Dysregulation of the hypothalamic pituitary adrenal (HPA) axis and cognitive capability at older ages: individual participant meta-analysis of five cohorts

Michael Gardner, Stafford Lightman, Diana Kuh, Hannie Comijs, Dorly Deeg, John Gallacher, Marie-Claude Geoffroy, Mika Kivimaki, Meena Kumari, Chris Power, Rebecca Hardy, Marcus Richards, Yoav Ben-Shlomo

Research output: Contribution to journalArticle (Academic Journal)peer-review

25 Citations (Scopus)
196 Downloads (Pure)

Abstract

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; I2 = 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; I2 = 49.2%; age and gender adjusted). A bigger cortisol awakening response (CAR) was weakly associated with better fluid (P = 0.09; I2 = 0.0%; age and gender adjusted) and crystallised (P = 0.10; I2 = 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.
Original languageEnglish
Article number4555
Number of pages13
JournalScientific Reports
Volume9
Issue number1
DOIs
Publication statusPublished - 14 Mar 2019

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