Examination of stress, depression, and cognitive function in the elderly: A biobehavioral approach

Lisa Boss, The University of Texas School of Nursing at Houston


Background: Chronic psychological stress, depression, and loneliness are associated with adverse cognitive health outcomes in a rapidly growing aging population. Prolonged activation of the HPA axis with elevated salivary cortisol is significantly associated with poor cognitive function. An increased cortisol/DHEA ratio may also be associated with detrimental cognitive health outcomes.^ Objectives: The purpose of this study was to examine specific relationships between chronic psychological stress, depression, loneliness, and cognitive function from a biobehavioral perspective and enhance understanding of how salivary biomarkers are related to cognitive function in an elderly population.^ Methods: Using a cross-sectional research design, data were collected once from 71 elderly (mean age 86.4). Stress, depression, loneliness, and cognitive function were measured with standardized instruments, and saliva samples were collected for salivary cortisol and DHEA. ^ Results: Main findings include that loneliness and stress were significantly and negatively correlated with global cognitive function (r = -.30, r = -.25, both p = < 05) and executive function (r = -.40, r = -.26, both p < .05). Cortisol also showed a significant negative correlation with executive function (r = -.30, p < .05) despite non-significant correlations with psychosocial variables. In contrast, the cortisol/DHEA ratio was not significantly correlated with psychosocial or cognitive function variables, and neither cortisol nor cortisol/DHEA ratio was a mediator between psychosocial variables and cognitive functions. ^ Discussion: Loneliness, stress, and cortisol seem to be important biobehavioral variables on cognitive function in the elderly. Additional biobehavioral research is needed in this area with more diverse study participants, longitudinal research designs, and other relevant biomarkers for cognitive functions. With increasing longevity, biobehavioral interactions and cognitive function will remain a significant area of research in the elderly and better understanding of such interactions may reduce adverse burdens in the aging population. ^ Key Words: Stress, Depression, Loneliness, Cognitive Function, Older Adult.^

Subject Area

Health Sciences, Mental Health|Health Sciences, Aging|Health Sciences, Nursing

Recommended Citation

Boss, Lisa, "Examination of stress, depression, and cognitive function in the elderly: A biobehavioral approach" (2013). Texas Medical Center Dissertations (via ProQuest). AAI3574416.