Hyperkinesia, plasma corticotropin releasing hormone and ACTH in senile dementia

Senile dementia of the Alzheimer type (SDAT), in contrast to multi-infarct dementia (MID) was associated with delirium and marked increases in the number of walking steps taken during both the day and night. In SDAT patients, plasma ACTH levels in the afternoon and evening were higher but plasma corticotropin releasing hormone (CRH) levels in the evening were lower than in the MID patients. A positive correlation between ACTH levels and walking steps and a negative correlation between plasma levels of CRH and ACTH were found. These results suggest relevance of hyper-kinetic delirium to disruption of diurnal rhythm of the pituitary-adrenal axis, and a possible mechanism of the short feedback suppression of CRH release by increased circulating ACTH.