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Cortisol levels among older people with and without depression and dementia

Published online by Cambridge University Press:  17 December 2018

Maria Lage Barca*
Affiliation:
Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
Rannveig S. Eldholm
Affiliation:
Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway Department of Geriatrics, St. Olav Hospital, Trondheim, Norway
Karin Persson
Affiliation:
Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
Guro Hanevold Bjørkløf
Affiliation:
Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
Tom Borza
Affiliation:
Centre for Old Age Psychiatric Research, Innlandet Hospital Trust, Ottestad, Norway
Elisabeth Telenius
Affiliation:
Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
Anne-Brita Knapskog
Affiliation:
Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
Anne Brækhus
Affiliation:
Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
Ingvild Saltvedt
Affiliation:
Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway Department of Geriatrics, St. Olav Hospital, Trondheim, Norway
Geir Selbæk
Affiliation:
Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
Knut Engedal
Affiliation:
Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
*
Correspondence should be addressed to: Maria Lage Barca, Norwegian Advisory Unit for Ageing and Health, Postbox 2136, 3103 Tønsberg, Norway; Phone: (+47) 9743-6610. Email: maria.barca@aldringoghelse.no.

Abstract

Cortisol dysregulation has been reported in dementia and depression. Cortisol levels and its associates were investigated among older people living at home and in nursing homes, in a cross-sectional study. A sample of 650 older people, from the community (home and nursing homes) and specialized care (memory clinics and old age psychiatry wards), mean age 76.8 (SD = 10.3) (dementia n = 319, depression, n = 154, dementia plus depression n = 53, and reference group n = 124), was included. Assessment included the Mini Mental State Examination (MMSE), Cornell scale for depression in dementia, activities of daily living scales, and salivary cortisol. Number of drugs was registered. The results showed that the cortisol ratio was highest among patients with dementia and co-morbid depression in comparison to those with either depression or dementia and the reference group. Characteristics significantly associated with cortisol levels were higher MMSE score (in patients with dementia and co-morbid depression), male gender (in people with dementia), and number of medications (in the reference group). We conclude that the cortisol ratio was highest among patients with dementia and co-morbid depression in comparison to those with either depression or dementia and the reference group. The association of cortisol level with MMSE score among patients with dementia and depression could further indicate that increased stress is related to cognitive function.

Type
Brief Report
Copyright
© International Psychogeriatric Association 2018 

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References

Balardin, J. B., Vedana, G., Luz, C. and Bromberg, E. (2011). Subjective mild depressive symptoms are associated with abnormal diurnal cycle of salivary cortisol in older adults. Journal of Geriatric Psychiatry and Neurology, 24, 1922. doi: 10.1177/0891988710373599.CrossRefGoogle ScholarPubMed
Barca, M. L. et al. (2017). Trajectories of depressive symptoms and their relationship to the progression of dementia. Journal of Affective Disorders, 222, 146152. doi: 10.1016/j.jad.2017.07.008.CrossRefGoogle Scholar
Bjorklof, G. H., Engedal, K., Selbaek, G., Maia, D. B., Coutinho, E. S. and Helvik, A. S. (2016). Locus of control and coping strategies in older persons with and without depression. Aging and Mental Health, 20, 831839. doi: 10.1080/13607863.2015.1040722.CrossRefGoogle ScholarPubMed
Borza, T., Engedal, K., Bergh, S., Benth, J. S. and Selbaek, G. (2015). The course of depression in late life as measured by the Montgomery and Asberg depression rating scale in an observational study of hospitalized patients. BMC Psychiatry, 15, 191. doi: 10.1186/s12888-015-0577-8.CrossRefGoogle Scholar
Johar, H. et al. (2014). Blunted diurnal cortisol pattern is associated with frailty: a cross-sectional study of 745 participants aged 65 to 90 years. The Journal of Clinical Endocrinology and Metabolism, 99, E464E468. doi: 10.1210/jc.2013-3079.CrossRefGoogle ScholarPubMed
Kovach, C. R., Woods, D. L., Logan, B. R. and Raff, H. (2011). Diurnal variation of cortisol in people with dementia: relationship to cognition and illness burden. American Journal of Alzheimer's Disease & Other Dementias, 26, 145150. doi: 10.1177/1533317510397329.CrossRefGoogle ScholarPubMed
Migliorelli, R., Teson, A., Sabe, L., Petracchi, M., Leiguarda, R. and Starkstein, S. E. (1995). Prevalence and correlates of dysthymia and major depression among patients with Alzheimer’s disease. American Journal of Psychiatry, 152, 3744. doi: 10.1176/ajp.152.1.37.Google ScholarPubMed
Nasman, B., Olsson, T., Viitanen, M. and Carlstrom, K. (1995). A subtle disturbance in the feedback regulation of the hypothalamic-pituitary-adrenal axis in the early phase of Alzheimer’s disease. Psychoneuroendocrinology, 20, 211220. doi: 10.1016/0306-4530(94)00054-E.CrossRefGoogle ScholarPubMed
Potvin, O., Forget, H., Preville, M., Berbiche, D., Chagnon, Y. C. and Hudon, C. (2013). Relationship between cortisol level and prevalent/incident cognitive impairment and its moderating factors in older adults. International Psychogeriatrics, 25, 252262. doi: 10.1017/S1041610212001706.CrossRefGoogle ScholarPubMed
Singh-Manoux, A., Dugravot, A., Elbaz, A., Shipley, M., Kivimaki, M. and Kumari, M. (2014). No evidence of a longitudinal association between diurnal cortisol patterns and cognition. Neurobiology of Aging, 35, 22392245. doi: 10.1016/j.neurobiolaging.2014.03.015.CrossRefGoogle ScholarPubMed
Souza-Talarico, J. N., Chaves, E. C., Nitrini, R. and Caramelli, P. (2009). Chronic stress is associated with high cortisol levels and emotional coping mechanisms in amnestic mild cognitive impairment. Dementia and Geriatric Cognitive Disorders, 28, 465470. doi: 10.1159/000259696.CrossRefGoogle ScholarPubMed
Telenius, E. W., Engedal, K. and Bergland, A. (2015). Effect of a high-intensity exercise program on physical function and mental health in nursing home residents with dementia: an assessor blinded randomized controlled trial. PLoS One, 10, e0126102. doi: 10.1371/journal.pone.0126102.CrossRefGoogle ScholarPubMed
WHO. (1993). The ICD-10 Classification of Mental and Behavioural Disorders: Diagnostic Criteria for Research. Geneva: World Health Organization.Google Scholar