Stress tied to cognitive deficits in middle age

  • Echouffo-Tcheugui JB & al.
  • Neurology
  • 24 Oct 2018

  • curated by Susan London
  • Clinical Essentials
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Takeaway

  • Asymptomatic middle-aged adults with higher cortisol levels had worse cognitive function and smaller brain volumes, as well as evidence of altered brain microstructure.

Why this matters

  • Previous studies have focused mainly on older adults and a limited number of brain areas.

Key results

  • Participants with top-tertile vs middle-tertile cortisol levels had:
    • Worse global cognition (β, –0.18; P=.001);
    • Worse visual perception, Hooper Visual Organization Test (−0.08; P=.002);
    • Smaller total cerebral brain volume (−0.38; P=.008);
    • Smaller occipital gray volume (−0.05; P=.052); and
    • Smaller frontal lobe gray volume (−0.12; P=.006).
  • Sex difference for association of higher cortisol with smaller cerebral brain volume:
    • Significant in women (β, −0.73; P=.001);
    • Not significant in men (β, −0.07; P=.717).
  • APOE4 genotype did not significantly modify association of cortisol with cognitive or imaging measures.

Study design

  • Cross-sectional cohort study of 2231 dementia-free Framingham Heart Study (generation 3) participants with mean age of 48.5 years.
  • Main outcomes: cognitive measures, brain MRI measures.
  • Funding: Framingham Heart Study’s National Heart, Lung, and Blood Institute Study; others.

Limitations

  • Causal and temporal relationships unknown.
  • Cortisol measured only once.
  • Unclear generalizability.

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