Evidence map›Paper›PMID 30355700›Full record

ArticleNeurology2018

Circulating cortisol and cognitive and structural brain measures: The Framingham Heart Study.

Justin B Echouffo-Tcheugui, Sarah C Conner, Jayandra J Himali, Pauline Maillard, Charles S DeCarli, Alexa S Beiser, Ramachandran S Vasan, Sudha Seshadri

Open access · bronzeAbstract read
In one paragraph

Article in Neurology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 70 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
70citing papers in PubMed, 2 pooled it
6.2field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

70 citing papers in PubMed, 2 syntheses or guidelines pooled it, 138 citations in OpenAlex.

  1. Social isolation and its impact on child and adolescent development: a systematic review.Revista paulista de pediatria : orgao oficial da Sociedade de Pediatria de Sao Paulo · 2021
    Pooled it
  2. Pooled it
  3. Trial
  4. Trial
  5. Trial
  6. Article
  7. Article
  8. Article
  9. Synergistic association of insomnia and anxiety with cognitive impairment and dementia in older adults.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026
    Article
  10. Article
  11. Article
  12. Observational
  13. Observational
  14. Mechanistic insights into the liver-brain axis during chronic liver disease.Nature reviews. Gastroenterology & hepatology · 2026
    Review
  15. Review
  16. Article
  17. Review
  18. Article
  19. Cortisol, Anxiety, and TNFα Mediate the Relationship Between BMI and Executive Functions.Stress and health : journal of the International Society for the Investigation of Stress · 2025
    Article
  20. Article

10 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 5 institutions in 1 country.

Justin B Echouffo-TcheuguiFrom the Division of Endocrinology, Diabetes and Hypertension (J.B.E.-T.), Brigham and Women's Hospital/Harvard Medical School, Boston; National Heart, Lung, and Blood Institute (J.B.E.-T., S.C.C., J.J.H., A.S.B., R.S.V., S.S.), Framingham Heart Study, MA; Department of Neurology (S.C.C., J.J.H., A.S.B., S.S.) and Sections of Preventive Medicine and Epidemiology (R.S.V.) and Cardiology (R.S.V.), Department of Medicine, Boston University School of Medicine; Departments of Biostatistics (J.J.H., A.S.B.) and Epidemiology (R.S.V.), Boston University School of Public Health, MA; Department of Neurology (P.M., C.S.D.), University of California, Davis, Sacramento; and Glenn Biggs Institute of Alzheimer's and Neurodegenerative Diseases (S.S.), University of Texas Health Sciences Center, San Antonio. jechouffotcheugui@bwh.harvard.edu echouffotcheugui@gmail.com.
Sarah C ConnerFrom the Division of Endocrinology, Diabetes and Hypertension (J.B.E.-T.), Brigham and Women's Hospital/Harvard Medical School, Boston; National Heart, Lung, and Blood Institute (J.B.E.-T., S.C.C., J.J.H., A.S.B., R.S.V., S.S.), Framingham Heart Study, MA; Department of Neurology (S.C.C., J.J.H., A.S.B., S.S.) and Sections of Preventive Medicine and Epidemiology (R.S.V.) and Cardiology (R.S.V.), Department of Medicine, Boston University School of Medicine; Departments of Biostatistics (J.J.H., A.S.B.) and Epidemiology (R.S.V.), Boston University School of Public Health, MA; Department of Neurology (P.M., C.S.D.), University of California, Davis, Sacramento; and Glenn Biggs Institute of Alzheimer's and Neurodegenerative Diseases (S.S.), University of Texas Health Sciences Center, San Antonio.
Jayandra J HimaliFrom the Division of Endocrinology, Diabetes and Hypertension (J.B.E.-T.), Brigham and Women's Hospital/Harvard Medical School, Boston; National Heart, Lung, and Blood Institute (J.B.E.-T., S.C.C., J.J.H., A.S.B., R.S.V., S.S.), Framingham Heart Study, MA; Department of Neurology (S.C.C., J.J.H., A.S.B., S.S.) and Sections of Preventive Medicine and Epidemiology (R.S.V.) and Cardiology (R.S.V.), Department of Medicine, Boston University School of Medicine; Departments of Biostatistics (J.J.H., A.S.B.) and Epidemiology (R.S.V.), Boston University School of Public Health, MA; Department of Neurology (P.M., C.S.D.), University of California, Davis, Sacramento; and Glenn Biggs Institute of Alzheimer's and Neurodegenerative Diseases (S.S.), University of Texas Health Sciences Center, San Antonio.
Pauline MaillardFrom the Division of Endocrinology, Diabetes and Hypertension (J.B.E.-T.), Brigham and Women's Hospital/Harvard Medical School, Boston; National Heart, Lung, and Blood Institute (J.B.E.-T., S.C.C., J.J.H., A.S.B., R.S.V., S.S.), Framingham Heart Study, MA; Department of Neurology (S.C.C., J.J.H., A.S.B., S.S.) and Sections of Preventive Medicine and Epidemiology (R.S.V.) and Cardiology (R.S.V.), Department of Medicine, Boston University School of Medicine; Departments of Biostatistics (J.J.H., A.S.B.) and Epidemiology (R.S.V.), Boston University School of Public Health, MA; Department of Neurology (P.M., C.S.D.), University of California, Davis, Sacramento; and Glenn Biggs Institute of Alzheimer's and Neurodegenerative Diseases (S.S.), University of Texas Health Sciences Center, San Antonio.
Charles S DeCarliFrom the Division of Endocrinology, Diabetes and Hypertension (J.B.E.-T.), Brigham and Women's Hospital/Harvard Medical School, Boston; National Heart, Lung, and Blood Institute (J.B.E.-T., S.C.C., J.J.H., A.S.B., R.S.V., S.S.), Framingham Heart Study, MA; Department of Neurology (S.C.C., J.J.H., A.S.B., S.S.) and Sections of Preventive Medicine and Epidemiology (R.S.V.) and Cardiology (R.S.V.), Department of Medicine, Boston University School of Medicine; Departments of Biostatistics (J.J.H., A.S.B.) and Epidemiology (R.S.V.), Boston University School of Public Health, MA; Department of Neurology (P.M., C.S.D.), University of California, Davis, Sacramento; and Glenn Biggs Institute of Alzheimer's and Neurodegenerative Diseases (S.S.), University of Texas Health Sciences Center, San Antonio.
Alexa S BeiserFrom the Division of Endocrinology, Diabetes and Hypertension (J.B.E.-T.), Brigham and Women's Hospital/Harvard Medical School, Boston; National Heart, Lung, and Blood Institute (J.B.E.-T., S.C.C., J.J.H., A.S.B., R.S.V., S.S.), Framingham Heart Study, MA; Department of Neurology (S.C.C., J.J.H., A.S.B., S.S.) and Sections of Preventive Medicine and Epidemiology (R.S.V.) and Cardiology (R.S.V.), Department of Medicine, Boston University School of Medicine; Departments of Biostatistics (J.J.H., A.S.B.) and Epidemiology (R.S.V.), Boston University School of Public Health, MA; Department of Neurology (P.M., C.S.D.), University of California, Davis, Sacramento; and Glenn Biggs Institute of Alzheimer's and Neurodegenerative Diseases (S.S.), University of Texas Health Sciences Center, San Antonio.
Ramachandran S VasanFrom the Division of Endocrinology, Diabetes and Hypertension (J.B.E.-T.), Brigham and Women's Hospital/Harvard Medical School, Boston; National Heart, Lung, and Blood Institute (J.B.E.-T., S.C.C., J.J.H., A.S.B., R.S.V., S.S.), Framingham Heart Study, MA; Department of Neurology (S.C.C., J.J.H., A.S.B., S.S.) and Sections of Preventive Medicine and Epidemiology (R.S.V.) and Cardiology (R.S.V.), Department of Medicine, Boston University School of Medicine; Departments of Biostatistics (J.J.H., A.S.B.) and Epidemiology (R.S.V.), Boston University School of Public Health, MA; Department of Neurology (P.M., C.S.D.), University of California, Davis, Sacramento; and Glenn Biggs Institute of Alzheimer's and Neurodegenerative Diseases (S.S.), University of Texas Health Sciences Center, San Antonio.
Sudha SeshadriFrom the Division of Endocrinology, Diabetes and Hypertension (J.B.E.-T.), Brigham and Women's Hospital/Harvard Medical School, Boston; National Heart, Lung, and Blood Institute (J.B.E.-T., S.C.C., J.J.H., A.S.B., R.S.V., S.S.), Framingham Heart Study, MA; Department of Neurology (S.C.C., J.J.H., A.S.B., S.S.) and Sections of Preventive Medicine and Epidemiology (R.S.V.) and Cardiology (R.S.V.), Department of Medicine, Boston University School of Medicine; Departments of Biostatistics (J.J.H., A.S.B.) and Epidemiology (R.S.V.), Boston University School of Public Health, MA; Department of Neurology (P.M., C.S.D.), University of California, Davis, Sacramento; and Glenn Biggs Institute of Alzheimer's and Neurodegenerative Diseases (S.S.), University of Texas Health Sciences Center, San Antonio.
National Heart Lung and Blood Institute · USFramingham Heart Study · USBoston University · USBrigham and Women's Hospital · USUniversity of California, Davis · US

Funding

UC Davis Alzheimer's Disease Core CenterP30AG010129 · NIA · UNIVERSITY OF CALIFORNIA DAVIS · PI DECARLI, CHARLES · 1991 to 2020
$28.3M
PRECURSORS OF STROKE INCIDENCE AND PROGNOSISR01NS017950 · NINDS · UNIVERSITY OF TEXAS HLTH SCIENCE CENTER · PI Hugo Javier Aparicio, Jose Rafael Romero · 1985 to 2026
$22.9M
EPIDEMIOLOGY OF DEMENTIA IN THE FRAMINGHAM STUDYR01AG008122 · NIA · BOSTON UNIVERSITY MEDICAL CAMPUS · PI AU, RHODA, SESHADRI, SUDHA · 1989 to 2015
$14.4M
Temporal Trends, Novel Imaging and Molecular Characterization of Preclinical and Clinical Alzheimer's Disease in the Framingham CohortsR01AG054076 · NIA · UNIVERSITY OF TEXAS HLTH SCIENCE CENTER · PI DECARLI, CHARLES, SESHADRI, SUDHA · 2016 to 2020
$12.3M
MRI, Cognitive, Genetic & Biomarker Precursors of AD & Dementia in Young AdultsR01AG033040 · NIA · BOSTON UNIVERSITY MEDICAL CAMPUS · PI AU, RHODA, SESHADRI, SUDHA · 2009 to 2019
$11.2M
Multidisciplinary Training Program in Cardiovascular EpidemiologyT32HL125232 · NHLBI · BOSTON UNIVERSITY MEDICAL CAMPUS · PI Matthew G. Nayor, Vanessa Xanthakis · 2016 to 2026
$5.0M
Collaborative GWAS of Dementia, AD and related MRI and Cognitive EndophenotypesR01AG033193 · NIA · BOSTON UNIVERSITY MEDICAL CAMPUS · PI SESHADRI, SUDHA · 2009 to 2016
$4.4M
CHARGE: Identifying Risk & Protective SNV for AD in ADSP Case-control SampleU01AG049505 · NIA · UNIVERSITY OF TEXAS HLTH SCIENCE CENTER · PI SESHADRI, SUDHA · 2014 to 2017
$3.0M
Vascular Stiffness as a Precursor of Hypertension in a Middle-aged CohortR01HL126136 · NHLBI · BOSTON UNIVERSITY MEDICAL CAMPUS · PI MITCHELL, GARY FRANK, RAMACHANDRAN, VASAN S · 2015 to 2018
$2.6M
Aortic Dysfunction, Pulsatile Stress and Target Organ Damage in FraminghamR01HL107385 · NHLBI · BOSTON UNIVERSITY MEDICAL CAMPUS · PI MITCHELL, GARY FRANK, RAMACHANDRAN, VASAN S · 2011 to 2014
$2.6M
Genome-wide Association Study of Cardiac Structure and FunctionR01HL093328 · NHLBI · BOSTON UNIVERSITY MEDICAL CAMPUS · PI RAMACHANDRAN, VASAN S · 2008 to 2011
$2.4M
Microglial, Inflammatory and Omics Markers of Cerebral Small Vessel Disease in the CHARGE ConsortiumUH2NS100605 · NINDS · BOSTON UNIVERSITY MEDICAL CAMPUS · PI FORNAGE, MYRIAM, SESHADRI, SUDHA · 2016 to 2017
$2.0M
NHLBI NIH HHS HHSN268201500001CNHLBI NIH HHS HHSN268201500001INHLBI NIH HHS N01 HC025195NHLBI NIH HHS R01 HL093328NHLBI NIH HHS R01 HL107385NHLBI NIH HHS R01 HL126136NHLBI NIH HHS T32 HL125232NIA NIH HHS P30 AG010129NIA NIH HHS R01 AG008122NIA NIH HHS R01 AG033040NIA NIH HHS R01 AG033193NIA NIH HHS R01 AG054076NIA NIH HHS U01 AG049505NIA NIH HHS U01 AG052409NINDS NIH HHS R01 NS017950NINDS NIH HHS UH2 NS100605
6 · The paper itself

Abstract

objectiveTo assess the association of early morning serum cortisol with cognitive performance and brain structural integrity in community-dwelling young and middle-aged adults without dementia.

methodsWe evaluated dementia-free Framingham Heart Study (generation 3) participants (mean age 48.5 years, 46.8% men) who underwent cognitive testing for memory, abstract reasoning, visual perception, attention, and executive function (n = 2,231) and brain MRI (n = 2018) to assess total white matter, lobar gray matter, and white matter hyperintensity volumes and fractional anisotropy (FA) measures. We used linear and logistic regression to assess the relations of cortisol (categorized in tertiles, with the middle tertile as referent) to measures of cognition, MRI volumes, presence of covert brain infarcts and cerebral microbleeds, and voxel-based microstructural white matter integrity and gray matter density, adjusting for age, sex,

resultsHigher cortisol (highest tertile vs middle tertile) was associated with worse memory and visual perception, as well as lower total cerebral brain and occipital and frontal lobar gray matter volumes. Higher cortisol was associated with multiple areas of microstructural changes (decreased regional FA), especially in the splenium of corpus callosum and the posterior corona radiata. The association of cortisol with total cerebral brain volume varied by sex (

conclusionHigher serum cortisol was associated with lower brain volumes and impaired memory in asymptomatic younger to middle-aged adults, with the association being evident particularly in women.

Indexed as

AdultAgedBrainCognitionFemaleHumansHydrocortisoneLongitudinal StudiesMaleMiddle AgedHydrocortisone

Identifiers

PMID30355700
PMCPMC6260201
OpenAlexW2898451626

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.