In populations of young and older adults, it has been shown that individuals may be categorized into one of three diurnal subgroups when salivary cortisol levels are assessed over a 2-day period and compared for their consistency across days: a typical subgroup, a flat subgroup, and an inconsistent subgroup. Interestingly, recent studies have reported that the typical subgroup represents the majority of the young and older adult population, a finding that is difficult to reconcile with previous studies showing increased cortisol levels in older adults with depression or cognitive impairments. In order to assess whether a typical diurnal cortisol profile is representative across different subgroups of older adults, we assessed diurnal cortisol cycle representation in a sample of older adults with subjective complaints of depression and/or memory problems. Furthermore, given the robust relationship between cortisol and cognitive function, the present study examined the association between the three diurnal subgroups and cognitive performance. Forty-two older individuals were recruited on the basis of reporting subjective complaints of either memory problems and/or depressive mood. Participants were asked to sample their saliva over a 2-day period and were then asked to undergo a neuropsychological evaluation that taps into short-term memory, declarative memory and language. The results showed that 69% of the sample presented a Flat cycle of salivary cortisol over a 2-day period while 19% presented an inconsistent pattern and 12% presented a typical pattern. Participants in the flat subgroup were significantly impaired on letter verbal fluency. Furthermore, a relationship was found between diurnal cortisol subgroup representation and subjective complaint profile. These findings show that older adults with complaints of memory problems and/or depressive symptoms do not present the typical profile of the diurnal cortisol cycle, and they provide a preliminary view of how diurnal cortisol profile relates to cognitive function during human aging.
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http://dx.doi.org/10.1080/10253890600965674 | DOI Listing |
Int J Surg
January 2025
Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
Introduction: Lung function has been associated with cognitive decline and dementia, but the extent to which lung function impacts brain structural changes remains unclear. We aimed to investigate the association of lung function with structural macro- and micro-brain changes across mid- and late-life.
Methods: The study included a total of 37 164 neurologic disorder-free participants aged 40-70 years from the UK Biobank, who underwent brain MRI scans 9 years after baseline.
JAMA Netw Open
January 2025
Amazon Health Services, Seattle, Washington.
Importance: Medication nonadherence imposes high morbidity, mortality, and costs but is challenging to address given its multiple causes. Subscription models are increasingly used in health care to encourage healthy behaviors; in January 2023, Amazon Pharmacy launched RxPass, a subscription program offering Amazon Prime members (hereafter, company members) in 45 states access to 60 common generic medications for a flat $5 monthly fee.
Objective: To evaluate the associations of program enrollment with medication refills, days' supply, and out-of-pocket costs.
JAMA Netw Open
January 2025
Division of Surgical Oncology, University of Utah, Salt Lake City.
Importance: An increasing number of older adults are undergoing surgery. Older adults face significant challenges throughout the spectrum of perioperative care. No frameworks exist to support primary care clinicians in helping older adults navigate perioperative care beyond preoperative medical clearance.
View Article and Find Full Text PDFJAMA Netw Open
January 2025
Department of Epidemiology and Biostatistics, University of California, San Francisco.
Importance: Incidence of distant stage prostate cancer is increasing in the United States. Research is needed to understand trends by social and geographic factors.
Objective: To examine trends in prostate cancer incidence and mortality rates in California by stage, age, race and ethnicity, and region.
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