Elevated cortisol levels have been associated with poorer cognitive performance in cross-sectional studies; this may be both a factor contributing to neurodegeneration and cognitive decline and a result of developing brain pathologies. However, it is still unclear (1) whether cortisol measures predict later cognitive decline and (2) whether cortisol changes over the years might be associated with cognitive changes. We analyzed data from CoLaus/PsyCoLaus, a prospective population-based study. Salivary cortisol (4 different measures on 1 day) and neuropsychological assessments were performed at a first visit and a follow-up visit 5 years later in 625 dementia-free participants aged ≥65 years. Salivary cortisol levels at waking and 30 minutes after waking, as well as longitudinal changes in cortisol 30 minutes after waking, cortisol awakening response, and cortisol AM-PM difference were associated with decline in global cognition. After controlling for potential confounders, only longitudinal changes in cortisol 30 minutes after waking remained associated with cognitive decline. These mostly negative findings indicate absent or subtle association between salivary cortisol and cognitive decline.

中文翻译：

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非痴呆老年受试者的唾液皮质醇和认知能力的 5 年变化：一项基于人群的研究

在横断面研究中，皮质醇水平升高与较差的认知能力有关；这可能是导致神经退行性疾病和认知能力下降的一个因素，也是发展大脑病变的结果。然而，目前尚不清楚（1）皮质醇测量是否可以预测以后的认知能力下降以及（2）多年来皮质醇的变化是否可能与认知变化有关。我们分析了 CoLaus/PsyCoLaus 的数据，这是一项基于人群的前瞻性研究。对 625 名年龄≥65 岁的无痴呆症参与者在第一次就诊和 5 年后的随访中进行了唾液皮质醇（1 天的 4 种不同测量）和神经心理学评估。清醒时和醒来后 30 分钟的唾液皮质醇水平，以及醒来后 30 分钟皮质醇的纵向变化，皮质醇觉醒反应和皮质醇 AM-PM 差异与整体认知能力下降有关。在控制了潜在的混杂因素后，只有醒来后 30 分钟皮质醇的纵向变化仍然与认知能力下降有关。这些大多为阴性的发现表明唾液皮质醇与认知能力下降之间缺乏或微妙的关联。