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Early and late life events and salivary cortisol in older persons

  • L. Gerritsen (a1), M. I. Geerlings (a1), A. T. F. Beekman (a2), D. J. H. Deeg (a2), B. W. J. H. Penninx (a2) and H. C. Comijs (a2)...

Abstract

Background

It has been hypothesized that stressful life events are associated with changes in hypothalamic–pituitary–adrenal (HPA) axis regulation, which increases susceptibility to psychiatric disorders. We investigated the association of early and late life events with HPA axis regulation in older persons.

Method

Within the Longitudinal Aging Study Amsterdam (LASA) 1055 participants (47% male), aged 63–93 years, collected saliva within 30 min after waking and late in the evening. Early and late life events were assessed during a home interview. The associations between life events and cortisol levels were examined using linear regression and analysis of covariance with adjustments for demographics, cardiovascular risk factors and depressive symptoms.

Results

Within our sample, the median morning and evening cortisol levels were 15.0 nmol/l [interdecile range (10–90%): 7.4–27.0 nmol/l] and 2.8 nmol/l (10–90%: 1.5–6.3 nmol/l), respectively. Persons who reported early life events showed lower levels of natural log-transformed morning cortisol [B=−0.10, 95% confidence interval (CI) −0.17 to −0.04] and flattened diurnal variability of cortisol (B=−1.06, 95% CI −2.05 to −0.08). Those reporting two or more late life events showed higher levels of natural log-transformed morning cortisol (B=0.10, 95% CI 0.02–0.18) and higher diurnal variability (B=1.19, 95% CI 0.05–2.33). No associations were found with evening cortisol.

Conclusions

The results of this large population-based study of older persons suggest a differential association of early and late life events with HPA axis regulation; early life events were associated with a relative hypo-secretion of morning cortisol and flattened diurnal variability, while late life events were associated with elevated secretion of morning cortisol and high diurnal variability of cortisol.

Copyright

Corresponding author

*Address for correspondence: H. C. Comijs, VU University Medical Center, Department of Psychiatry, EMGO Institute, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands. (Email: h.comijs@vumc.nl)

References

Hide All
Badrick, E, Bobak, M, Britton, A, Kirschbaum, C, Marmot, M, Kumari, M (2008). The relationship between alcohol consumption and cortisol secretion in an aging cohort. Journal of Clinical Endocrinology and Metabolism 93, 750757.
Beekman, AT, Deeg, DJH, van Limbeek, J, Braam, AW, de Vries, MZ, van Tilburg, T (1997). Criterion validity of the Center for Epidemiologic Studies Depression Scale (CES-D): results from a community based sample of older subjects in the Netherlands. Psychological Medicine 27, 231235.
Boyce, WT, Ellis, BJ (2005). Biological sensitivity to context: I. An evolutionary–developmental theory of the origins and functions of stress reactivity. Developmental Psychopathology 17, 271301.
Bremner, D, Vermetten, E, Kelley, ME (2007). Cortisol, dehydroepiandrosterone, and estradiol measured over 24 hours in women with childhood sexual abuse-related posttraumatic stress disorder. Journal of Nervous and Mental Disease 195, 919927.
Bremner, JD, Vermetten, E, Mazure, CM (2000). Development and preliminary psychometric properties of an instrument for the measurement of childhood trauma: the Early Trauma Inventory. Depression and Anxiety 12, 112.
Brilman, EI, Ormel, J (2001). Life events, difficulties and onset of depressive episodes in later life. Psychological Medicine 31, 859869.
Checkley, S (1996). The neuroendocrinology of depression and chronic stress. British Medical Bulletin 52, 597617.
Comijs, H, Beekman, AT, Smit, F, Bremmer, M, van Tilburg, T, Deeg, DJ (2007). Childhood adversity, recent life events and depression in later life. Journal of Affective Disorders 103, 243246.
de Beurs, E, Beekman, A, Geerlings, S, Deeg, D, van Dyck, R, van Tilburg, W (2001). On becoming depressed or anxious in late life: similar vulnerability factors but different effects of stressful life events. British Journal of Psychiatry 179, 426431.
Deeg, DJ, van Tilburg, T, Smit, JH, de Leeuw, ED (2002). Attrition in the Longitudinal Aging Study Amsterdam. The effect of differential inclusion in side studies. Journal of Clinical Epidemiology 55, 319328.
Elzinga, BM, Roelofs, K, Tollenaar, MS, Bakvis, P, van Pelt, J, Spinhoven, P (2008). Diminished cortisol responses to psychosocial stress associated with lifetime adverse events: a study among healthy young subjects. Psychoneuroendocrinology 33, 227237.
Essex, MJ, Klein, MH, Cho, E, Kalin, NH (2002). Maternal stress beginning in infancy may sensitize children to later stress exposure: effects on cortisol and behavior. Biological Psychiatry 52, 776784.
Fink, LA, Bernstein, D, Handelsman, L, Foote, J, Lovejoy, M (1995). Initial reliability and validity of the childhood trauma interview: a new multidimensional measure of childhood interpersonal trauma. American Journal of Psychiatry 152, 13291335.
Folstein, MF, Folstein, SE, McHugh, PR (1975). ‘Mini-Mental-State’: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatry Research 12, 189198.
Fries, E, Dettenborn, L, Kirschbaum, C (2009). The cortisol awakening response (CAR): facts and future directions. International Journal of Psychophysiology 72, 6773.
Goodyer, IM, Herbert, J, Tamplin, A, Altham, PM (2000). Recent life events, cortisol, dehydroepiandrosterone and the onset of major depression in high-risk adolescents. British Journal of Psychiatry 177, 499504.
Gunnar, M, Quevedo, K (2007). The neurobiology of stress and development. Annual Review of Psychology 58, 145173.
Gunnar, MR, Vazquez, DM (2001). Low cortisol and a flattening of expected daytime rhythm: potential indices of risk in human development. Developmental Psychopathology 13, 515538.
Halligan, SL, Herbert, J, Goodyer, IM, Murray, L (2004). Exposure to postnatal depression predicts elevated cortisol in adolescent offspring. Biological Psychiatry 55, 376381.
Hardy, SE, Concato, J, Hill, TM (2002). Stressful life events among community-living older persons. Journal of General Internal Medicine 17, 841847.
Harkness, KL, Monroe, SM (2002). Childhood adversity and the endogenous versus nonendogenous distinction in women with major depression. American Journal of Psychiatry 159, 387393.
Harris, TO, Borsanyi, S, Messari, S, Stanford, K, Cleary, SE, Shiers, HM, Brown, GW, Herbert, J (2000). Morning cortisol as a risk factor for subsequent major depressive disorder in adult women. British Journal of Psychiatry 177, 505510.
Heim, C, Ehlert, U, Hellhammer, D (2000 a). The potential role of hypocortisolism in the pathophysiology of stress-related bodily disorders. Psychoneuroendocrinology 25, 135.
Heim, C, Newport, DJ, Bonsall, R, Miller, AH, Nemeroff, CB (2001). Altered pituitary–adrenal axis responses to provocative challenge tests in adult survivors of childhood abuse. American Journal of Psychiatry 158, 575581.
Heim, C, Newport, DJ, Heit, S, Graham, YP, Wilcox, M, Bonsall, R, Miller, AH, Nemeroff, CB (2000 b). Pituitary–adrenal and autonomic responses to stress in women after sexual and physical abuse in childhood. Journal of the American Medical Association 284, 592597.
Holsboer, F (2000). The corticosteroid receptor hypothesis of depression. Neuropsychopharmacology 23, 477501.
Kendler, KS, Karkowski, LM, Prescott, CA (1999). Causal relationship between stressful life events and the onset of major depression. American Journal of Psychiatry 156, 837841.
Kraemer, HC, Giese-Davis, J, Yutsis, M, O'Hara, R, Nevi, E, Gallagher-Thompson, D, Taylor, B, Spiegel, D (2006). Design decisions to optimize reliability of daytime cortisol slopes in an older population. American Journal of Geriatric Psychiatry 14, 325333.
Kriegsman, DM, Penninx, BW, van Eijk, JT, Boeke, AJ, Deeg, DJ (1996). Self-report and general practitioner information on the presence of chronic diseases in community dwelling elderly. A study on the accuracy of patients' self-report and on determinants of inaccuracy. Journal of Clinical Epidemiology 49, 14071417.
Kudielka, BM, Buske-Kirschbaum, A, Hellhammer, DH, Kirschbaum, C (2004). HPA axis responses to laboratory psychosocial stress in healthy elderly adults, younger adults, and children: impact of age and gender. Psychoneuroendocrinology 29, 8398.
Kudielka, BM, Kirschbaum, C (2003). Awakening cortisol responses are influenced by health status and awakening time but not by menstrual cycle phase. Psychoneuroendocrinology 28, 3547.
Lauc, G, Zvonar, K, Vuksic-Mihaljevic, Z, Flögel, M (2004). Post-awakening changes in salivary cortisol in veterans with and without PTSD. Stress and Health 20, 99102.
McEwen, BS (1998). Protective and damaging effects of stress mediators. New England Journal of Medicine 338, 171179.
McEwen, BS (2000). Effects of adverse experiences for brain structure and function. Biological Psychiatry 48, 721731.
Meewisse, ML, Reitsma, JB, de Vries, GJ, Gersons, BP, Olff, M (2007). Cortisol and post-traumatic stress disorder in adults: systematic review and meta-analysis. British Journal of Psychiatry 191, 387392.
Miller, GE, Chen, E, Zhou, ES (2007). If it goes up, must it come down? Chronic stress and the hypothalamic–pituitary–adrenocortical axis in humans. Psychological Bulletin 133, 2545.
Nemeroff, CB (1996). The corticotropin-releasing factor (CRF) hypothesis of depression: new findings and new directions. Molecular Psychiatry 1, 336342.
Otte, C, Hart, S, Neylan, TC, Marmar, CT, Yaffe, K, Mohr, DC (2005). A meta-analysis on cortisol response to challenge in human aging: importance of gender. Psychoneuroendocrinology 30, 8091.
Peeters, GM, van Schoor, NM, van Rossum, EF, Visser, M, Lips, P (2008). The relationship between cortisol, muscle mass and muscle strength in older persons and the role of genetic variations in the glucocorticoid receptor. Clinical Endocrinology 69, 673682.
Pico-Alfonso, MA, Garcia-Linares, MI, Celda-Navarro, N, Herbert, J, Martinez, M (2004). Changes in cortisol and dehydroepiandrosterone in women victims of physical and psychological intimate partner violence. Biological Psychiatry 56, 233240.
Pitman, RK, Orr, SP (1990). Twenty-four hour urinary cortisol and catecholamine excretion in combat-related posttraumatic stress disorder. Biological Psychiatry 27, 245247.
Radloff, LS (1977). The CES-D scale: a self-report depression scale for research in the general population. Applied Psychological Measurement 1, 385401.
Rasmusson, AM, Lipschitz, DS, Wang, S, Hu, S, Vojvoda, D, Bremner, JD, Southwick, SM, Charney, DS (2001). Increased pituitary and adrenal reactivity in premenopausal women with posttraumatic stress disorder. Biological Psychiatry 50, 965977.
Schilling, EA, Aseltine, RH, Gore, S (2008). The impact of cumulative childhood adversity on young adult mental health: measures, models, and interpretations. Social Science and Medicine 66, 11401151.
Selye, H (1937). The significance of the adrenals for adaptation. Science 85, 247248.
Smeets, T, Geraerts, E, Jelicic, M, Merckelbach, H (2007). Delayed recall of childhood sexual abuse memories and the awakening rise and diurnal pattern of cortisol. Psychiatry Research 152, 197204.
Strickland, PL, Deakin, JF, Percival, C, Dixon, J, Gater, RA, Goldberg, DP (2002). Bio-social origins of depression in the community. Interactions between social adversity, cortisol and serotonin neurotransmission. British Journal of Psychiatry 180, 168173.
Tennant, C, Andrews, G (1976). A scale to measure the stress of life events. Australian and New Zealand Journal of Psychiatry 10, 2732.
Vreeburg, SA, Kruijtzer, BP, van Pelt, J, van Dyck, R, Derijk, RH, Hoogendijk, WJ, Smit, JH, Zitman, FG, Penninx, BW (2009). Associations between sociodemographic, sampling and health factors and various salivary cortisol indicators in a large sample without psychopathology. Psychoneuroendocrinology 34, 11091120.
Weems, CF, Carrion, VG (2007). The association between PTSD symptoms and salivary cortisol in youth: the role of time since the trauma. Journal of Traumatic Stress 20, 903907.
Wust, S, Wolf, J, Hellhammer, DH, Federenko, I, Schommer, N, Kirschbaum, C (2000). The cortisol awakening response – normal values and confounds. Noise and Health 2, 7988.
Yehuda, R, Morris, A, Labinsky, E, Zemelman, S, Schmeidler, J (2007). Ten-year follow-up study of cortisol levels in aging holocaust survivors with and without PTSD. Journal of Traumatic Stress 20, 757761.
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