TY - JOUR
T1 - Dysregulation of the hypothalamic pituitary adrenal (HPA) axis and cognitive capability at older ages: individual participant meta-analysis of five cohorts
AU - Gardner, Michael
AU - Lightman, Stafford
AU - Kuh, Diana
AU - Comijs, Hannie
AU - Deeg, Dorly
AU - Gallacher, John
AU - Geoffroy, Marie-Claude
AU - Kivimaki, Mika
AU - Kumari, Meena
AU - Power, Chris
AU - Hardy, Rebecca
AU - Richards, Marcus
AU - Ben-Shlomo, Yoav
PY - 2019/12/1
Y1 - 2019/12/1
N2 - Evidence on the association between functioning of the hypothalamic pituitary adrenal (HPA) axis and cognitive capability at older ages is mixed. We undertook a systematic review (until October 2016) and individual participant data (IPD) meta-analysis to test if dysregulation of the HPA axis is associated with worse cognitive capability. Five cohort studies were included in the IPD meta-analysis of diurnal cortisol patterns with crystallised and fluid cognitive ability. Higher night time cortisol was associated with worse fluid ability (standardised coefficient per SD increase −0.063, 95% CI −0.124, −0.002, P = 0.04; I 2 = 79.9%; age and gender adjusted). A larger diurnal drop was associated with better fluid ability (standardised coefficient per SD increase 0.037, 95% CI 0.008, 0.065, P = 0.01; I 2 = 49.2%; age and gender adjusted). A bigger cortisol awakening response (CAR) was weakly associated with better fluid (P = 0.09; I 2 = 0.0%; age and gender adjusted) and crystallised (P = 0.10; I 2 = 0.0%; age and gender adjusted) ability. There is weak evidence that a greater diurnal decline of the HPA axis and a larger CAR are associated with improvements in cognition at older ages. As associations are cross-sectional, we cannot rule out reverse causation.
AB - Evidence on the association between functioning of the hypothalamic pituitary adrenal (HPA) axis and cognitive capability at older ages is mixed. We undertook a systematic review (until October 2016) and individual participant data (IPD) meta-analysis to test if dysregulation of the HPA axis is associated with worse cognitive capability. Five cohort studies were included in the IPD meta-analysis of diurnal cortisol patterns with crystallised and fluid cognitive ability. Higher night time cortisol was associated with worse fluid ability (standardised coefficient per SD increase −0.063, 95% CI −0.124, −0.002, P = 0.04; I 2 = 79.9%; age and gender adjusted). A larger diurnal drop was associated with better fluid ability (standardised coefficient per SD increase 0.037, 95% CI 0.008, 0.065, P = 0.01; I 2 = 49.2%; age and gender adjusted). A bigger cortisol awakening response (CAR) was weakly associated with better fluid (P = 0.09; I 2 = 0.0%; age and gender adjusted) and crystallised (P = 0.10; I 2 = 0.0%; age and gender adjusted) ability. There is weak evidence that a greater diurnal decline of the HPA axis and a larger CAR are associated with improvements in cognition at older ages. As associations are cross-sectional, we cannot rule out reverse causation.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85062960870&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/30872618
U2 - https://doi.org/10.1038/s41598-019-40566-x
DO - https://doi.org/10.1038/s41598-019-40566-x
M3 - Article
C2 - 30872618
SN - 2045-2322
VL - 9
JO - Scientific reports
JF - Scientific reports
IS - 1
M1 - 4555
ER -