Correlation of Higher Cortisol Levels, Cognitive Deficits, and Lower Brain Volume Varies by Sex


In a study published in today’s issue of Neurology, data from participants in the Framingham Heart study (generation 3) identified a correlation among high blood cortisol levels (> 15.8 mcg/L) and global cognition scores (< .001). For women in this study, higher cortisol levels also correlated with lower total brain volumes (P= .001). Both correlations were seen after adjusting for age, APOe, depression, sex, and vascular risk factors.

Neither low cortisol levels nor APOe-positive status were associated with structural brain differences. White matter tracts most affected in those with high cortisol compared to those with low or referent levels of cortisol included the superior and posterior corona radiata and the splenium and body of the corpus collusum. 

 In this study, data from 2,231 women (53.2%) and men (46.8%) with a mean age of 48.5 years and without a history of neurologic disease, were administered cognitive testing for abstract reasoning, attention, executive function, verbal and visual memory, and visual perception approximately 1 year after study entry; 2,018 participants also had a brain MRI. Fasting blood cortisol levels were measured upon entry into the study for all participants. Patients were categorized as having high, typical, or low blood cortisol levels based on tertiles of the full range of levels measured; those who were taking exogenous glucocorticoids were excluded from the study. Most participants were of European descent. 


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