hydrocortisone, Adrenalectomy, Cross-Sectional Studies, Cognition, Longitudinal Studies, Aged, Adult, adrenal incidentaloma, cognitive function, steroid profiling, mood, adrenal mass
Published Open-Access
yes
Recommended Citation
Saini, Jasmine; Nathani, Rohit; Singh, Sumitabh; et al., "Cognition in Patients With Mild Autonomous Cortisol Secretion at Baseline and Post-Adrenalectomy" (2024). Faculty, Staff and Students Publications. 8390.
https://digitalcommons.library.tmc.edu/baylor_docs/8390