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Relationship between cortisol level and prevalent/incident cognitive impairment and its moderating factors in older adults

Published online by Cambridge University Press:  23 October 2012

Olivier Potvin*
Faculté de médecine et des sciences sociales, Université de Sherbrooke, Sherbrooke, Canada Centre de recherche Hôpital Charles LeMoyne, Longueuil, Canada Centre de recherche de l'Institut universitaire en santé mentale de Québec, Québec, Canada
Hélène Forget
Département de psychoéducation et de psychologie, Université du Québec en Outaouais, Gatineau, Canada
Michel Préville
Faculté de médecine et des sciences sociales, Université de Sherbrooke, Sherbrooke, Canada Centre de recherche Hôpital Charles LeMoyne, Longueuil, Canada
Djamal Berbiche
Faculté de médecine et des sciences sociales, Université de Sherbrooke, Sherbrooke, Canada Centre de recherche Hôpital Charles LeMoyne, Longueuil, Canada
Yvon C. Chagnon
Centre de recherche de l'Institut universitaire en santé mentale de Québec, Québec, Canada École de psychologie, Université Laval, Québec, Canada
Carol Hudon
Centre de recherche de l'Institut universitaire en santé mentale de Québec, Québec, Canada École de psychologie, Université Laval, Québec, Canada
Correspondence should be addressed to: Olivier Potvin, Centre de recherche de l'Institut universitaire en santé mentale de Québec, 2601, de la Canardière, Québec G1J 2G3, Canada. Phone: +418-663-5000, ext. 6857; Fax: +418-663-5971. Email:


Background: The objectives of this study were to examine the factors modifying the relationship between cortisol level and prevalent/incident cognitive impairment in older adults and to verify whether these relationships were non-linear.

Methods: Data were collected from 1,226 individuals aged 65 and older by two in-home interviews separated by 12 months. Cortisol level was measured using saliva samples taken at the beginning of the baseline interview before cognitive, mental, and physical health evaluations. Prevalent and incident cognitive impairment were defined using the Mini-Mental State Examination scores according to normative data for age, education level, and sex.

Results: High morning cortisol level increased the risk of incident cognitive impairment in participants with anxiety or depressive episode while low cortisol level increased the risk in participants without anxiety or depressive episode. In high educated participants, but not in low educated participants, high morning cortisol level was associated with prevalent cognitive impairment and high afternoon cortisol level increased the risk of incident cognitive impairment. The results also suggested that lower morning cortisol values could increase the risk of incident cognitive impairment in individuals with few chronic diseases. A curvilinear relationship was observed between morning cortisol and the probability of incident cognitive impairment, but further analyses suggested that it was likely explained by anxiety and depressive episode.

Conclusions: These results suggest that cognitive impairment in older adults is linked to higher or lower cortisol level depending on characteristics such as anxiety, depressive episode, education level, and physical health.

Research Article
Copyright © International Psychogeriatric Association 2012

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