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Diurnal cortisol and mental well-being in middle and older age: evidence from four cohort studies.

ABSTRACT: OBJECTIVES:We conducted an individual participant meta-analysis to test the hypothesis that cortisol patterns indicative of dysregulated hypothalamic-pituitary-adrenal axis functioning would be prospectively associated with poorer well-being at follow-up. SETTING:Four large UK-based cohort studies. PARTICIPANTS:Those providing valid salivary or serum cortisol samples (n=7515 for morning cortisol; n=1612 for cortisol awakening response) at baseline (age 44-82) and well-being data on the Warwick Edinburgh Mental Wellbeing Scale at follow-up (0-8 years) were included. RESULTS:Well-being was not associated with morning cortisol, diurnal slope or awakening response though a borderline association with evening cortisol was found. Adjusting for sex and follow-up time, each 1 SD increase in evening cortisol was associated with a -0.47 (95% CI -1.00 to 0.05) point lower well-being. This was attenuated by adjustment for body mass index, smoking and socioeconomic position. Between-study heterogeneity was low. CONCLUSIONS:This study does not support the hypothesis that diurnal cortisol is prospectively associated with well-being up to 8 years later. However, replication in prospective studies with cortisol samples over multiple days is required.

SUBMITTER: Stafford M

PROVIDER: S-EPMC5652457 | biostudies-other | 2017 Oct

REPOSITORIES: biostudies-other

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Diurnal cortisol and mental well-being in middle and older age: evidence from four cohort studies.

Stafford Mai M Ben-Shlomo Yoav Y Cooper Cyrus C Gale Catharine C Gardner Michael P MP Geoffroy Marie-Claude MC Power Chris C Kuh Diana D Cooper Rachel R

BMJ open 20171012 10

<h4>Objectives</h4>We conducted an individual participant meta-analysis to test the hypothesis that cortisol patterns indicative of dysregulated hypothalamic-pituitary-adrenal axis functioning would be prospectively associated with poorer well-being at follow-up.<h4>Setting</h4>Four large UK-based cohort studies.<h4>Participants</h4>Those providing valid salivary or serum cortisol samples (n=7515 for morning cortisol; n=1612 for cortisol awakening response) at baseline (age 44-82) and well-being ...[more]

PMID: 29025828

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Project description:Introduction:Although income is among the major social determinants of mental health of middle-aged and older individuals, socially marginalized groups gain less health from their income and other socioeconomic status (SES) resources compared to socially privileged groups. This pattern is called marginalization-related diminished returns (MDRs). Most of the existing knowledge on MDRs, however, has been derived from studies that have defined marginalization based on race, ethnicity, or sexual orientation. As a result, very limited information exists on whether similar MDRs can be observed for middle-aged and older immigrants or not. Building on the MDRs framework, this study compared a national sample of immigrants and non-immigrants for the effects of income on the mental well-being of middle-aged and older adults in the United States. Methods:This is a cross-sectional study. The 2015 National Health Interview Survey (NHIS) enrolled 14?149 middle-aged and older individuals who were either immigrants (n=1977; 14.0%) or non-immigrants (n=12?166; 86.0%). The independent variable (IV) was income that was treated as a continuous variable. The dependent variable was mental well-being, also treated as a continuous variable. Age, gender, race, ethnicity, education, marital status, employment, self-rated health, obesity, and region were confounders. Immigration (nativity status) was the moderator. Logistic regression was applied for data analysis. Results:High income was associated with higher odds of good mental well-being in middle-aged and older adults. However, immigration showed a significant statistical interaction with income, which was suggestive of a smaller protective effect of high income on mental well-being for immigrant than non-immigrant middle-aged and older adults. Conclusion:In line with MDRs, the association between income and mental well-being is weaker for immigrant than non-immigrant middle-aged and older adults. There is a need to help high income immigrants secure health outcomes similar to those of non-immigrants. Such changes may require bold and innovative economic, public, and social policies that help immigrants more effectively translate their income and socioeconomic resources into tangible outcomes such as mental well-being.

Dataset Information

Diurnal cortisol and mental well-being in middle and older age: evidence from four cohort studies.

Publications

Diurnal cortisol and mental well-being in middle and older age: evidence from four cohort studies.

Similar Datasets

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