Examining HPA-axis functioning as a mediator of the relationship between depression and cognition across the adult lifespan

Aimee James Karstens, Inez Korzun, Erich T. Avery, Michelle T. Kassel, Rachel Keelan, Helen Kales, Heather Abercrombie, Tory Eisenlohr-Moul, Scott A. Langenecker, Sara Weisenbach

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Altered HPA-axis functioning is a hypothesized mechanism for worsened cognition in depression. The current study examines the indirect effects of depression on processing speed, executive functioning, and memory as a function of the HPA-axis. 38 individuals with a depression diagnosis and 50 healthy controls (HCs) aged 18–86 underwent neuropsychological testing and at-home diurnal salivary cortisol collection. Depression was assessed via structured clinical interviews and rating scales. Cognitive composite scores were derived from factor analysis. Daytime cortisol exposure was estimated using area under the curve (AUC). Depression was associated with higher cortisol levels and slower processing speed. A significant suppression effect of AUC was present on the relationship between depression and processing speed. Limitations include the cross-sectional design and limited sample heterogeneity. Though poorly modulated HPA-axis is one proposed mechanism of cognitive alterations in depression, our results did not support this conclusion for processing speed. Alternative mechanisms should be considered to inform interventions to target cognitive alterations in depression.

Original languageEnglish (US)
Pages (from-to)507-520
Number of pages14
JournalAging, Neuropsychology, and Cognition
Issue number4
StatePublished - Jul 4 2019
Externally publishedYes


  • cognition
  • cortisol
  • Depression
  • HPA-axis
  • memory
  • speeded processing

ASJC Scopus subject areas

  • Neuropsychology and Physiological Psychology
  • Experimental and Cognitive Psychology
  • Geriatrics and Gerontology
  • Psychiatry and Mental health


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