Relationship between cortisol and age-related memory impairments in Holocaust survivors with PTSD

Division of Traumatic Stress Studies, Department of Psychiatry OOMH, Mount Sinai School of Medicine, Bronx, NY 10468, USA.
Psychoneuroendocrinology (Impact Factor: 5.59). 09/2005; 30(7):678-87. DOI: 10.1016/j.psyneuen.2005.02.007
Source: PubMed

ABSTRACT Holocaust survivors with PTSD appear to show an accelerated aging effect as evidenced by their performance on tests of explicit memory, and also show more exaggerated patterns on age-related alterations in cortisol release over the diurnal cycle than Holocaust survivors without PTSD and nonexposed subjects. To investigate the implications of age-related HPA axis alterations on cognition, we examined correlations between parameters reflecting circadian cortisol release and implicit and explicit memory performance.
Nineteen Holocaust survivors with PTSD (7 men, 12 women), 16 Holocaust survivors without PTSD (7 men, 9 women), and 28 non-exposed healthy comparison subjects (13 men, 15 women) collected salivary samples at six times over the diurnal cycle, and were tested with Paired Associates and Word Stem Completion Tests.
Negative correlations were observed between several measures of salivary cortisol concentrations and explicit memory in Holocaust survivors with PTSD after adjusting for IQ, years of education and current age reflecting poorer performance in association with higher cortisol levels. This relationship was absent in Holocaust survivors without PTSD and in demographically-comparable subjects who were not exposed to the Holocaust or other extremely traumatic events.
The significantly different relationship between cortisol and memory performance in these groups suggests that the neuropsychological impairments observed in Holocaust survivors with PTSD may reflect an interaction of PTSD and aging effects.

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    • "Variations in this diurnal profile have been shown to be related to a number of clinical conditions [25]. In particular, a flatter profile has been observed in people with depression [26], breast cancer [27], PTSD [28], and under severe parenting stress [29]. Despite the demonstrated sensitivity of the cortisol diurnal rhythm to psychosocial factors and clinical conditions, it has not attracted due attention in geriatric research until recently . "
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    • "Studies that included trauma-exposed participants with current MDD were excluded unless only a small minority (<10%) of TE participants met criteria for current MDD (Yehuda et al., 2005); for studies in which current MDD was not assessed, TE groups were included if they represented a sufficiently large sample size (n >70) for expected rates of MDD to exert minimal influence on cortisol outcomes (Boscarino, 1996; Pervanidou et al., 2007). One study included TE participants with current dysthymia (De Bellis et al., 1994); removing this study did not significantly alter results. "
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    • "None of the studies used time-monitoring devices. Twentyfive studies checked for potential confounders (Yehuda et al., 2005a), adjusted for potential confounders (Yehuda et al., 2002, 2004b, 2005b, 2009; Bonne et al., 2003; Neylan et al., 2003b; Pico-Alfonso et al., 2004; Rohleder et al., 2004; Young et al., 2004; Young and Breslau, 2004; Griffin et al., 2005; Golier et al., 2006, 2007; Inslicht et al., 2006; Olff et al., 2006; Wessa et al., 2006; de Kloet et al., 2007; Shalev et al., 2008; Gill et al., 2008; Johnson et al., 2008; Metzger et al., 2008; Klaassens et al., 2010a,b) or excluded participants on potentially confounding variables such as smoking (Eckart et al., 2009). Of the 37 included studies, 19 excluded all psychotropic medication, seven did not mention medication use (Neylan et al., 2003b; Lauc et al., 2004; Young et al., 2004; Bierer et al., 2006; Roth et al., 2006; Shalev et al., 2008; Metzger et al., 2008). "
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