https://doi.org/10.4081/gc.2022.10975
Does a steroid dementia syndrome really exist? A brief narrative review of what the literature highlights about the relationship between glucocorticoids and cognition
Submitted: 27 October 2022
Accepted: 3 March 2023
Published: 15 March 2023
Accepted: 3 March 2023
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Glucocorticoids (GCs) may cause cognitive impairment through complex pathways involving specific receptors. In the human brain, hippocampal CA1 neurons exhibit the highest level of GCs receptors. Even the elderly expressed these receptors. The purpose of this brief review is to concentrate on the relationship between GCs and cognition in order to discuss the effects of the so-called steroid dementia in routine clinical practice.
Wolkowitz OM, Burke H, Epel ES, Reus VI. Glucocorticoids: mood, memory, and mechanisms. Ann N Y Acad Sci 2009;1179:19-40.
DOI: https://doi.org/10.1111/j.1749-6632.2009.04980.x
Oliveri RL, Sibilia G, Valentino P, et al. Pulsed methylprednisolone induces a reversible impairment of memory in patients with relapsing-remitting multiple sclerosis. Acta Neurol Scand 1998;97:366-9.
DOI: https://doi.org/10.1111/j.1600-0404.1998.tb05967.x
Brunner R, Schaefer D, Hess K, et al. Effect of corticosteroids on short-term and long-term memory. Neurology 2005;64:335-7.
DOI: https://doi.org/10.1212/01.WNL.0000149523.35039.4C
Varney NR, Alexander B, MacIndoe JH. Reversible steroid dementia in patients without steroid psychosis. Am J Psychiatry 1984;141:369-72.
DOI: https://doi.org/10.1176/ajp.141.3.369
Wolkowitz OM, Lupien SJ, Bigler E, et al. The steroid dementia syndrome: an unrecognized complication of glucocorticoid treatment. Ann N Y Acad Sci 2004;1032:191-4.
DOI: https://doi.org/10.1196/annals.1314.018
Wolkowitz OM, Lupien SJ, Bigler E. The steroid dementia syndrome: a possible model of human glucocorticoid neurotoxicity. Neurocase 2007;13:189-200.
DOI: https://doi.org/10.1080/13554790701475468
Ikeda N, Yamada S, Yamamoto M, et al. Two cases of steroid dementia showing partial recovery during 2-year follow-up. Psychiat Clin Neuros Rep 2022;1:49.
DOI: https://doi.org/10.1002/pcn5.49
De Kloet ER. From receptor balance to rational glucocorticoid therapy. Endocrinology 2014;155:2754-69.
DOI: https://doi.org/10.1210/en.2014-1048
Jing L, Duan TT, Tian M, et al. Despair-associated memory requires a slow-onset CA1 long-term potentiation with unique underlying mechanisms. Sci Rep 2015;5:15000.
DOI: https://doi.org/10.1038/srep15000
Wang Q, Van Heerikhuize J, Aronica E, et al. Glucocorticoid receptor protein expression in human hippocampus; stability with age. Neurobiol Aging 2013;34:1662-73.
DOI: https://doi.org/10.1016/j.neurobiolaging.2012.11.019
Hibberd C, Yau JL, Seckl JR. Glucocorticoids and the ageing hippocampus. J Anat 2000;197:553-62.
DOI: https://doi.org/10.1046/j.1469-7580.2000.19740553.x
Manzo C, Serra-Mestres J, Castagna A, Isetta M. Behavioral, psychiatric, and cognitive adverse events in older persons treated with glucocorticoids. Medicines (Basel) 2018;5:82.
DOI: https://doi.org/10.3390/medicines5030082
Morris JC. Early-stage and preclinical Alzheimer disease. Alzheimer Dis Assoc Disord 2005;19:163-5.
DOI: https://doi.org/10.1097/01.wad.0000184005.22611.cc
Huang CW, Lui CC, Chang WN, et al. Elevated basal cortisol level predicts lower hippocampal volume and cognitive decline in Alzheimer’s disease. J Clin Neurosci 2009;16:1283-6.
DOI: https://doi.org/10.1016/j.jocn.2008.12.026
Joëls M. Corticosteroid actions in the hippocampus. J Neuroendocrinol 2001;13:657-69.
DOI: https://doi.org/10.1046/j.1365-2826.2001.00688.x
Sapolsky RM. Glucocorticoids, hippocampal damage and the glutamatergic synapse. Progr Brain Res 1990;86:13-23.
DOI: https://doi.org/10.1016/S0079-6123(08)63163-5
Sacks O, Shulman M. Steroid dementia: an overlooked diagnosis?. Neurology 2005;64:707-9.
DOI: https://doi.org/10.1212/01.WNL.0000151977.18440.C3
Manzo C, Visco G, Lombardo G, Natale M. Dementia and corticosteroidal therapy: about a clinical case [Article in Italian]. Psicogeriatria 2007;1:22-4.
Agbabiaka TB, Savovic J, Ernst E. Methods for causality assessment of adverse drug reactions. Drug Saf 2008;31:21-37.
DOI: https://doi.org/10.2165/00002018-200831010-00003
Nicol C, Moulis F, Bondon-Guitton E, et al. Does spontaneous adverse drug reactions' reporting differ between different reporters? A study in Toulouse Pharmacovigilance Centre. Therapie 2019;74:521-5.
DOI: https://doi.org/10.1016/j.therap.2019.01.008
Naranjo CA, Busto U, Sellers EM, et al. A method for estimating the probability of adverse drug reaction. Clin Pharmacol Ther 1981;30:239-45.
DOI: https://doi.org/10.1038/clpt.1981.154
Manzo C, Castagna A, Ruotolo G. A jouney inside the elderly-onset primary Sjogren’s syndrome, looking for useful tips for the geriatrician. Geriatric Care 2022; 8:10668.
DOI: https://doi.org/10.4081/gc.2022.10668
Manzo C, Martinez-Suarez E, Kechida M, et al. Cognitive function in primary Sjögren’s syndrome: a systematic review. Brain Sci 2019;9:85.
DOI: https://doi.org/10.3390/brainsci9040085
Zandonella Callegher S, Giovannini I, Zenz S, et al. Sjögren syndrome: looking forward to the future. Ther Adv Musculoskelet Dis 2022;14:1759720X221100295.
DOI: https://doi.org/10.1177/1759720X221100295
Pieper NT, Grossi CM, Chan WY, et al. Anticholinergic drugs and incident dementia, mild cognitive impairment and cognitive decline: a meta-analysis. Age Ageing 2020;49:939-47.
DOI: https://doi.org/10.1093/ageing/afaa090
Mur J, Russ TC, Cox SR, et al. Association between anticholinergic burden and dementia in UK Biobank. Alzheimers Dement (NY) 2022;8:e12290.
DOI: https://doi.org/10.1002/trc2.12290
Poncet M, Gardette V, Couret A, et al. Benzodiazepine exposure in subjects with incident Alzheimer's disease and related syndromes in France: a longitudinal study 2011-2017. Int Clin Psychopharmacol 2020;35:270-8.
DOI: https://doi.org/10.1097/YIC.0000000000000312
Picton JD, Marino AB, Nealy KL. Benzodiazepine use and cognitive decline in the elderly. Am J Health Syst Pharm 2018;75:e6-e12.
DOI: https://doi.org/10.2146/ajhp160381
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington, VA: American Psychiatric Association 2013.
DOI: https://doi.org/10.1176/appi.books.9780890425596
Lippi M, Fanelli G, Fabbri C, et al. The dilemma of polypharmacy in psychosis: is it worth combining partial and full dopamine modulation? Int Clin Psychopharmacol 2022;37:263-75.
DOI: https://doi.org/10.1097/YIC.0000000000000417
Hirjak D, Meyer-Lindenberg A, Brandt GA, et al. Differential diagnostic distinction between substance-induced and primary psychoses: recommendations for general psychiatric and forensic practice. Nervenarzt 2022;93:11-23.
DOI: https://doi.org/10.1007/s00115-021-01083-3
Freyne A. Neuropsychiatric complications of corticosteroids in older people. Ir J Psychol Med 2005;22:22–5.
DOI: https://doi.org/10.1017/S0790966700008752
Cerullo MA. Expect psychiatric side-effects from corticosteroid use in the elderly. Geriatrics 2008;63:15-8.
Niebrzydowska A, Grabowski J. Medication-induced psychotic disorder. A review of selected drugs side effects. Psychiatr Danub 2022;34:11-8.
DOI: https://doi.org/10.24869/psyd.2022.11
The Boston Collaborative Drug Surveillance Program. Acute adverse reactions to prednisone in relation to dose. Clin Pharmacol Ther 1972;13:694-8.
DOI: https://doi.org/10.1002/cpt1972135part1694
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Manzo, C., Castagna, A., Ruberto , C., & Ruotolo, G. (2023). Does a steroid dementia syndrome really exist? A brief narrative review of what the literature highlights about the relationship between glucocorticoids and cognition. Geriatric Care, 8(3). https://doi.org/10.4081/gc.2022.10975
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