Cushing's Disease in Older Patients

Presentation and Outcome

Nidan Qiao; Brooke Swearingen; Nicholas A. Tritos


Clin Endocrinol. 2018;89(4):444-453. 

In This Article


Cushing's disease appears to have different manifestations in older as opposed to younger patients, including lower BMI, and increased muscle wasting, suggestive of a more catabolic phenotype. Several comorbidities associated with Cushing's disease (hypertension, diabetes mellitus, cardiovascular disease, and venous thromboembolism) may be more pronounced in the older age group, as the effects of normal ageing are compounded by pathologic hypercortisolemia. Surgical outcomes remain favourable in older patients with comparable remission rates and similarly low complication rates, despite the increased rate of comorbidities. In summary, our data suggest that the clinical phenotype in older patients with CD may be different from those of younger patients, which may compound the diagnostic difficulties, and merit increased attention from endocrinologists and neurosurgeons. More quantitative prospective studies would be helpful to confirm these findings and define the underlying mechanisms.