Dementia debate

From Chris Burke Mark Cox’s letter about the decline in dementia rates  contains the unjustifiably broad statement that high levels of corticosteroids cause the damage in vascular dementia and Alzheimer’s (15 February, p 35). The statement has little meaning, since “corticosteroids” means steroids produced by the adrenal cortex, including adrenal androgens, mineralocorticoids, such as aldosterone, and glucocorticoids, such as cortisol. I was involved with  numerous people given high doses of glucocorticoids as an immunosuppressant or inflammation suppressant, but  I never saw one develop dementia or cognitive impairment. High levels of cortisol tend to cause things like insomnia. For example, for 40 years people  have searched for a causative  link between glucocorticoids and depression, with mixed results. Sidmouth, Devon, UK