A group of 19 healthy elderly subjects previously shown to differ in terms of their cortisol levels over a 4 year period were administered a neuropsychological test battery assessing memory, attention, and language. Correlational analyses performed on various corticosteroid measures showed that the slope of the change in cortisol levels over time predicted cognitive deficits in this elderly population. Aged subjects showing a significant increase in cortisol levels with years and with high current basal cortisol levels were impaired on tasks measuring explicit memory and selective attention when compared to aged subjects presenting either decreasing cortisol levels with years or increasing cortisol levels with moderate current basal cortisol levels. We further showed that subjects presenting a decrease in cortisol levels with years performed as well as young healthy subjects with regard to cognitive performance. Thus, impaired cognitive performance was associated with recent evidence of hypothalamic-pituitary-adrenal (HPA) dysregulation and elevated basal cortisol levels. These results are consistent with recent animal studies showing the existence of subpopulations of aged rats that differ in HPA activity and cognitive performance. Finally, the pattern of cognitive results related to the cortisol history of subjects is in agreement with a role played by the hippocampus in age-related HPA dysfunction and cognitive performance.

https://www.jneurosci.org/content/jneuro/14/5/2893.full.pdf

Basal cortisol levels and cognitive deficits in human aging

http://www.utdallas.edu/~tres/aging_seminar2011/Lupien.2005.pdf

Stress hormones and human memory function across the lifespan

http://webs.wofford.edu/steinmetzkr/teaching/Thesis/Quervain%20-%20Cortisol%20-%202009.pdf

Glucocorticoids and the regulation of memory in health and disease

Objective: The authors’ objective was to compare the urinary cortisol excretion of Holocaust survivors with posttraumatic stress disorder (PTSD) (N=22) to that ofHolocaust survivors without PTSD (N=25) and comparison subjects not exposed to the Holocaust (N=15). Method: Twenty-four-hour urine samples were collected, and the following day, subjects were evaluated for the presence and severity ofpast and current PTSD and other psychiatric conditions. Results: Holocaust survivors with PTSD showed significantly lower mean 24-hour urinary cortisol excretion than the two groups ofsubjects without PTSD. Multiple correlation analysis revealed a significant relationship between cortisol levels and severity of PTSD that was due to a substantial association with scores on the avoidance subscale. Conclusions: The present findings replicate the authors’ previous observation oflow urinary cortisol excretion in combat veterans with PTSD and extend these findings to a non-treatment-seeking civilian group. The results also demonstrate that low cortisol levels are associated with PTSD symptoms ofa clinically significant nature, rather than occurring as a result ofexposure to trauma per se, and that low cortisollevels may persist for decades following exposure to trauma among individuals with chronic PTSD. (AmJ Psychiatry 1995; 152:982-986)

Low Urinary Cortisol Excretion in Holocaust Survivors With Posttraumatic Stress Disorder

Aging is a time of reduced adaptability to metabolic perturbation. This is particularly true in endocrinology which, after all, is the science of chemically regulated biologic systems. There is no evidence that equilibrium concentrations of the principal hormones are altered with age. However, the systems utilized to reach those equilibria become progressively taxed, and new equilibria may be achieved reflecting that regulatory problem. Thus, with advancing age there are significant alterations in hormone production, metabolism, and action: Some of these changes may play a role in the pathophysiology of senescence, although the evidence for that is limited. The magnitude of age-related alterations is highly variable and sex dependent. Whereas only subtle changes occur in pituitary dynamics, adrenal gland physiology, and thyroid function, the changes in glucose homeostasis, reproductive function, and calcium metabolism are more apparent. In the elderly, the interpretation of endocrine tests should reflect the nutritional status of the patient and the presence of coexisting illnesses. In this review, we describe the principles of endocrinology in the geriatric population and elaborate on the changes in specific glandular functions with aging. We also define strategies of evaluation and management protocols appropriate for the elderly with suspected endocrine dysfunction.

Endocrinology in aging

In this study the influence of old age on adrcnocortical function and cortisol metabolism was investigated, along with renal, hepatic and thyroid function in 15 young men (25–40 years old) and 50 old men (60–96 years old). By the criteria of 8-a.m. plasma levels of free and conjugated 17-hydroxycorticosteroids (17-OH-CS) and the plasma corticoid response to ACTH stimulation, no significant change in adrenocortical function could be demonstrated with advancing age. However, there was a progressive and significant decrease in the urinary excretion of 17-OH-CS with aging. Following intravenous administration of a standard dose, cortisol disappeared from the circulation at a significantly slower rate in the old men. The maximal levels of plasma conjugated 17-OH-CS observed after cortisol infusion were statistically the same for all ages, but the rate of decay from peak values was slower in the older subjects. These alterations in cortisol metabolism were associated with a significant increase in the level of ...

D. B. Carter

Papers

Adrknocortical function and cortisol metabolism in old age