Cushing's Syndrome in the Elderly: Data From the European Registry on Cushing's Syndrome

    February 2023 in “ European journal of endocrinology ”
    Vincent Amodru, Amandine Ferrière, A. Tabarin, Frédéric Castinetti, Stylianos Tsagarakis, Miklós Tóth, Richard A Feelders, Susan M. Webb, Martín Reincke, Romana T. Netea‐Maier, Darko Kaštelan, Атанаска Еленкова, Dominique Maiter, Oskar Ragnarsson, Alicia Santos, Elena Valassi
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    TLDR Older patients with Cushing's syndrome often have different symptoms and treatment outcomes compared to younger patients.
    The study analyzed 1,791 patients with Cushing's syndrome (CS) from the European Registry on Cushing's Syndrome (ERCUSYN), finding that older patients (≥65 years old, 9.8% of the cohort) presented with CS differently than younger patients (<65 years old, 90.2% of the cohort). Older patients were more often male, had lower BMI and waist circumference, and had fewer cases of skin alterations, depression, hair loss, hirsutism, and reduced libido. However, they had a higher prevalence of muscle weakness, diabetes, hypertension, cardiovascular disease, venous thromboembolism, and bone fractures. Diagnostic use of urinary free cortisol was less supportive in older patients. Older patients with pituitary-dependent CS (PIT-CS) had more extrasellar macroadenomas and were more frequently treated with cortisol-lowering medications and radiotherapy, while younger patients were more likely to undergo surgery. Additionally, the remission rate post-transsphenoidal surgery was lower in the elderly.
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