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A Novel Method: Super-selective Adrenal Venous Sampling
Published on: September 15, 2017
Cognitive assessment in patients with primary aldosteronism vs patients with mild autonomous cortisol secretion
Kai Yu1,2, Jasmine Saini2,3, Elizabeth J Atkinson4
1Division of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China.
Context:
Data on cognition in patients with primary aldosteronism (PA) are scarce. Mild autonomous cortisol secretion (MACS), defined based on post-dexamethasone cortisol >1.8 mcg/dL, is diagnosed in up to 30% of patients with PA.
Objectives:
(1) Assess cognition in patients with PA vs referent subjects with hypertension and (2) determine differences in cognition between patients with PA and those with MACS.
Methods:
A prospective, cross-sectional study, 2019-2023. Cognition was assessed by National Institute of Health Toolbox Cognition Battery and reported as T-scores corrected for age, sex, race, and education. Only subjects with hypertension were included.
Results:
Cognitive assessment was performed in 52 patients with PA (including 11 patients with both PA and MACS, median age of 51.0 years, 30 (57.7%) women), 47 patients with MACS (median age of 57.0 years, 31 (66.0%) women), and 52 referent subjects (median age of 66.1 years, 30 (57.7%) women). When compared to referents, and after adjusting for age, smoking, systolic blood pressure, and alcohol use, patients with PA had lower total cognition (β = -5.7, P = .023), notably fluid cognition (β = -6.8, P = .017), including attention and executive function (β = -5.6, P = .012) and cognitive flexibility and executive function (β = -8.2, P = .006). When compared to patients with MACS, patients with PA had a higher processing speed (β = 9.0, P = .003). No differences in cognition were found between patients with PA with and without MACS.
Conclusion:
Patients with PA demonstrated lower cognition compared with referents and processing speed compared with MACS. Future studies should characterize the impact of MACS on the cognition of patients with PA.
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