Stress, cortisol levels and coping strategies on memory performance of healthy elderly, individuals with mild cognitive impairment and Alzheimers disease

Author(s)

Juliana Nery de Souza Talarico

• Document type: Doctoral Thesis
• Press: São Paulo.
• Institution: Universidade de São Paulo (USP). Escola de Enfermagem (EE/SBD)
• Defense date: 2009-04-29

Examining board members

Eliane Correa Chaves; Elke Bromberg; Paulo Caramelli; Deborah Suchecki; Esdras Guerreiro Vasconcelos

• Advisor: Eliane Corrêa Chaves; Paulo Caramelli

Abstract

Increased cortisol levels have been reported in elderly with Alzheimers disease (AD) as a result of the lack in the hypothalamic-pituitary-adrenal (HPA) axis inhibition as a function of hipocampal atrophy observed in those subjects. Moreover, association between high cortisol levels and memory impairment has been demonstrated in healthy elderly subjects. However, little is known about the stress involvement in the cortisol levels, in the cognitive performance and in the coping strategies in both elderly with mild cognitive impairment (MCI) and with AD. Thus, this study aimed to investigate the association between stress intensity, cortisol levels, coping strategies and cognitive performance in healthy elderly, subjects with CCL and with DA. Basal salivary cortisol was measured in a sample composed of 40 healthy elderly subjects, 31 individuals with amnestic MCI and 40 subjects with mild AD. Global cognitive performance was evaluated with the Mini Mental State Exam (MMSE) and memory performance was assessed with the Brief Cognitive Screening Battery (BCSB) and the backward digit span test. Stress intensity was evaluated with the Stress Symptoms List (SSL) and coping strategies with the Jalowiec Coping Scale (JCS). Marginally higher cortisol levels were observed in the subjects with AD group in comparison with healthy elderly (p = 0.062). Furthermore, positive association between cortisol levels and memory performance was observed in the healthy elderly (p = 0.008) while negative correlation was observed between these variables in the MCI group (p = 0.011). No significant association was exhibited in the AD group (p > 0.05). Moreover, positive correlation between cortisol levels and stress intensity was observed only in the MCI group (p = 0.056). Regarding the coping strategies, it was observed that those MCI subjects who elect problem focused coping exhibit higher stress intensity than those MCI who use emotion focused coping (p = 0.048). These results suggest the association between cortisol levels, memory performance, stress intensity and coping strategies may vary as a function of the presence or absence of cognitive impairment and as a function of the cognitive deficits awareness (AU)

• FAPESP's process: 06/50998-4 - Stress effect on cognitive and functional performance of elderly people with Alzheimer's disease and mild cognitive impairment
• Grantee: Juliana Nery de Souza Talarico
• Support Opportunities: Scholarships in Brazil - Doctorate