Personality and Hypothalamic–Pituitary–Adrenal Axis in Older Men and Women

Personality has been related to health and mortality risk, which has created interest in the biological pathways that could explain this relationship. Although a dysregulation of the hypothalamic–pituitary–adrenal (HPA) axis has been associated with health outcomes and aging, few studies have explored the association between personality and HPA axis functioning in older adults. In addition, it has been suggested that sex could moderate the relationship between personality and HPA axis functioning. Thus, our aim was to analyze the relationship between the big five personality traits and the diurnal cortisol pattern in older adults, as well as sex differences in this relationship. To do so, 79 older people (40 men and 39 women) from 59 to 81 years old (M = 69.19, SD = 4.60) completed the NEO-Five-Factor Inventory (FFI) to measure neuroticism, conscientiousness, extraversion, openness, and agreeableness. Saliva samples were provided on three consecutive days (awakening; 15, 30, and 45 min post-awakening; and bedtime) in order to analyze the diurnal cortisol pattern and, specifically, two cortisol indexes: the cortisol awakening response (CAR) and the diurnal cortisol slope (DCS). Results showed that neuroticism and conscientiousness moderated the diurnal cortisol pattern. Thus, individuals with higher neuroticism and lower conscientiousness scores showed higher bedtime cortisol levels, suggesting a less healthy diurnal cortisol pattern. Regarding the cortisol indexes, higher neuroticism and lower conscientiousness were related to greater CAR and DCS. Sex moderated the association between extraversion and the DCS. Specifically, higher extraversion was related to a lower DCS only in women. Openness and agreeableness were not related to the diurnal cortisol pattern. In conclusion, our results show that in older adults, neuroticism is a vulnerability factor for HPA axis dysregulation, with possible adverse effects on health. By contrast, conscientiousness, and extraversion only in women, appear to be protective factors of HPA axis functioning, with potential beneficial effects on health

Hypothalamic-Pituitary-Adrenal axis and cognitive function in healthy older people: genetic, situational and individual factors

The world population is getting older, and this age group faces important health challenges, among which age-related cognitive decline stands out. Therefore, it is important to identify vulnerability and protective health factors in order to understand ways to prevent cognitive decline. This thesis aimed to address the relationship between the Hypothalamic–Pituitary–Adrenal (HPA) axis and cognitive functioning during aging, taking into account genetic (Apolipoprotein E, ApoE, polymorphism), situational (loneliness), and individual factors (personality traits). To do this, a group of healthy older people over 55 years of age, men and women, were evaluated. A neuropsychological battery was administered to assess global cognition, attention, executive function, working and declarative verbal memory. Participants also provided saliva samples to measure the HPA-axis functioning (cortisol levels) and the ApoE genotype. In addition, participants completed the revised UCLA loneliness scale, the NEO-Five Factor Inventory to measure the big five personality traits, the Cognitive Reserve Questionnaire, and the Short Form Health Survey (SF-36) to assess subjective physical and mental health. Furthermore, different objective health measures were also obtained: Body Mass Index (BMI), Waist-Hip Ratio (WHR), Glycated Hemoglobin (HbA1c), Low-Density Lipoprotein (LDL) and High-Density Lipoprotein (HDL) Cholesterol, and Pulse Pressure. The main results/conclusions of this thesis are, first, that the ApoE-ε2 allele has been shown to be a protective factor for learning ability. The ApoE-ε3 allele was related to a more adaptive HPA-axis response, with beneficial effects on cognitive performance, whereas the ApoE-ε4 allele could be a vulnerability factor in the adverse effects of HPA-axis dysregulation on cognition. In addition, loneliness was associated with a dysregulation of the HPA-axis. Furthermore, loneliness was not associated directly with cognitive function in healthy older adults, but it was indirectly related to worse cognitive performance via higher bedtime cortisol levels. Therefore, the dysregulation of the HPA-axis appears to be one of the mechanisms underlying the relationship between loneliness and cognitive impairment. Concerning personality dimensions, our results confirm that neuroticism is an important health risk factor in aging because it is associated with a dysregulation of the HPA-axis, decline in attention via a dysregulation of the HPA-axis, and worse objective and subjective health. In contrast, conscientiousness appears as a robust protective factor for health in older people because it is associated with healthier HPA-axis functioning and better objective and subjective health; however, it is not a predictor of cognitive change in healthy older adults. Regarding extraversion, it could protect against decline in executive function and delayed memory recall, but favor decline in immediate memory recall, which could be explained by cognitive reserve. Openness and agreeableness did not seem important predictors of health outcomes in older people, but they are protective factors against decline in immediate recall via cognitive reserve, and delayed recall, respectively. Finally, it is worth noting that regarding to the sex/gender, our results suggest that neuroticism is a greater risk factor for decline in working memory in men, and for health in women, whereas extraversion is a protective factor for health in women, but a risk factor in men

Openness to experience and cognitive functioning and decline in older adults: The mediating role of cognitive reserve

Objective Openness to experience has been consistently associated with better cognitive functioning in older people, but its association with cognitive decline is less clear. Cognitive reserve has been proposed as a mechanism underlying this relationship, but previous studies have reported mixed findings, possibly due to the different ways of conceptualizing cognitive reserve. We aimed to analyze the potential mediating role of cognitive reserve in the association between openness and cognitive functioning and decline in healthy older people. Method In Wave 1 and at the four-year follow-up (Wave 2), 87 healthy older people (49.4% women; M age = 65.08, SD = 4.54) completed a neuropsychological battery to assess cognitive functioning and a questionnaire to assess cognitive reserve. Openness was measured with the NEO- Five-Factor Inventory. Mediation models were proposed to investigate the relationship between openness and cognitive function or decline through cognitive reserve or its change. Results Cognitive reserve mediated the openness-cognitive functioning association. Thus, individuals with higher openness showed greater cognitive reserve, and this greater cognitive reserve was associated with better cognitive functioning. Moreover, greater cognitive reserve at baseline also mediated the association between higher openness and slower cognitive decline. However, change in cognitive reserve did not mediate the association between openness and change in cognitive functioning. Conclusions Cognitive reserve is a mechanism underlying the association between openness and cognitive functioning and decline. These findings support the differential preservation hypothesis, suggesting that healthy older adults who engage in more cognitively stimulating activities would show less age-related cognitive decline

Acute cortisol levels and memory performance in older people with high and normal Body Mass Index

Previous studies have shown that healthy older adults may be less sensitive to the effects of acute cortisol levels on memory performance than young adults. Importantly, being overweight has recently been associated with an increase in both cortisol concentration and cortisol receptors in central tissues, suggesting that Body Mass Index (BMI) may contribute to differences in the relationship between memory and acute cortisol. This study investigates the role of BMI in the relationship between memory performance and acute cortisol levels in older people (M = 64.70 years; SD = 4.24). We measured cortisol levels and memory performance (working memory and declarative memory) in 33 participants with normal BMI (normal BMI = 18.50-24.99) and 36 participants with overweight BMI (overweight BMI = 25-29.99). Overweight BMI participants showed worse performance on word-list learning (p = .036, 95% CI [0.08, 2.18], eta(2)(p) = 0.07). Higher cortisol levels were related to higher proactive interference (beta = .364, p = .016, 95% CI [0.07, 0.66]), and BMI did not moderate any of the relationships investigated. In accordance with previous studies, our results show worse memory performance in individuals with overweight BMI. However, our results do not support the idea that memory performance in older people with higher BMI may be more sensitive to differences in acute cortisol levels than in older people with normal BMI. More research is needed to test this hypothesis with obese individuals (BMI > 30 Kg/cm(2))

Relationship between cortisol changes during the night and subjective and objective sleep quality in healthy older people

The aim of this study was to investigate whether the nighttime cortisol release was associated with subjective and objective sleep quality and the discrepancy between them. Forty-five healthy older adults (age range from 56 to 75 years) collected salivary samples immediately before sleep and immediately after awakening on two consecutive nights. Actigraphy was used to assess objective sleep quality and quantity. A sleep diary was used to assess subjective sleep quality. Linear mixed models were performed using subjective and objective sleep quality data from 76 nights to investigate between-subject associations. We observed that larger changes in cortisol levels between sleep onset and awakening, reflecting a healthier circadian rhythm of the Hypothalamic-Pituitary-Adrenal (HPA) axis, were associated with better subjective sleep quality, but not with objective sleep quality. Moreover, smaller changes in nighttime cortisol were associated with lower subjective sleep quality relative to objective sleep quality. All these results were observed even after controlling for important confounders such as sleep quantity, age, sex, subjective socioeconomic status, stress perception, depression, physical activity, and adherence to the salivary sampling protocol. This study demonstrates that subjective sleep quality in older people may be explained, to some extent, by the activity of the HPA axis

The relationship between cortisol and cognitive function in healthy older people : the moderating role of Apolipoprotein E polymorphism

The Apolipoprotein E4 (ApoE-epsilon 4) allele has been suggested as the main risk factor for late onset Alzheimer's disease (AD), whereas the ApoE-epsilon 2 allele has been proposed as a protective factor. These proposals have increased the interest in the effect of the ApoE genotype in healthy people. Additionally, high cortisol levels have been related to negative effects on cognition. However, few studies have investigated the relationship between cognitive performance and cortisol, taking into account the different ApoE alleles. For this reason, the aim of this study was to evaluate different cognitive domains (declarative and working memory, attention, and executive function) and their relationship with cortisol, considering the ApoE-epsilon 2, ApoE-epsilon 3, and ApoE-epsilon 4 alleles in healthy older people (55-77 years old). Two saliva samples were collected during the neuropsychological session to obtain cortisol levels and the ApoE genotype. Results showed an association between the ApoE genotype and declarative memory, specifically learning ability, where ApoE-epsilon 2 group performed better than ApoE-epsilon 4 and ApoE-epsilon 3 groups. No differences in cortisol levels were obtained considering the ApoE genotype. In addition, higher mean cortisol levels were related to a worse performance on declarative memory, for the whole sample, and when considering the three allelic variation, for the ApoE-epsilon 4 group. On the contrary, an increase of cortisol levels during the neuropsychological session was associated to a better performance on declarative memory for the whole sample, and for the ApoE-epsilon 3 group when considering the three alleles. Besides, ApoE-epsilon 3 group also showed an association between higher mean cortisol levels and a better attention performance. Therefore, our results suggest that carrying the ApoE-epsilon 4 allele may be a vulnerability factor in the adverse effects of Hypothalamic-Pituitary-Adrenal (HPA) axis dysregulation on cognition during aging, while ApoE-epsilon 3 allele could be associated to a more adaptive HPA axis response

La motivación de las tareas digitales mediante “pseudo-ApS” en Biología Celular del grado de Medicina

[ES] Los grupos tutorizados de la asignatura “Biología” de 1º de Medicina (Universitat de València) son un entorno estupendo en el que desarrollas actividades que aúnen el carácter formativo conceptual con el desarrollo competencial transversal. Para ello, en el curso 19-20, hemos implementado la vinculación de la cuenta institucional UV con Microsoft 365, gracias al convenio existente entre ambas entidades para facilitar la utilización de las Tecnologías de la Información y la Comunicación (TICs) en la gestión del tiempo y del intercambio de información. Se propone a los alumnos la elaboración de objetos de aprendizaje propios y originales, en formato animación, que serán utilizados durante los próximos dos años por otros estudiantes y en último término, por asociaciones externas, en un proyecto que trata de aunar el Aprendizaje-Servicio con la utilización de las TIC en un contexto en que el alumno se hace responsable de su aprendizaje y del de sus compañeros.[EN] The tutored groups of the subject “Biology” of 1st year of Medicine (Universitat de València) are a wonderful environment in which you develop activities that combine the character of conceptual training with the transversal development of competences. For this purpose, during the academic year 19-20, we have implemented the link between the UV institutional account with Microsoft 365, thanks to the existing agreement between both entities to facilitate the use of Information and Communication Technologies (ICTs) in the management of the time and information exchange. Students are proposed to create their own original learning objects, in animation format, which will be used over the next two years by other students and ultimately by external associations, in a project that tries to combine Service-Learning with the use of ICT in a context in which students are responsible for their own learning and that of his classmates.San-Miguel, T.; Megias, J.; Serna, E.; Calabuig, S.; Morales, JM.; Montoliu, C.; Monleón, D. (2021). La motivación de las tareas digitales mediante “pseudo-ApS” en Biología Celular del grado de Medicina. En IN-RED 2020: VI Congreso de Innovación Educativa y Docencia en Red. Editorial Universitat Politècnica de València. 866-873. https://doi.org/10.4995/INRED2020.2020.11966OCS86687

Is systematic training in opioid overdose prevention effective?

The objectives were to analyze the knowledge about overdose prevention, the use of naloxone, and the number of fatal overdoses after the implementation of Systematic Training in Overdose Prevention (STOOP) program. We conducted a quasi-experimental study, and held face-to-face interviews before (n = 725) and after (n = 722) implementation of systematic training in two different samples of people who injected opioids attending harm reduction centers. We asked participants to list the main causes of overdose and the main actions that should be taken when witnessing an overdose. We created two dependent variables, the number of (a) correct and (b) incorrect answers. The main independent variable was Study Group: Intervention Group (IG), Comparison Group (CG), Pre-Intervention Group With Sporadic Training in Overdose Prevention (PREIGS), or Pre-Intervention Group Without Training in Overdose Prevention (PREIGW). The relationship between the dependent and independent variables was assessed using a multivariate Poisson regression analysis. Finally, we conducted an interrupted time series analysis of monthly fatal overdoses before and after the implementation of systematic program during the period 2006-2015. Knowledge of overdose prevention increased after implementing systematic training program. Compared to the PREIGW, the IG gave more correct answers (IRR = 1.40;95%CI:1.33-1.47), and fewer incorrect answers (IRR = 0.33;95%CI:0.25-0.44). Forty percent of people who injected opioids who received a naloxone kit had used the kit in response to an overdose they witnessed. These courses increase knowledge of overdose prevention in people who use opioids, give them the necessary skills to use naloxone, and slightly diminish the number of fatal opioid overdoses in the city of Barcelon