Cortisol and the Brain

How Cortisol Can Affect Brain Function And Cognition

When our body is put under stress it goes into a fight or flight response that is facilitated by the release of the bodies stress hormone, cortisol. When the stressful situation passes, cortisol levels drop and return to normal resting levels. If our body is under chronic stress, our fight or flight response stays on and cortisol levels in our body remain at an elevated level. This can lead to several adverse health effects including altered mood, anxiety, depression, along with memory and concentration impairment.

Research shows that in healthy individuals cognitive processing improves until around age 60, plateaus until around age 80 and then starts to decline as we continue to age (1). In today’s world our bodies are constantly put under stress from work, COVID, family, and other stressors from daily life that causes chronically elevated cortisol levels, which can start to cause this decline at a much earlier age. Studies that have investigated individuals who are under constant stress have found “that elevated cortisol was associated with poorer overall cognitive functioning, as well as with poorer episodic memory, executive functioning, language, spatial memory, processing speed, and social cognition” (2). The same study has even found that patients with Alzheimer’s and dementia have higher cerebral spinal fluid cortisol levels when compared to cognitively healthy subjects.

Cortisol effects on the brain are exerted through two distinct receptors, inducing complex and even opposite effects on the cerebral structures implicated in the various cognitive functions. High cortisol may also have deleterious effects on the brain structures and contribute to neurodegeneration, in particular Alzheimer’s disease (AD), via different mechanisms.

High cortisol has also been linked to decreased volume of several brain regions involved in cognitive functions.  Elevated cortisol was found to be associated with decreased volumes in all brain regions, in particular the gray matter, with decreased total brain volume, in particular decreased occipital and frontal gray matter volumes. In addition,, increased cortisol levels were associated with some microstructural changes, specifically in the corpus callosum and the posterior corona radiate, as well as hippocampal atrophy.

There is a growing body of evidence that increased cortisol may be deleterious for the late-life cognitive performance, and may be associated with an increased risk for cognitive decline and dementia, in particular dementia due to AD. In patients with AD, the increased cortisol at preclinical and early clinical stages is associated with a poorer prognosis and a more rapid cognitive decline. Increased cortisol may represent a pathophysiological mediator between stressful life events, personality, mood, and sleep, and may increase both the risk of AD and the extent of symptoms at clinical stages of the disease. Yet, the exact underlying mediating factors are not fully understood.

Prolonged stress is often associated with health problems, such as heart disease, anxiety disorders, and sleep problems. A recent study published in Neurology reported that higher blood levels of the stress hormone cortisol are also associated with memory impairments and smaller brain volumes in young and middle-aged adults. This relationship was especially pronounced in women compared to men.

Managing proper cortisol levels is important to reduce your cognitive decline risk. Here is a suggested list of ways to maintain healthy cortisol levels:

  • Reduce stress
  • Cut out caffeine, or consume less
  • Reduce sugar intake
  • Avoid or limit alcohol
  • Stay hydrated
  • Stick to a regular meal schedule
  • Avoid stress foods
  • Sleep well
  • Laugh a lot
  • Regular exercise
  • Drink tea
  • Walk in nature
  • Meditate
  • Eat cortisol lowering foods (dark chocolate, bananas and pears, probiotics in yogurt) 

 Do you know where your brain stands compared to your peers?

We are currently recruiting candidates for a unique opportunity to assess and enhance cognitive health.  The Healthy Aging Brain Research Study is your chance to take charge of your brain health!  Apply for The Healthy Aging Brain Program Research Study here or click here to learn more about it!


Written by: Efan Gonsalves, PT, AT (retired) Clinical Director- Markham 



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