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 journalArticleAcademicpeer-review

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; 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.
LanguageEnglish
Article number4555
JournalScientific Reports
Volume9
Issue number1
DOIs
Publication statusPublished - 2019

Cite this

Gardner, Michael ; Lightman, Stafford ; Kuh, Diana ; Comijs, Hannie ; Deeg, Dorly ; Gallacher, John ; Geoffroy, Marie-Claude ; Kivimaki, Mika ; Kumari, Meena ; Power, Chris ; Hardy, Rebecca ; Richards, Marcus ; Ben-Shlomo, Yoav. / Dysregulation of the hypothalamic pituitary adrenal (HPA) axis and cognitive capability at older ages: individual participant meta-analysis of five cohorts. In: Scientific Reports. 2019 ; Vol. 9, No. 1.
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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; 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.",
author = "Michael Gardner and Stafford Lightman and Diana Kuh and Hannie Comijs and Dorly Deeg and John Gallacher and Marie-Claude Geoffroy and Mika Kivimaki and Meena Kumari and Chris Power and Rebecca Hardy and Marcus Richards and Yoav Ben-Shlomo",
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Gardner, M, Lightman, S, Kuh, D, Comijs, H, Deeg, D, Gallacher, J, Geoffroy, M-C, Kivimaki, M, Kumari, M, Power, C, Hardy, R, Richards, M & Ben-Shlomo, Y 2019, 'Dysregulation of the hypothalamic pituitary adrenal (HPA) axis and cognitive capability at older ages: individual participant meta-analysis of five cohorts', Scientific Reports, vol. 9, no. 1, 4555. https://doi.org/10.1038/s41598-019-40566-x

Dysregulation of the hypothalamic pituitary adrenal (HPA) axis and cognitive capability at older ages: individual participant meta-analysis of five cohorts. / Gardner, Michael; Lightman, Stafford; Kuh, Diana; Comijs, Hannie; Deeg, Dorly; Gallacher, John; Geoffroy, Marie-Claude; Kivimaki, Mika; Kumari, Meena; Power, Chris; Hardy, Rebecca; Richards, Marcus; Ben-Shlomo, Yoav.

In: Scientific Reports, Vol. 9, No. 1, 4555, 2019.

Research output: Contribution to journalArticleAcademicpeer-review

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AU - Geoffroy, Marie-Claude

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AU - Ben-Shlomo, Yoav

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