Article

Increased saliva cortisol awakening response in patients with mild cognitive impairment

Institute of Neuroscience and Physiology, Sahlgrenska Academy, Göteborg University, Mölndal, Sweden.
Dementia and Geriatric Cognitive Disorders (Impact Factor: 2.81). 02/2007; 24(5):389-95. DOI: 10.1159/000109938
Source: PubMed

ABSTRACT It is unknown whether HPA-axis dysfunction is present in patients with mild cognitive impairment (MCI). The aim of the present study was to investigate whether cortisol levels are elevated among patients with MCI and/or whether the individuals have adequate feedback control of their HPA axis.
27 patients with MCI and 15 healthy controls were included in the study. Saliva samplings were performed 5 times a day before intake of 0.5 mg dexamethasone, and 5 times a day after intake of dexamethasone, respectively.
Significantly higher cortisol levels were found 15 min after awakening among patients with MCI in comparison with the controls, both before and after dexamethasone administration (p<0.05). Also, the ratio between cortisol at awakening time and 15 min after awakening was lower in the patient group after dexamethasone administration (p<0.05). There were no significant differences in basal cortisol levels before or after dexamethasone between groups.
The results indicate that there is an HPA-axis disturbance, with normal basal cortisol levels and increased awakening response among patients with MCI. The dissociation between basal values and the awakening response may be of pathophysiological importance for the cognitive impairment.

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    • "The CAR has been examined in relation to cognitive function in a number of studies in both healthy subjects and patients with a variety of psychiatric illnesses (e.g. Lind et al., 2007; Aas et al., 2011; van der Werf-Eldering et al., 2012). Studies examining the relationship between CAR and memory performance have been largely equivocal , although a study by Almela et al. (2012) did suggest a quadratic relationship between CAR and measures of declarative memory processes in 55-to 77-year-olds. "
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    ABSTRACT: Objective The association between hypothalamic–pituitary–adrenal (HPA)-axis function and cognition has long been investigated. An inverted U-shaped relationship has been described between various measures of HPA-axis function and neuropsychological performance in animals and man. Work with glucocorticoid receptor manipulation has corroborated these findings, with particular effects observed in relation to spatial working memory (SWM). As HPA-axis dysfunction is frequently found in patients with psychiatric illness, research in this area has potential implications for the treatment of the commonly observed cognitive impairment in such disorders. Here, we present the results of a pilot study examining the relationship between cortisol awakening response (CAR) and cognitive functions known to be susceptible to HPA-axis manipulation.Methods Nineteen healthy male volunteers were recruited, and their CAR and performance in a task of SWM were assessed.ResultsA highly significant quadratic relationship was observed between the CAR and SWM error rate (R2 = 0.63, p = 0.001).Conclusion We provide novel evidence supporting the existence of an inverted U-shaped relationship between corticosteroid levels and cognitive function in humans. Copyright © 2014 John Wiley & Sons, Ltd.
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    • "Although the current literature recommends five readings of cortisol levels taken throughout the day to assess the diurnal rhythm secretion of glucocorticoids [41], some authors have demonstrated that morning cortisol levels also represent a reliable measure of basal hypothalamic-pituitary-adrenal (HPA) axis activity [42] [43]. Moreover, results from diurnal rhythm of cortisol assessment in both MCI and AD subjects have revealed that when high cortisol levels were detected in these individuals, this tended to occur during the morning after awakening [19] [44]. "
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