Increased Saliva Cortisol Awakening Response in Patients with Mild Cognitive Impairment

ArticleinDementia and Geriatric Cognitive Disorders 24(5):389-95 · February 2007with15 Reads
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.
    • "Alterations in the CAR may be related to cognitive function. Increased CAR has been associated with both poorer and better behavioral performance in higher order functions such as working memory and attention-switching (Aas et al., 2011; Almela et al., 2012; Evans et al., 2012; Lind et al., 2007; Moriarty et al., 2014). The relationship between the CAR and the neurocognitive processing that underlies explicit behavior, however, remains unknown. "
    [Show abstract] [Hide abstract] ABSTRACT: The cortisol awakening response (CAR), a rapid increase in cortisol levels following morning awakening, is an important aspect of hypothalamic-pituitary-adrenocortical axis activity. Alterations in the CAR have been linked to a variety of mental disorders and cognitive function. However, little is known regarding the relationship between the CAR and error processing, a phenomenon that is vital for cognitive control and behavioral adaptation. Using high-temporal resolution measures of event-related potentials (ERPs) combined with behavioral assessment of error processing, we investigated whether and how the CAR is associated with two key components of error processing: error detection and subsequent behavioral adjustment. Sixty university students performed a Go/No-go task while their ERPs were recorded. Saliva samples were collected at 0, 15, 30 and 60 min after awakening on the two consecutive days following ERP data collection. The results showed that a higher CAR was associated with slowed latency of the error-related negativity (ERN) and a higher post-error miss rate. The CAR was not associated with other behavioral measures such as the false alarm rate and the post-correct miss rate. These findings suggest that high CAR is a biological factor linked to impairments of multiple steps of error processing in healthy populations, specifically, the automatic detection of error and post-error behavioral adjustment. A common underlying neural mechanism of physiological and cognitive control may be crucial for engaging in both CAR and error processing.
    Full-text · Article · Jul 2015
    • "The present investigation also provided data on the differences between dementia and MCI which adds to current, contradicting literature. Previous studies have reported that MCI individuals showed increased cortisol levels compared to cognitively healthy subjects (Lee et al., 2007; Lind et al., 2007; Lupien et al., 1998) while others found no significant differences (Wolf et al., 2002 ). This is particularly important as MCI is an established risk factor for cognitive decline (Peavy et al., 2007). "
    [Show abstract] [Hide abstract] ABSTRACT: 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), 30min 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.
    Full-text · Article · Jan 2015
    • "By measuring salivary (Talarico et al., 2010; Wolf et al., 2002), plasma (Csernansky et al., 2006), or CSF (Gil-Bea et al., 2010; Popp et al., 2009) cortisol levels in different body fluids as a proxy of HPA-axis activity, most previous studies did not find differences between patients with MCI and cognitively healthy subjects . In contrast, others reported higher salivary cortisol levels (Arsenault-Lapierre et al., 2010) and increased saliva cortisol awakening response in subjects with MCI but no differences in basal cortisol levels (Lind et al., 2007). Overall, these studies, however, were limited by small numbers of included participants. "
    [Show abstract] [Hide abstract] ABSTRACT: Increased peripheral and central nervous system cortisol levels have been reported in Alzheimer's disease (AD) and may reflect dysfunction of cerebral components of the hypothalamic-pituitary-adrenal (HPA) axis. However, brain exposure to high cortisol concentrations may also accelerate disease progression and cognitive decline. The objectives of this study were to investigate whether HPA-axis dysregulation occurs at early clinical stages of AD and whether plasma and CSF cortisol levels are associated with clinical disease progression. Morning plasma and CSF cortisol concentrations were obtained from the subjects with AD dementia, mild cognitive impairment of AD type (MCI-AD), MCI of other type (MCI-O), and controls with normal cognition included in a multicenter study from the German Dementia Competence Network. A clinical and neuropsychological follow-up was performed in a subgroup of participants with MCI-AD, MCI-O, and AD dementia. CSF cortisol concentrations were increased in the subjects with AD dementia or MCI-AD compared with subjects with MCI-O or normal cognition. After controlling for possible confounders including CSF measures of amyloid beta1-42 and total tau, higher baseline CSF cortisol levels were associated with faster clinical worsening and cognitive decline in MCI-AD. The findings suggest that HPA-axis dysregulation occurs at the MCI stage of AD and may accelerate disease progression and cognitive decline. Copyright © 2014 Elsevier Inc. All rights reserved.
    Full-text · Article · Oct 2014
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