Melatonin and cortisol profiles in late midlife and their association with age-related changes in cognition

Katja Linda Waller,1,2 Erik Lykke Mortensen,2,3 Kirsten Avlund,2,3,†, Merete Osler,3,4 Birgitte Fagerlund,5 Martin Lauritzen,2,6 Steen Gammeltoft,7 Poul Jennum1,2 1Danish Center for Sleep Medicine, Clinic of Clinical Neurophysiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; 2Center for Healthy Aging, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark; 3Department of Public Health, University of Copenhagen, Copenhagen, Denmark; 4Research Center for Prevention and Health, Rigshospitalet, Glostrup, Denmark; 5Center for Neuropsychiatric Schizophrenia Research (CNSR), Lundbeck Foundation Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, Glostrup, Denmark; 6Department of Clinical Neurophysiology, Rigshospitalet, Glostrup, Denmark; 7Department of Clinical Biochemistry, Rigshospitalet, Glostrup, Denmark †Kirsten Avlund passed away on June 15, 2012 Abstract: Previous studies have reported an association between circadian disturbances and age-related cognitive impairment. The aim was to study the 24-hour profiles of melatonin and cortisol in relation to cognitive function in middle-aged male subjects. Fifty healthy middle-aged males born in 1953 were recruited from a population-based cohort based on previous cognitive assessments in young adulthood and late midlife. The sample included 24 cognitively high-functioning and 26 cognitively impaired participants. Saliva samples were collected every 4 hours over a 24-hour period and analyzed for cortisol and melatonin levels by immunoassay. All participants exhibited clear circadian rhythms of salivary melatonin and cortisol. Salivary melatonin concentrations had a nocturnal peak at approximately 4 am. The median nocturnal melatonin response at 4 am was significantly lower in the cognitively impaired group than in the high-functioning group (−4.6 pg/mL, 95% CI: −7.84, −1.36, P=0.006). The 24-hour mean melatonin concentration (high-functioning group: 4.80±0.70 pg/mL, vs cognitively impaired group: 4.81±0.76 pg/mL; P>0.05) (or the area under the curve, AUC) was not significantly different between the two groups. Cortisol levels were low during the night, and peaked at approximately 8 am. Median cortisol concentrations were similar at all times, as were the 24-hour mean cortisol concentrations and AUC. To the best of our knowledge, ours is the first study to assess circadian measures (ie, melatonin and cortisol) in healthy middle-aged men with different cognitive trajectories in midlife. We found evidence of altered circadian rhythms with a reduced nocturnal melatonin response at 4 am in men with cognitive impairment. The 24-hour concentration and AUC of melatonin and cortisol were similar in the cognitively high-functioning group and in the cognitively impaired. Keywords: diurnal variation, middle-aged males, minimal cognitive impairmen