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Background: Adrenocorticotropic hormone ACTH -producing pituitary adenoma is the most common cause of endogenous Cushing syndrome CS , but the relative proportion of adrenal causes of CS is rising. Limited data are available on the clinical manifestations and cause of CS in older women.

Objective: Determine the clinical presentation, biochemical profile, and cause of CS in women 65 years of age and older, compared with younger patients with CS.

Methods: Retrospective charts review of women with pituitary or adrenal CS, treated at Rabin Medical Center between and , or at Maccabi Healthcare Services in Israel between and Results: The cohort included women mean age, Pituitary source for CS was more common among young patients 48 patients, Weight gain was evident in Cushingoid features were more common among young vs.

Among patients with adrenal CS, diagnosis of hypercortisolism was established following an incidental finding of an adrenal mass in 3 of 20 Mean urinary free cortisol levels were highest for young women 5. Adrenal or pituitary tumor size was not different between groups. While in young patients with CS, urinary free cortisol levels were higher for those with adrenal vs. Conclusions: Older patients with CS have distinct disease cause and presentation, as pituitary source is less common than adrenal CS, the latter is associated with milder hypercortisoluria and is frequently diagnosed incidentally.