title: Increase in epinephrine excretion is associated with cognitive decline in elderly men: MacArthur studies of successful aging.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  We conclude that increase in urinary excretion of epinephrine predicts subsequent cognitive decline in older men.
authors.affiliation: Division of Geriatrics, David Geffen School of Medicine at UCLA, 10945 Le Conte 2339, Los Angeles, CA 90095-1687, USA. akarlamangla@mednet.ucla.edu
authors.forename: Arun S
authors.initials: AS
authors.lastname: Karlamangla
authors.forename: Burton H
authors.initials: BH
authors.lastname: Singer
authors.forename: Gail A
authors.initials: GA
authors.lastname: Greendale
authors.forename: Teresa E
authors.initials: TE
authors.lastname: Seeman
mesh_terms: D000368:Aged; D000375:Aging / Q000502:physiology*; D003072:Cognition Disorders / Q000523:psychology* / Q000652:urine*; D015331:Cohort Studies; D004837:Epinephrine / Q000652:urine*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008568:Memory / Q000502:physiology; D009483:Neuropsychological Tests; D012727:Sex Characteristics
chemical_list: D004837:Epinephrine