Karlamangla Arun S, Singer Burton H, Greendale Gail A, Seeman Teresa E
Division of Geriatrics, David Geffen School of Medicine at UCLA, 10945 Le Conte 2339, Los Angeles, CA 90095-1687, USA.
Psychoneuroendocrinology. 2005 Jun;30(5):453-60. doi: 10.1016/j.psyneuen.2004.11.004.
High stress hormone levels are associated with increased risk of cognitive decline in elderly individuals. However, the effect of late-life changes in stress hormone levels on cognitive decline risk has not been examined. Our objective was to investigate whether increase over time in urinary epinephrine excretion in older adults was associated with subsequent cognitive decline.
Measurements were made on 154 high-functioning men and women, 70-79 years of age, in 1988, 1991, and 1995. Twelve-hour overnight urinary excretion of epinephrine (normalized by creatinine excretion to adjust for body size) was recorded in 1988 and 1991. Cognitive functioning was assessed in 1991 and 1995 by summary scores based on standard tests of language, memory, abstraction, spatial recognition, and spatial construction.
Compared to individuals whose epinephrine excretion decreased between 1988 and 1991, the individuals whose epinephrine excretion increased over the same period had greater subsequent declines in summary cognitive scores between 1991 and 1995. After adjusting for baseline epinephrine, baseline cognitive function, and relevant covariates, and stratifying by gender, increases in urine epinephrine were positively associated with cognitive decline only in men.
We conclude that increase in urinary excretion of epinephrine predicts subsequent cognitive decline in older men.
高应激激素水平与老年人认知能力下降风险增加有关。然而，应激激素水平的晚年变化对认知能力下降风险的影响尚未得到研究。我们的目的是调查老年人尿肾上腺素排泄量随时间增加是否与随后的认知能力下降有关。
对1988年、1991年和1995年的154名70 - 79岁的高功能男性和女性进行测量。1988年和1991年记录了12小时夜间尿肾上腺素排泄量（通过肌酐排泄量进行标准化以调整身体大小）。1991年和1995年通过基于语言、记忆、抽象、空间识别和空间构建的标准测试的综合得分来评估认知功能。
与1988年至1991年肾上腺素排泄量下降的个体相比，同期肾上腺素排泄量增加的个体在1991年至1995年期间综合认知得分随后下降幅度更大。在调整基线肾上腺素、基线认知功能和相关协变量并按性别分层后，尿肾上腺素增加仅在男性中与认知能力下降呈正相关。
我们得出结论，尿肾上腺素排泄量增加预示着老年男性随后的认知能力下降。
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