Minerva Endocrinologica 2021 Jan 12

DOI: 10.23736/S0391-1977.20.03295-2

Copyright © 2020 EDIZIONI MINERVA MEDICA

lingua: Inglese

Endocrine dysfunction and cognitive impairment

Valeria CALSOLARO, Marina BOTTARI, Giulia COPPINI, Bianca LEMMI, Fabio MONZANI ✉

Geriatrics Unit, Department of Clinical & Experimental Medicine, University Hospital of Pisa, Pisa, Italy

Dementia is a highly prevalent chronic disease among the older population, affecting more than 50 million people worldwide and representing a huge healthcare, social and economic burden. Dementia, and in particular Alzheimer’s disease, prevalence is expected to raise within the next few years. Unfortunately, no disease-modifying therapies are available so far, despite a plethora of clinical trials targeting the hallmarks of Alzheimer’s disease. Given these premises, it appears crucial to address not only the neuropathological correlates of the disease, but also the modifiable risk factors. Among them, several evidences suggest a role of the endocrine system not only in the brain development, but also in the maintenance of its health, having neurotrophic, anti-oxidant and metabolic functions crucial for the cognitive abilities. This review focuses on the evidences evaluating the impact of the endocrine systems, in particular thyroid function, insulin resistance, parathyroid hormone, Vitamin D and sexual hormones on cognitive status. Results from epidemiological, preclinical and some clinical studies demonstrated the link between thyroid, parathyroid hormone and vitamin D and cognitive status, between diabetes, and insulin resistance in particular, and dementia, between sexual and adrenal hormones, particularly estrogen variation at menopause, and cognitive decline. The growing interest on the modifiable risks factors of cognitive decline increased the knowledge about the complex interplay of endocrine systems and cognition, highlighting the need and the usefulness of a multidisciplinary approach to the prevention of a complex and devastating disease.

KEY WORDS: Dementia; Alzheimer’s disease; Endocrine dysfunction