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. 2019 Jul;26(4):507-520.
doi: 10.1080/13825585.2018.1495309. Epub 2018 Jul 11.

Examining HPA-axis functioning as a mediator of the relationship between depression and cognition across the adult lifespan

Aimee James Karstens  1 , Inez Korzun  2 , Erich T Avery  3 , Michelle T Kassel  4 , Rachel Keelan  3   5 , Helen Kales  3 , Heather Abercrombie  4 , Tory Eisenlohr-Moul  1 , Scott A Langenecker  1   3 , Sara Weisenbach  1   3   6   7
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Examining HPA-axis functioning as a mediator of the relationship between depression and cognition across the adult lifespan

Aimee James Karstens et al. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn. 2019 Jul.

Abstract

Altered HPA-axis functioning is a hypothesized mechanism for worsened cognition in depression. The current study examines the indirect effects of depression on processing speed, executive functioning, and memory as a function of the HPA-axis. 38 individuals with a depression diagnosis and 50 healthy controls (HCs) aged 18-86 underwent neuropsychological testing and at-home diurnal salivary cortisol collection. Depression was assessed via structured clinical interviews and rating scales. Cognitive composite scores were derived from factor analysis. Daytime cortisol exposure was estimated using area under the curve (AUC). Depression was associated with higher cortisol levels and slower processing speed . A significant suppression effect of AUC was present on the relationship between depression and processing speed. Limitations include the cross-sectional design and limited sample heterogeneity. Though poorly modulated HPA-axis is one proposed mechanism of cognitive alterations in depression, our results did not support this conclusion for processing speed. Alternative mechanisms should be considered to inform interventions to target cognitive alterations in depression.

Keywords: Depression; HPA-axis; cognition; cortisol; memory; speeded processing.

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Figures

Figure 1.
Figure 1.
Estimated group mean and standard error of the mean salivary diurnal cortisol measurements. ∔p<.10, * p < .05, **p < .01
Figure 2.
Figure 2.
Mediation model test the indirect effect of depression on speeded processing via area under the curve. * p < .05, **p < .01
See this image and copyright information in PMC

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