{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T15:36:02Z","timestamp":1791387362313,"version":"4.3.3"},"reference-count":44,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,7,16]],"date-time":"2018-07-16T00:00:00Z","timestamp":1531699200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>To define the symptoms, signs and treatment outcomes in a population of older patients with Cushing's disease (CD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We analysed the clinical presentation and treatment outcomes in 45 CD patients older than 60\u00a0years, in comparison with 90 CD patients younger than 60, and a control group of 45 older patients with nonfunctioning pituitary adenomas. We reviewed preoperative clinical characteristics, medical comorbidities, imaging findings and endocrine testing as well as surgical and endocrine outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Older CD patients had significantly lower body mass index (BMI) (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.031), were more likely to have muscle wasting (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.006) and women were less likely to have hirsutism (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.033). Older patients with CD had more medical comorbidities than younger patients, which correlated with a higher ASA grade (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001), but the surgical complication rates were similar in both groups. Surgical remission was achieved in 38\/45 (84.4%) older patients and 78\/90 (86.7%) younger patients (<jats:italic>P<\/jats:italic>\u00a0=\u00a0NS). Recurrent disease was more frequent in younger patients (19.2%) in comparison with older patients (2.6%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.019).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Older patients with CD appear to have a distinct phenotype with a more catabolic picture, including a lower BMI and greater prevalence of muscle wasting. Surgical outcomes are similar without a significant age\u2010related increase in complications.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.13799","type":"journal-article","created":{"date-parts":[[2018,6,25]],"date-time":"2018-06-25T17:05:08Z","timestamp":1529946308000},"page":"444-453","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Cushing's disease in older patients: Presentation and outcome"],"prefix":"10.1111","volume":"89","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5478-3555","authenticated-orcid":false,"given":"Nidan","family":"Qiao","sequence":"first","affiliation":[{"name":"Department of Neurosurgery Huashan Hospital  Shanghai China"},{"name":"Harvard Medical School  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brooke","family":"Swearingen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Massachusetts General Hospital and Harvard 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