Design Decisions to Optimize Reliability of Daytime Cortisol Slopes in an Older Population

Kraemer, Helena C.; Giese‐Davis, Janine; Yutsis, Maya; O’Hara, Ruth; Neri, Eric; Gallagher‐Thompson, Dolores; Taylor, C. Barr; Spiegel, David

doi:10.1097/01.jgp.0000201816.26786.5b

Cited by 150 publications

(149 citation statements)

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“…This yields a slope value for each participant. The sample obtained upon awakening was used as the slope anchor (Kraemer et al, 2006) and the second sample (30 min after waking) was excluded from the estimation of the slopes (Cohen et al, 2006). Repeated measures ANOVA was used to examine the diurnal cortisol rhythm, first in relation to age cohort, and second, in relation to age cohort and each separate psychosocial variable, in order to test main effects of age and psychosocial variables, and any interaction effects.…”

Section: Discussionmentioning

confidence: 99%

Ageing, depression, anxiety, social support and the diurnal rhythm and awakening response of salivary cortisol

Heaney¹,

Phillips²,

Carroll³

2010

International Journal of Psychophysiology

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The present study compared the cortisol awakening response and diurnal rhythm in 24 young healthy students and 48 community-dwelling older adults. The associations with diurnal cortisol and depression, anxiety and social support were also examined in relation to age. Salivary cortisol was measured over the course of one day: immediately upon awakening, 30 min later, and then 3 h, 6 h, 9 h and 12 h post-awakening. Participants completed a questionnaire measuring symptoms of anxiety and depression and social support was assessed. Older adults exhibited a significantly reduced awakening response, overall cortisol levels, area under the curve (AUC) and diurnal slopes than younger adults, resulting in a flatter diurnal rhythm. Younger adults with higher depression scores had significantly higher overall cortisol and higher levels upon awakening and 30 min postawakening. In the younger adults, anxiety and depression correlated positively with AUC and the cortisol awakening response (CAR). Older adults with lower social support had a reduced AUC where younger adults with lower social support displayed a larger AUC. These findings suggest that the diurnal rhythm and awakening response of salivary cortisol are significantly reduced in older adults and the associations between anxiety, depression and social support and diurnal cortisol vary with age.

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Section: Discussionmentioning

confidence: 99%

Ageing, depression, anxiety, social support and the diurnal rhythm and awakening response of salivary cortisol

Heaney¹,

Phillips²,

Carroll³

2010

International Journal of Psychophysiology

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“…Aggregate measures (AUC AG , AUC I , AUC TG ) were calculated for each day of sampling using equations previously reported (cf. Pruessner et al, 2003;Kraemer et al, 2006; see Table 1). Diurnal slope was estimated using two formulas (linear regression, rise over run), each with two different anchoring points (awake 0 , peak morning sample).…”

Section: Statistical Analysesmentioning

confidence: 99%

“…Among the awakening response measures, AUC AG is more stable and evidences moderate stability over 2 days of sampling (ICC = 0.69), while AUC I necessitates 5 days of sampling to reach comparable reliability (ICC = 0.65; Hellhammer et al, 2007). Diurnal slope also has moderate stability over 2 days (r = .45-.66;Kraemer et al, 2006). Interestingly, anchoring the diurnal slope to the awake sample (+0 min) rather than the +30 min post-awakening sample, has been found to be more stable in older adults (r s = .…”

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Stability of the diurnal cortisol profile in children and adolescents

Rotenberg

McGrath

Roy-Gagnon

et al. 2012

Psychoneuroendocrinology

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SummaryThe diurnal cortisol profile has been implicated in multiple physical and mental health conditions in children and adolescents; however, current knowledge regarding the stability of the diurnal cortisol profile is largely based on adults. Developmental changes throughout childhood and adolescence warrant examination of the stability of the diurnal cortisol profile during this stage in the lifecourse. The aim of the present study was to conduct a comprehensive evaluation of the diurnal cortisol profile in children and adolescents. Participants (N = 233; M = 12.40, SD = 1.83; 44.2% girls) in the Healthy Heart Project collected saliva samples, completed demographic questionnaires, and recorded bed and waking time. Intra-class correlations were calculated to evaluate the stability of aggregate and single sample measures of the diurnal cortisol profile. Total cortisol concentration (AUC TG , AUC AG ) and maximum sample were the most stable cortisol measures (ICC avg = 0.54). Dynamic measures (AUC I , slope; ICC avg = 0.22) and other single sample measures (awake, lunch, dinner, bedtime, morning random, day random; ICC avg = 0.28) were less stable. Of the developmentally relevant covariates tested, sleep duration, adrenarche, and time of awakening were most associated with cortisol values. Altogether, the diurnal cortisol profile yielded moderate to high stability in children and adolescents. These findings can inform methodological decisions regarding cortisol sampling protocols for children and adolescents. KeywordsCortisol; Stability; Children; Adolescents; HPA axis; Methodology Cortisol, the end product of the hypothalamic pituitary adrenal (HPA) axis, is released in a circadian fashion and in response to stress. The circadian rhythm of cortisol, or the diurnal cortisol profile, has been implicated in multiple physical and mental health conditions in children and adolescents, including asthma (Wolf et al., 2008;Dreger et al., 2010), bipolar disorder (Ellenbogen et al., 2006), major depression (Van den Bergh and Van Calster, 2009;Adam et al., 2010), and sleep disturbances (El-Sheikh et al., 2008), among others. However, * Corresponding author. jennifer.mcgrath@concordia.ca (J.J. McGrath). Conflict of interest statementAll authors declare that they have no conflict of interest.Psychoneuroendocrinology. Author manuscript; available in PMC 2018 January 09.Published in final edited form as: Psychoneuroendocrinology. 2012 December ; 37(12): 1981-1989. doi:10.1016/j.psyneuen.2012.014. CIHR Author ManuscriptCIHR Author Manuscript CIHR Author Manuscript the measurement of cortisol varies widely, and few studies have considered the stability of the diurnal cortisol profile in children and adolescents.The diurnal cortisol profile is characterized by cortisol levels that peak roughly 30 min after awakening (morning acrophase) and gradually decline throughout the day, reaching nadir at bedtime (Fries et al., 2009). The diurnal cortisol profile is described using aggregate measures such as: the awakening response, diurna...

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“…Our prior work comparing actual times recorded by participants at each saliva collection with the actual intervals between collection times recorded by Medication Event Monitoring Units indicated that older adults were highly compliant with the protocol. 48 Full details of our protocol are provided in Kraemer et al 48 Samples were stored at 801C before laboratory centrifugation and assays for salivary cortisol using luminescence immunoassay reagents provided by Immuno-Biological Laboratories, Inc. (Hamburg, Germany). Assay sensitivity was 0.015 mg/dl.…”

Section: Cortisol Measuresmentioning

confidence: 99%

Serotonin transporter polymorphism, memory and hippocampal volume in the elderly: association and interaction with cortisol

et al. 2007

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The s allele variant of the serotonin transporter gene (5-HTT) has recently been observed to moderate the relationship of stress to depression and anxiety. To date no study has considered interactive effects of 5-HTT genotype, stress and hypothalamic-pituitary-adrenal (HPA) function on cognition in healthy, older adults, which may reflect developmental, functional or neurodegenerative effects of the serotonin transporter polymorphism. We investigated whether 5-HTT genotype interacts with cumulative life stress and HPA-axis measures of waking and diurnal cortisol slope to impact cognition in 154 non-depressed, older adults. Structural images of hippocampal volume were acquired on a subsample of 56 participants. The 5-HTT s allele was associated with both significantly lower delayed recall and higher waking cortisol levels. Presence of the s allele interacted with higher waking cortisol to negatively impact memory. We also observed a significant interaction of higher waking cortisol and the s allele on lower hippocampal volume. Smaller hippocampi and higher cortisol were associated with lower delayed recall only in s allele carriers. No impact or interactions of cumulative life stress with 5-HTT or cortisol were observed. This is the first investigation to identify an association of the 5-HTT s allele with poorer memory function in older adults. The interactive effects of the s allele and waking cortisol levels on reduced hippocampal volume and lower memory suggest that the negative effect of the serotonin polymorphism on memory is mediated by the HPA axis. Further, given the significant association of the s allele with higher waking cortisol in our investigation, future studies may be needed to evaluate the impact of the serotonin transporter polymorphism on any neuropsychiatric or behavioral outcome which is influenced by HPA axis function in older adults.

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Design Decisions to Optimize Reliability of Daytime Cortisol Slopes in an Older Population

Cited by 150 publications

References 27 publications

Ageing, depression, anxiety, social support and the diurnal rhythm and awakening response of salivary cortisol

Ageing, depression, anxiety, social support and the diurnal rhythm and awakening response of salivary cortisol

Stability of the diurnal cortisol profile in children and adolescents

Serotonin transporter polymorphism, memory and hippocampal volume in the elderly: association and interaction with cortisol

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