TY - JOUR
T1 - Lower morning to evening cortisol ratio is associated with cognitive impairment in men but not women
T2 - An analysis of 733 older subjects of the cross-sectional KORA-Age study
AU - Johar, Hamimatunnisa
AU - Emeny, Rebecca T.
AU - Bidlingmaier, Martin
AU - Lacruz, Maria Elena
AU - Reincke, Martin
AU - Peters, Annette
AU - Heier, Margit
AU - Ladwig, Karl Heinz
N1 - Funding Information:
The KORA research platform (KORA, Cooperative Research in the Region of Augsburg) was initiated and financed by the Helmholtz Zentrum Muenchen—German Research Center for Environmental Health, which is funded by the German Federal Ministry of Education and Research and by the State of Bavaria. The KORA-Age project was financed by the German Federal Ministry of Education and Research [ BMBF FKZ 01ET0713 ] as part of the ‘Health in Old Age’ program. M.R. is recipient of a grant by the Else Kröner-Fresenius Stiftung for the German Cushing's Registry . H. J. is a recipient of a postgraduate study grant by the Majlis Amanah Rakyat (MARA) , a Malaysian government agency.
Publisher Copyright:
© 2014 Elsevier Ltd.
PY - 2015/1/1
Y1 - 2015/1/1
N2 - Background: A dysregulated hypothalamic-pituitary-adrenocortical axis (HPA) is thought to play a role in the pathophysiology of cognitive impairment. Surprisingly, little agreement exists on the association of cortisol and cognitive impairment. Thus, we sought to examine the association between cognitive function and salivary cortisol levels in a representative sample of older men and women. Methods: A cross-sectional analysis was conducted among 733 study participants (65-90 years old, mean age. =. 74.9) of the population-based KORA (Cooperative Health Research in the Region of Augsburg)-Age study. Associations were examined between cognitive function (determined by telephone interview for cognitive status-modified, TICS-m) and salivary cortisol measured upon waking (M1), 30. min after awakening (M2), and in the late evening (E). Results: In a dose response manner, lower morning (M1 and M2), and increased evening levels were observed in participants with probable dementia (4.5%, N=. 33) and slightly increased in those with mild cognitive impairment (MCI) (13.8%, N=. 101) compared to healthy individuals. Higher morning to evening ratios were associated with reduced odds of cognitive impairment, even after adjustments for important confounders (M1/E ratio: OR. =. 1.50, 95% CI. =. 1.08-2.07, M2/E ratio: 1.41, 1.01-1.95, per 1 standard deviation (SD) increase). However, the significant association of an increased risk for cognitive impairment was observed among men (M1/E: OR. =. 1.94, 95% CI. =. 1.24-3.02; M2/E. =. 1.74, 1.12-2.71) but not women (M1/E: OR. =. 1.11, 0.69-1.78; M2/E. =. 1.09, 0.67-1.77). Conclusion: Our findings suggest that dysregulated HPA axis reactivity, evidenced by blunted diurnal cortisol responses, are associated with impaired cognitive function in an aged population.
AB - Background: A dysregulated hypothalamic-pituitary-adrenocortical axis (HPA) is thought to play a role in the pathophysiology of cognitive impairment. Surprisingly, little agreement exists on the association of cortisol and cognitive impairment. Thus, we sought to examine the association between cognitive function and salivary cortisol levels in a representative sample of older men and women. Methods: A cross-sectional analysis was conducted among 733 study participants (65-90 years old, mean age. =. 74.9) of the population-based KORA (Cooperative Health Research in the Region of Augsburg)-Age study. Associations were examined between cognitive function (determined by telephone interview for cognitive status-modified, TICS-m) and salivary cortisol measured upon waking (M1), 30. min after awakening (M2), and in the late evening (E). Results: In a dose response manner, lower morning (M1 and M2), and increased evening levels were observed in participants with probable dementia (4.5%, N=. 33) and slightly increased in those with mild cognitive impairment (MCI) (13.8%, N=. 101) compared to healthy individuals. Higher morning to evening ratios were associated with reduced odds of cognitive impairment, even after adjustments for important confounders (M1/E ratio: OR. =. 1.50, 95% CI. =. 1.08-2.07, M2/E ratio: 1.41, 1.01-1.95, per 1 standard deviation (SD) increase). However, the significant association of an increased risk for cognitive impairment was observed among men (M1/E: OR. =. 1.94, 95% CI. =. 1.24-3.02; M2/E. =. 1.74, 1.12-2.71) but not women (M1/E: OR. =. 1.11, 0.69-1.78; M2/E. =. 1.09, 0.67-1.77). Conclusion: Our findings suggest that dysregulated HPA axis reactivity, evidenced by blunted diurnal cortisol responses, are associated with impaired cognitive function in an aged population.
KW - Aging
KW - Cognitive function
KW - Cortisol
UR - http://www.scopus.com/inward/record.url?scp=84920556177&partnerID=8YFLogxK
U2 - 10.1016/j.psyneuen.2014.10.011
DO - 10.1016/j.psyneuen.2014.10.011
M3 - Article
C2 - 25462902
AN - SCOPUS:84920556177
SN - 0306-4530
VL - 51
SP - 296
EP - 306
JO - Psychoneuroendocrinology
JF - Psychoneuroendocrinology
ER -
