Associations of Salivary Cortisol With Cognitive Function in the Baltimore Memory Study

Abstract

Context:The stress responses of the hypothalamicpituitary-adrenal axis can produce adverse effects on the brain. Previous studies have concluded that an elevated level of cortisol is a risk factor for cognitive dysfunction and decline in aging but have been limited by sex exclusion, restricted cognitive batteries, and small sample sizes.Objective: To examine associations among salivary cortisol metrics and cognitive domain scores in an urban adult population.Design, Setting, and Participants: A crosssectional analysis was conducted using data from a longitudinal study involving 1140 Baltimore, Maryland, residents aged 50 to 70 years. Four salivary cortisol samples were obtained from 967 participants across 1 study visit (before, during, and after cognitive testing as well as at the end of the visit) from which 7 cortisol metrics were created. We examined associations of cortisol metrics with cognitive performance using multiple linear regression. Main Outcome Measures:Performance on 20 standard cognitive tests was measured and combined to form summary measures in 7 domains (language, processing speed, eye-hand coordination, executive functioning, verbal memory and learning, visual memory, and visuoconstruction).Results: Higher levels of pretest and mean cortisol as well as the area under the curve of cortisol over the study visit were associated with worse performance (PϽ.05) in 6 domains (language, processing speed, eye-hand coordination, executive functioning, verbal memory and learning, and visual memory). For instance, an interquartile range increase in the area under the curve was equivalent to a decrease in the language score expected from an increase in 5.6 (95% confidence interval, 4.2-7.1) years of age.Conclusions: Elevated cortisol was associated with poorer cognitive function across a range of domains in this large population-based study. We believe the findings are consistent with the hypothesis that hypothalamic-pituitaryadrenal axis dysregulation may be a risk factor for poorer cognitive performance in older persons. Psychiatry. 2007;64(7):810-818 Arch Gen

Psychosocial Correlates of Cognitive Function in the Elderly: A Biobehavioral Approach

“…The findings of cortisol and cognitive function aresimilar to previous findings (Beluche et al, 2009;Franz et al, 2011;Lee et al, 2007). In a 4-year follow up study, higher cortisolin the morning and throughout the day predicted worse executive function at follow-up but not for global cognitive function (Beluche et al, 2009).Also, in cross-sectional studies,executive function was significantly and positively associated with elevated cortisol throughout the day, but not global cognitive function (Franz et al, 2011;Lee et al, 2007). Although participants in other studies were far younger (50's) than our participants, cortisol consistently shows greater sensitivity for executive function than general cognitive function.…”

“…Cortisol showed negative correlations with executive function and global cognitive function, but only the correlationof cortisolwith executive function reached a statistical significance. The findings of cortisol and cognitive function aresimilar to previous findings (Beluche et al, 2009;Franz et al, 2011;Lee et al, 2007). In a 4-year follow up study, higher cortisolin the morning and throughout the day predicted worse executive function at follow-up but not for global cognitive function (Beluche et al, 2009).Also, in cross-sectional studies,executive function was significantly and positively associated with elevated cortisol throughout the day, but not global cognitive function (Franz et al, 2011;Lee et al, 2007).…”

Cognitive Function Is Preserved in Older Adults With a Reported History of Childhood Sexual Abuse

“…The damaging effect of a prolonged elevation of cortisol levels on structures such as the hippocampus and prefrontal cortex is now well established. Higher cortisol levels in middle-and old-age have also been associated with cognitive decline in longitudinal studies (Lee et al, 2007;Lupien et al, 1998). Thus, a trauma-associated decrease in adrenal cortisol production could potentially be neuroprotective, with the functional implications not becoming evident until middle to old-age when the impact of accumulated damage and a lack of ability to compensate would normally exacerbate cognitive decline.…”

Phobic Anxiety and Cognitive Performance Over 4 Years Among Community-Dwelling Older Women in the Nurses' Health Study

“…Potential mechanisms through which phobic anxiety may influence late-life cognition include effects of inflammation(9, 10) and activation of the hypothalamic-pituitary-adrenal (HPA) axis/hypercortisolism(35, 36). Specifically, it has been hypothesized that prolonged stress in anxiety disorders might lead to chronically elevated levels of pro-inflammatory cytokines and stress hormones and, consequently, to injury or atrophy of key brain regions, such as the hippocampus, involved in memory and cognition.…”