Identifying patterns in cortisol secretion in an older population. Findings from the Whitehall II study
Open accessAbstract
Alterations in the patterning of diurnal cortisol secretion are associated with poor health in clinical populations with 'flat' patterns a particular risk. Flatter patterns in cortisol secretion may reflect impaired negative feedback in the hypothalamic-pituitary-adrenal axis. The correlates of discrete clusters of patterns in the diurnal secretion of cortisol have not been well described in large community dwelling populations. We describe discrete clusters of patterns of cortisol secretion and examine the correlates of these patterns using a latent variable mixture modelling approach. Analyses use data from 2802 participants with complete information on cortisol secretion, age, walking/gait speed, stress, waking up time and sleep duration. Cortisol was assessed from six saliva samples collected at waking, waking plus 30 min, 2.5h, 8h, 12h and bedtime. We find two patterns ("curves") of diurnal cortisol secretion. These curves are described as 'normative' [prevalence 73%] and a 'raised' [27%] curve differentiated by a lower cortisol awakening response in the normative group, a higher diurnal cortisol and 'flatter' pattern of release in the raised group. Older age, being male, a smoker, stress on the day of sampling, slower walking speed and shorter sleep duration increased the odds of being in the raised curve, relative to the normative curve. In conclusion, two patterns of cortisol secretion occur in middle aged men and women. Raised pattern of secretion, which occurs in 27% of our participants is associated with demographic variables, adverse health behaviours, psychosocial environment and impaired physical functioning.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The text we found for this paper looks like another document, so the self-check wasn’t run.
Cites
Nylund, K. L., Asparouhov, T., & Muthén, B. O. (2007) · Structural Equation Modeling: A Multidisciplinary Journal · doi:10.1080/10705510701575396 · Cited by 11,415 · see citing works
McLachlan, G., & Peel, D. (2000) · Wiley Series in Probability and Statistics · doi:10.1002/0471721182 · Cited by 10,991 · see citing works
Guralnik, J. M., Simonsick, E. M., Ferrucci, L., Glynn, R. J., Berkman, L. F., Blazer, D. G., Scherr, P. A., & Wallace, R. B. (1994) · Journal of Gerontology · doi:10.1093/geronj/49.2.m85 · Cited by 9,792 · see citing works
Testing the number of components in a normal mixture
Lo, Y. (2001) · Biometrika · doi:10.1093/biomet/88.3.767 · Cited by 4,640 · see citing works
Impact of sleep debt on metabolic and endocrine function
Spiegel, K., Leproult, R., & Van Cauter, E. (1999) · The Lancet · doi:10.1016/s0140-6736(99)01376-8 · Cited by 3,672 · see citing works
Pruessner, J. C., Kirschbaum, C., Meinlschmid, G., & Hellhammer, D. H. (2003) · Psychoneuroendocrinology · doi:10.1016/s0306-4530(02)00108-7 · Cited by 3,638 · see citing works
Mayer, T. F., Lazarsfeld, P. F., & Henry, N. W. (1969) · American Sociological Review · doi:10.2307/2092222 · Cited by 2,412 · see citing works
Salivary Cortisol in Psychobiological Research: An Overview
Kirschbaum, C., & Hellhammer, D. H. (2008) · Neuropsychobiology · doi:10.1159/000118611 · Cited by 1,532 · see citing works
Diurnal Cortisol Rhythm as a Predictor of Breast Cancer Survival
Sephton, S. E. (2000) · Journal of the National Cancer Institute · doi:10.1093/jnci/92.12.994 · Cited by 1,082 · see citing works
Effects of gender and age on the levels and circadian rhythmicity of plasma cortisol
Van Cauter, E. (1996) · Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.81.7.2468 · Cited by 951 · see citing works
Assessing salivary cortisol in large-scale, epidemiological research
Adam, E. K., & Kumari, M. (2009) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2009.06.011 · Cited by 936 · see citing works
The awakening cortisol response: methodological issues and significance
Clow, A., Thorn, L., Evans, P., & Hucklebridge, F. (2004) · Stress · doi:10.1080/10253890410001667205 · Cited by 856 · see citing works
Cohort Profile: The Whitehall II study
Marmot, M. G., & Brunner, E. J. (2004) · International Journal of Epidemiology · doi:10.1093/ije/dyh372 · Cited by 790 · see citing works
Day-to-day dynamics of experience–cortisol associations in a population-based sample of older adults
Adam, E. K., Hawkley, L. C., Kudielka, B. M., & Cacioppo, J. T. (2006) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.0605053103 · Cited by 782 · see citing works
Child maltreatment and the developing HPA axis
Tarullo, A. R., & Gunnar, M. R. (2006) · Hormones and Behavior · doi:10.1016/j.yhbeh.2006.06.010 · Cited by 737 · see citing works
Demitrack, M. A., Dale, J. K., Straus, S. E., Laue, L., LISTWAK, S. J., Kruesi, M. J. P., Chrousos, G. P., & Gold, P. W. (1991) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem-73-6-1224 · Cited by 727 · see citing works
The cortisol awakening response - normal values and confounds.
Wüst, S., Wolf, J. M., Hellhammer, D. H., Federenko, I. S., Schommer, N. C., & Kirschbaum, C. (2000) · PubMed · Cited by 700 · see citing works
Hellhammer, J., Fries, E., Schweisthal, O. W., Schlotz, W., Stone, A. A., & Hagemann, D. (2007) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2006.10.005 · Cited by 540 · see citing works
Ferrie, J. E., Shipley, M. J., Cappuccio, F. P., Brunner, E., Miller, M. A., Kumari, M., & Marmot, M. G. (2007) · Sleep · doi:10.1093/sleep/30.12.1659 · Cited by 515 · see citing works
Kudielka, B. M., Broderick, J. E., & Kirschbaum, C. (2003) · Psychosomatic Medicine · doi:10.1097/01.psy.0000058374.50240.bf · Cited by 489 · see citing works
Cohen, S., Schwartz, J. E., Epel, E. S., Kirschbaum, C., Sidney, S., & Seeman, T. E. (2006) · Psychosomatic Medicine · doi:10.1097/01.psy.0000195967.51768.ea · Cited by 404 · see citing works
Hypothalamic-pituitary-adrenal dysfunction in posttraumatic stress disorder
Yehuda, R., Giller, E. L., Southwick, S. M., Lowy, M. T., & Mason, J. W. (1991) · Biological Psychiatry · doi:10.1016/0006-3223(91)90123-4 · Cited by 388 · see citing works
Schmidt-Reinwald, A., Pruessner, J. C., Hellhammer, D. H., Federenko, I., Rohleder, N., Schürmeyer, T. H., & Kirschbaum, C. (1999) · Life Sciences · doi:10.1016/s0024-3205(99)00103-4 · Cited by 367 · see citing works
Self-citationJob strain and anger expression predict early morning elevations in salivary cortisol
Steptoe, A., Cropley, M., Griffith, J., & Kirschbaum, C. (2000) · Psychosomatic Medicine · doi:10.1097/00006842-200003000-00022 · Cited by 365 · see citing works
Self-citationIndividual differences in the diurnal cycle of cortisol
Smyth, J. M., Ockenfels, M. C., Gorin, A. A., Catley, D., Porter, L. S., Kirschbaum, C., Hellhammer, D. H., & Stone, A. A. (1997) · Psychoneuroendocrinology · doi:10.1016/s0306-4530(96)00039-x · Cited by 350 · see citing works
Cortisol, Testosterone, and Coronary Heart Disease
Smith, G. D., Ben‐Shlomo, Y., Beswick, A. D., Yarnell, J., Lightman, S. L., & Elwood, P. C. (2005) · Circulation · doi:10.1161/circulationaha.104.489088 · Cited by 340 · see citing works
Flattened cortisol rhythms in metastatic breast cancer patients
Abercrombie, H. C., Giese‐Davis, J., Sephton, S. E., Epel, E. S., Turner‐Cobb, J. M., & Spiegel, D. (2004) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2003.11.003 · Cited by 287 · see citing works
Neuroendocrine Aspects of Primary Endogenous Depression
Rubín, R. T. (1987) · Archives of General Psychiatry · doi:10.1001/archpsyc.1987.01800160032006 · Cited by 287 · see citing works
The relationship between smoking status and cortisol secretion.
Badrick, E., Kirschbaum, C., & Kumari, M. (2007) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2006-2155 · Cited by 284 · see citing works
Self-citationDeuschle, M., Gotthardt, U., Schweiger, U., Weber, B., Körner, A., Schmider, J., Standhardt, H., Lammers, C.-H., & Heuser, I. (1997) · Life Sciences · doi:10.1016/s0024-3205(97)00926-0 · Cited by 235 · see citing works
Smoking, cortisol and nicotine
Steptoe, A., & USSHER, M. H. (2005) · International Journal of Psychophysiology · doi:10.1016/j.ijpsycho.2005.10.011 · Cited by 225 · see citing works
Higher levels and blunted diurnal variation of cortisol in frail older women
Varadhan, R., Walston, J., Cappola, A. R., Carlson, M. C., Wand, G. S., & Fried, L. P. (2008) · The Journals of Gerontology Series A: Biological Sciences and Medical Sciences · doi:10.1093/gerona/63.2.190 · Cited by 182 · see citing works
Dockray, S., Bhattacharyya, M. R., Molloy, G. J., & Steptoe, A. (2007) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2007.10.001 · Cited by 157 · see citing works
Salivary Cortisol Is Related to Atherosclerosis of Carotid Arteries
Dekker, M. J. H. J., Koper, J. W., van Aken, M. O., Pols, H. A. P., Albert Hofman, D., de Jong, F. H., Kirschbaum, C., Witteman, J. C. M., Lamberts, S. W. J., & Tiemeier, H. W. (2008) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2008-0496 · Cited by 154 · see citing works
Physiologic Markers of Chronic Stress in Premenopausal, Middle-Aged Women
Powell, L. H., Lovallo, W. R., Matthews, K. A., Meyer, P., MIDGLEY, A. R., Baum, A. E., Stone, A. A., Underwood, L., McCann, J. J., Herro, K. J., et al. (2002) · Psychosomatic Medicine · doi:10.1097/00006842-200205000-00015 · Cited by 136 · see citing works
Diurnal cycles of salivary cortisol in older adults.
Ice, G., Katz-Stein, A., Himes, J., & Kane, R. L. (2004) · Psychoneuroendocrinology · doi:10.1016/s0306-4530(03)00034-9 · Cited by 132 · see citing works
de Beurs, E., Beekman, A. T. F., Geerlings, S. W., Deeg, D. J. H., van Dyck, R., & van Tilburg, W. (2001) · The British Journal of Psychiatry · doi:10.1192/bjp.179.5.426 · Cited by 118 · see citing works
Urinary cortisol excretion as a predictor of incident cognitive impairment
Karlamangla, A. S., Singer, B. H., Chodosh, J., McEwen, B. S., & Seeman, T. E. (2005) · Neurobiology of Aging · doi:10.1016/j.neurobiolaging.2005.09.037 · Cited by 112 · see citing works
A 5‐year follow‐up study of disease incidence in men with an abnormal hormone pattern
Rosmond, R., Wallerius, S., Wanger, P., Martin, L., Holm, G., & Björntorp, P. A. (2003) · Journal of Internal Medicine · doi:10.1046/j.1365-2796.2003.01205.x · Cited by 108 · see citing works
Raff, H., Raff, J. L., Duthie, E. H., Wilson, C. R., Sasse, E. A., Rudman, I. W., & Mattson, D. L. (1999) · The Journals of Gerontology Series A · doi:10.1093/gerona/54.9.m479 · Cited by 108 · see citing works
Spiegel, D., Giese‐Davis, J., Taylor, C. B., & KRAEMER, H. C. (2006) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2006.09.004 · Cited by 99 · see citing works
Modeling cortisol rhythms in a population-based study
Ranjit, N., Young, E. A., Raghunathan, T. E., & Kaplan, G. A. (2005) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2005.02.003 · Cited by 92 · see citing works
The impact of time of waking and concurrent subjective stress on the cortisol response to awakening
Williams, E. D., Magid, K. S., & Steptoe, A. (2004) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2004.06.006 · Cited by 91 · see citing works
Psychosocial Stress and HPA Functioning: No Evidence for a Reduced Resilience in Healthy Elderly Men
Kudielka, B. M., Schmidt-Reinwald, A. K., Hellhammer, D. H., Schürmeyer, T. H., & Kirschbaum, C. (2000) · Stress · doi:10.3109/10253890009001127 · Cited by 78 · see citing works
Melzer, D. R., Lan, T.-Y., & Guralnik, J. M. (2003) · Age and Ageing · doi:10.1093/ageing/afg107 · Cited by 76 · see citing works
DeSantis, A. S., Adam, E. K., Mendelsohn, K. A., & Doane, L. D. (2009) · International Journal of Behavioral Medicine · doi:10.1007/s12529-009-9053-5 · Cited by 62 · see citing works
A Flexible Model for Human Circadian Rhythms
Wang, Y., & Brown, M. B. (1996) · Biometrics · doi:10.2307/2532897 · Cited by 58 · see citing works
Ryzin, M. J. V., Chatham, M., Kryzer, E. M., Kertes, D. A., & Gunnar, M. R. (2008) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2008.08.014 · Cited by 56 · see citing works
Jacobs, S., Mason, J. W., Kosten, T. R., Brown, S., & Ostfeld, A. M. (1984) · Psychosomatic Medicine · doi:10.1097/00006842-198405000-00003 · Cited by 38 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Green space and stress: Evidence from cortisol measures in deprived urban communities
Roe, J., Thompson, C., Aspinall, P., Brewer, M., Duff, E., Miller, D., Mitchell, R., & Clow, A. (2013) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph10094086 · Cited by 674 · see citing works
“In contrast, stressed middle-aged women presented with low cortisol concentration and a lower and flatter cortisol slope [17].”
BackgroundThe Functional and Clinical Significance of the 24-Hour Rhythm of Circulating Glucocorticoids
Oster, H., Challet, E., Ott, V., Arvat, E., de Kloet, E. R., Dijk, D.-J., Lightman, S., Vgontzas, A., & Van Cauter, E. (2017) · Endocrine Reviews · doi:10.1210/er.2015-1080 · Cited by 548 · see citing works
“and impaired physical functioning (316).”
Aging and the HPA axis: Stress and resilience in older adults
Gaffey, A. E., Bergeman, C. S., Clark, L. A., & Wirth, M. M. (2016) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2016.05.036 · Cited by 273 · see citing works
Frailty and the endocrine system
Clegg, A. P., & Hassan-Smith, Z. K. (2018) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(18)30110-4 · Cited by 273 · see citing works
Simultaneous measurement of salivary cortisol and alpha-amylase: Application and recommendations
Strahler, J., Skoluda, N., Kappert, M. B., & Nater, U. M. (2017) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2017.08.015 · Cited by 254 · see citing works
“altered CAR and increased evening levels compared to a normative pattern [305, 306].”
BackgroundSalivary Cortisol in Ambulatory Assessment—Some Dos, Some Don’ts, and Some Open Questions
Kudielka, B. M., Gierens, A., Hellhammer, D. H., Wüst, S., & Schlotz, W. (2012) · Psychosomatic Medicine · doi:10.1097/psy.0b013e31825434c7 · Cited by 225 · see citing works
“More recently, latent growth curve modeling (170) has been used to analyze cortisol trajectories, for example, to find and compare groups of subjects with similar trajectories (171).”
MethodHypothalamic‐Pituitary‐Adrenal (HPA) Axis and Aging
Gupta, D., & Morley, J. E. (2014) · Comprehensive physiology · doi:10.1002/cphy.c130049 · Cited by 196 · see citing works
Lananna, B. V., & Musiek, E. S. (2020) · Neurobiology of Disease · doi:10.1016/j.nbd.2020.104832 · Cited by 145 · see citing works
Predictors of hair cortisol concentrations in older adults
Feller, S., Vigl, M., Bergmann, M. M., Boeing, H., Kirschbaum, C., & Tobias Stalder, A. (2013) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2013.10.007 · Cited by 127 · see citing works
“, 2006), physical functioning (Kumari et al., 2010), lifestyle-related factors (e.”
BackgroundGuyon, A., Balbo, M., Morselli, L. L., Tasali, E., Leproult, R., L'Hermite-Balériaux, M., Van Cauter, E., & Spiegel, K. (2014) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2013-4254 · Cited by 127 · see citing works
Ryan, R., Booth, S., Spathis, A., Mollart, S., & Clow, A. (2016) · Annals of Behavioral Medicine · doi:10.1007/s12160-015-9753-9 · Cited by 108 · see citing works
“[3, 4], and frailty and cognitive decline [5].”
Dmitrieva, N., Almeida, D. M., Dmitrieva, J., Loken, E., & Pieper, C. F. (2013) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2013.05.003 · Cited by 99 · see citing works
“Moreover, relatively few studies have conducted a formal investigation into heterogeneity of the diurnal rhythm by identifying commonly observed cortisol profiles (cf. Lasikiewicz et al., 2008; Van Ryzin et al., 2009; Kumari et al., 2010).”
Effects of stress hormones on the brain and cognition: Evidence from normal to pathological aging
Souza‐Talarico, J. N., Marin, M., Sindi, S., & LUPIEN, S. J. (2011) · Dementia & Neuropsychologia · doi:10.1590/s1980-57642011dn05010003 · Cited by 98 · see citing works
“Further, a study on the circadian rhythm cortisol profile in a large community dwelling population showed that those with a raised cortisol profile tended to be older than those with normative curves.(103) Different sampling methods as well as times at which samples were collected may partly explain the diverse result…”
BackgroundSchlotz, W., Hammerfald, K., Ehlert, U., & Gaab, J. (2011) · Biological Psychology · doi:10.1016/j.biopsycho.2011.03.005 · Cited by 97 · see citing works
Johar, H., Emeny, R. T., Bidlingmaier, M., Reincke, M., Thorand, B., Peters, A., Heier, M., & Ladwig, K. (2014) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2013-3079 · Cited by 85 · see citing works
Schlotz, W. (2018) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2018.11.038 · Cited by 81 · see citing works
Neuroendocrine Effects of Stress on Immunity in the Elderly: Implications for Inflammatory Disease
Heffner, K. L. (2010) · Immunology and Allergy Clinics of North America · doi:10.1016/j.iac.2010.09.005 · Cited by 76 · see citing works
“Evidence from animal and human studies suggests that glucocorticoid levels remain constant throughout adulthood(32,33) and may even increase(7,34,35); although observed diurnal increases may be more evident among distressed older adults(36) or individuals with impairments in physical functioning.(37) Other”
BackgroundGardner, M. P., Lightman, S., Sayer, A. A., Cooper, C., Cooper, R., Deeg, D., Ebrahim, S., Gallacher, J., Kivimaki, M., Kumari, M., et al. (2013) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2012.04.016 · Cited by 72 · see citing works
“Physical performance outcome measures were walking speed, balance time, chair rise time and grip strength.”
InfluentialVitamin D in Osteosarcopenic Obesity
di Filippo, L., LORENZO, R. D., Giustina, A., Rovere, P. Q., & Conte, C. (2022) · Nutrients · doi:10.3390/nu14091816 · Cited by 70 · see citing works
The cortisol awakening response and memory performance in older men and women
Almela, M., van der Meij, L., Hidalgo, V., Villada, C., & Salvador, A. (2012) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2012.04.009 · Cited by 60 · see citing works
“(Kumari et al., 2010).”
Brummett, B. H., Kuhn, C. M., Boyle, S. H., Babyak, M. A., Siegler, I. C., & Williams, R. B. (2012) · Biological Psychology · doi:10.1016/j.biopsycho.2011.09.013 · Cited by 50 · see citing works
“Increased stress in daily life is associated with a higher cortisol awakening response and higher mean day and evening cortisol levels (Kumari et al., 2010).”
BackgroundSocial isolation and diurnal cortisol patterns in an ageing cohort
Stafford, M., Gardner, M. P., Meena Kumari, B., Kuh, D. J., & Ben‐Shlomo, Y. (2013) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2013.07.002 · Cited by 47 · see citing works
Miller, C. M., Rindflesch, T. C., Marcelo Fiszman, B., Hristovski, D., Shin, D., Rosemblat, G., Zhang, H., & Strohl, K. P. (2012) · SLEEP · doi:10.5665/sleep.1640 · Cited by 47 · see citing works
Lederbogen, F., Kühner, C., Kirschbaum, C., Meisinger, C., Lammich, J., Holle, R., Krumm, B., von Lengerke, T., Wichmann, H. ‐., Deuschle, M., et al. (2010) · European Journal of Endocrinology · doi:10.1530/eje-10-0491 · Cited by 47 · see citing works
Stoffel, M., Neubauer, A., & Ditzen, B. (2021) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2021.105391 · Cited by 44 · see citing works
Gex‐Fabry, M., Jermann, F., Kosel, M., Rossier, M. F., der Linden, M. V., Bertschy, G., Bondolfi, G., & Aubry, J. (2011) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2011.09.011 · Cited by 44 · see citing works
“Several large epidemiological surveys focused on inter-individual variability and its determinants (Kumari et al., 2010; Lederbogen et al., 2010; Vreeburg et al., 2009b).”
BackgroundGardner, M. P., Lightman, S. L., Kuh, D. J., Comijs, H. C., Deeg, D. J. H., Gallacher, J., Geoffroy, M., Mika Kivimaki, B., Meena Kumari, B., Power, C., et al. (2019) · Scientific Reports · doi:10.1038/s41598-019-40566-x · Cited by 42 · see citing works
Adult attachment style and cortisol responses across the day in older adults
Kidd, T., Hamer, M., & Steptoe, A. (2013) · Psychophysiology · doi:10.1111/psyp.12075 · Cited by 39 · see citing works
“The collection of cortisol has been described previously (Kumari et al., 2010).”
Trait positive and negative emotionality differentially associate with diurnal cortisol activity
Miller, K., Wright, A. G. C., Peterson, L. M., Kamarck, T. W., Anderson, B. A., Kirschbaum, C., Marsland, A. L., Muldoon, M. F., & Manuck, S. B. (2016) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2016.03.004 · Cited by 41 · see citing works
“Regarding the former, a steep decline in cortisol levels over the day is thought to reflect normative HPA activity, whereas a flatter diurnal slope is considered maladaptive, associating with a number of negative health outcomes such as coronary artery calcification, mortality among cancer patients, and all-cause card…”
Diurnal cortisol and mental well-being in middle and older age: evidence from four cohort studies
Stafford, M., Ben‐Shlomo, Y., Cooper, C. C., Galé, C. R., Gardner, M. P., Geoffroy, M., Power, C., Kuh, D. J., & Cooper, R. (2017) · BMJ Open · doi:10.1136/bmjopen-2017-016085 · Cited by 38 · see citing works
Collomp, K., Baillot, A., Forget, H., Coquerel, A., Rieth, N., & Vibarel-Rebot, N. (2016) · Physiology & Behavior · doi:10.1016/j.physbeh.2016.05.039 · Cited by 38 · see citing works
Lucertini, F., Ponzio, E., Palma, M. D., Galati, C., Federici, A., Barbadoro, P., D’Errico, M. M., Prospero, E., Ambrogini, P., Cuppini, R., et al. (2015) · PLoS ONE · doi:10.1371/journal.pone.0141970 · Cited by 34 · see citing works
Changing family routines at kindergarten entry predict biomarkers of parental stress
DeCaro, J. A., & Worthman, C. (2011) · International Journal of Behavioral Development · doi:10.1177/0165025411406853 · Cited by 36 · see citing works
“A ‘‘flat’’ diurnal rhythm, typically resulting from elevated evening levels and reflecting impaired regulation of the HPA axis, may contribute to the development of cardiovascular disease and diabetes (Kumari et al., 2010; Rosmond et al., 2003), and high within-individual cortisol variance has been implicated in depre…”
BackgroundGardner, M. P., Lightman, S. L., Gallacher, J., Hardy, R., Kuh, D. J., Ebrahim, S. B. J., Bayer, A. J., Ben‐Shlomo, Y., & the Halcyon study team (2011) · International Journal of Epidemiology · doi:10.1093/ije/dyr113 · Cited by 32 · see citing works
Johar, H., Emeny, R. T., Bidlingmaier, M., Lacruz, M. E., Reincke, M., Peters, A., Heier, M., & Ladwig, K. (2014) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2014.10.011 · Cited by 30 · see citing works
Piazza, J. R., Dmitrieva, N., Charles, S. T., Almeida, D. M., & Orona, G. A. (2018) · Health Psychology · doi:10.1037/hea0000629 · Cited by 30 · see citing works
“Although cross-sectional studies have identified a link between cortisol and functional limitations (e.g., Kumari et al., 2010; Peeters et al., 2007; Sousa et al., 2017), few longitudinal studies have examined this question, and those that have primarily focused on plasma cortisol (e.g., Baylis et…”
Xiong, F., Wang, Y., Li, S., Tian, M., Zheng, C.-H., & Huang, G.-Y. (2014) · Journal of Huazhong University of Science and Technology [Medical Sciences] · doi:10.1007/s11596-014-1351-8 · Cited by 30 · see citing works
Lead exposure is related to hypercortisolemic profiles and allostatic load in Brazilian older adults
Souza‐Talarico, J. N., Suchecki, D., Juster, R., Plusquellec, P., Barbosa, F., Bunscheit, V., Marcourakis, T., Matos, T. M., & LUPIEN, S. J. (2017) · Environmental Research · doi:10.1016/j.envres.2017.01.012 · Cited by 30 · see citing works
Physiological stress markers, mental health and objective physical function
Milligen, B. A. L.-V., Lamers, F., Smit, J. H., & Penninx, B. W. J. H. (2020) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2020.109996 · Cited by 29 · see citing works
Dijckmans, B., Tortosa‐Martínez, J., Pertegáz, N. C. I., González-Caballero, G., Martínez-Pelegrin, B., Manchado, C., Cortell-Tormo, J. M., Chulvi‐Medrano, I., & Clow, A. (2017) · European Review of Aging and Physical Activity · doi:10.1186/s11556-017-0175-5 · Cited by 28 · see citing works
“Other studies observed associations between slower walking speed and a slower decline in cortisol levels during the day [23, 24] and higher levels of cortisol [25], between greater lower body strength and a faster decline in cortisol levels [24], and between inferior lower body strength and higher levels of cortisol i…”
BackgroundExercise, the diurnal cycle of cortisol and cognitive impairment in older adults
Tortosa‐Martínez, J., Manchado, C., Cortell-Tormo, J. M., & Chulvi‐Medrano, I. (2018) · Neurobiology of Stress · doi:10.1016/j.ynstr.2018.08.004 · Cited by 28 · see citing works
Thomas, K. S., Bower, J. E., Williamson, T. J., Hoyt, M. A., Wellisch, D. K., Stanton, A. L., & Irwin, M. R. (2012) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2011.12.008 · Cited by 26 · see citing works
“Age (Kumari et al., 2010), daily sleep efficiency (Kumari et al., 2010), as well as daily tobacco (Lovallo, 2006) and caffeine usage (Ice et al., 2004) were controlled as covariates in analyses based on research demonstrating that these factors are associated with altered HPA activity.”
BackgroundTortosa‐Martínez, J., & Clow, A. (2012) · Stress · doi:10.3109/10253890.2011.629323 · Cited by 26 · see citing works
“Other studies report aberrant cycles in sub-populations of the healthy old (Ice et al. 2004; Kumari et al. 2010).”
BackgroundBrummett, B. H., Babyak, M. A., Jiang, R., Shah, S. H., Becker, R. C., Haynes, C. S., Chryst‐Ladd, M., Craig, D. M., Hauser, E. R., Siegler, I. C., et al. (2013) · PLoS ONE · doi:10.1371/journal.pone.0082781 · Cited by 23 · see citing works
Social Network Characteristics and Salivary Cortisol in Healthy Older People
Lai, J. C. L., Chong, A. M. L., Siu, O. T., Evans, P. D., Chan, C., & Ho, R. (2012) · The Scientific World JOURNAL · doi:10.1100/2012/929067 · Cited by 22 · see citing works
“, [30]) or relatively younger ones in an older sample [31], implying that cultivation of social ties may serve to “rejuvenate” the diurnal cortisol profile in older people.”
A functional polymorphism in the HTR2C gene associated with stress responses: A validation study
Brummett, B. H., Babyak, M. A., Kuhn, C. M., Siegler, I. C., & Williams, R. B. (2014) · Biological Psychology · doi:10.1016/j.biopsycho.2014.10.006 · Cited by 22 · see citing works
“P A A uthor M anuscript with a higher cortisol awakening response and higher mean day and evening cortisol levels (e.g., Kumari et al., 2010), and as noted earlier, cortisol response to laboratory stressors has been shown to correspond to cortisol response in daily life (Kidd, et al., 2014).”
BackgroundEffort reward imbalance, and salivary cortisol in the morning
Eller, N. H., Nielsen, S. F., Blønd, M., Nielsen, M. L., Hansen, Å. M., & Netterstrøm, B. (2011) · Biological Psychology · doi:10.1016/j.biopsycho.2011.11.007 · Cited by 19 · see citing works
Neuroendocrine recovery after 2-week 12-h day and night shifts: an 11-day follow-up
Merkus, S. L., Holte, K. A., Huysmans, M. A., Hansen, Å. M., van de Ven, P. M., van Mechelen, W., & van der Beek, A. J. (2014) · International Archives of Occupational and Environmental Health · doi:10.1007/s00420-014-0954-5 · Cited by 19 · see citing works
Le, N. P., Varadhan, R., Fried, L. P., & Cappola, A. R. (2020) · The Journals of Gerontology Series A · doi:10.1093/gerona/glaa134 · Cited by 19 · see citing works
Cortisol Awakening Response and Walking Speed in Older People
Pulopulos, M. M., Puig‐Pérez, S., Hidalgo, V., Villada, C., & Salvador, A. (2016) · PLoS ONE · doi:10.1371/journal.pone.0152071 · Cited by 19 · see citing works
de Feijter, M., Katimertzoglou, A., Tiemensma, J., Ikram, M. A., & Luik, A. I. (2022) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2022.105749 · Cited by 18 · see citing works
“feedback have been associated with negative health outcomes [2, 3].”
BackgroundSánchez, B. N., Wu, M. C., Raghunathan, T. E., & Roux, A. V. D. (2012) · American Journal of Epidemiology · doi:10.1093/aje/kws182 · Cited by 16 · see citing works
Interplay between circadian rhythm, ageing and neurodegenerative disorder
Nagayach, A., Bhaskar, R., Ghosh, S., Dhivyadharshni, M., Abomughaid, M. M., Han, S. S., Singh, D. K. K., Almutary, A. G., Chaudhary, K., Atteri, S., et al. (2025) · Open Biology · doi:10.1098/rsob.240161 · Cited by 18 · see citing works
Hernández, B., Scarlett, S., Moriarty, F., Romero‐Ortuño, R., Kenny, R. A., & Reilly, R. B. (2022) · BMC Public Health · doi:10.1186/s12889-022-14108-6 · Cited by 15 · see citing works
Adult-Life Occupational Exposures: Enriched Environment or a Stressor for the Aging Brain?
Burzynska, A. Z., Jiao, Y., & Ganster, D. C. (2018) · Work Aging and Retirement · doi:10.1093/workar/way007 · Cited by 14 · see citing works
Watermeyer, T., Robb, C. E., Gregory, S., & Udeh‐Momoh, C. T. (2020) · Frontiers in Neuroendocrinology · doi:10.1016/j.yfrne.2020.100877 · Cited by 15 · see citing works
Hypothalamic‐Pituitary‐Adrenal (HPA) Axis and Aging
Gupta, D., & Morley, J. E. (2014) · Comprehensive physiology · doi:10.1002/j.2040-4603.2014.tb00585.x · Cited by 14 · see citing works
“In the Whitehall II and Caterphilly Prospective Cohort slower walking speed was associated with a reduction in diurnal cortisol variability (79, 129).”
Nys, L. D., Ofosu, E. F., Ryde, G. C., Connelly, J., & Phillips, A. C. (2022) · Journal of Aging and Physical Activity · doi:10.1123/japa.2021-0501 · Cited by 13 · see citing works
Mardomingo, C. D., Utrera, L., Baliyan, S., García‐Herranz, S., Suárez-Falcón, J. C., Rodríguez‐Fernández, R., Sampedro‐Piquero, P., Valencia, A., & Venero, C. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1199405 · Cited by 12 · see citing works
The role of the circadian timing system in sarcopenia in old age: a scoping review
Palmese, F., Druda, Y., Toro, R. D., Bedogni, G., Domenicali, M., & Silvani, A. (2025) · European Geriatric Medicine · doi:10.1007/s41999-024-01129-0 · Cited by 12 · see citing works
“These studies generally agreed on the association between a higher diurnal cortisol drop (i.e., a greater difference between morning and evening cortisol concentration) and lower night-time cortisol level with better physical performance [15, 18, 19, 22, 25].”
Maina, G., Bovenzi, M., Palmas, A., Rossi, F., & Filon, F. L. (2011) · Toxicology Letters · doi:10.1016/j.toxlet.2011.08.019 · Cited by 12 · see citing works
Ge, N., Westbrook, R., Langdon, J. M., Yang, H., Marx, R., Abadir, P. M., Xue, Q., & Walston, J. D. (2020) · Experimental Gerontology · doi:10.1016/j.exger.2020.111136 · Cited by 12 · see citing works
Diurnal Cortisol and Functional Outcomes in Post-Acute Rehabilitation Patients
Fiorentino, L., Saxbe, D., Alessi, C., Woods, D. L., & Martin, J. L. (2012) · The Journals of Gerontology Series A · doi:10.1093/gerona/glr230 · Cited by 12 · see citing works
Cortisol profile and depressive symptoms in older adults residing in Brazil and in Canada
Tu, M. T., Zunzunegui, M. V., Guerra, R. O., Alvarado, B., & Guralnik, J. M. (2013) · Aging Clinical and Experimental Research · doi:10.1007/s40520-013-0111-0 · Cited by 11 · see citing works
“[16] and lower CAR compared to young adults [17, 18].”
BackgroundThe cortisol awakening response is related with PERIOD1 clock gene expression in older women
Olbrich, D., & Dittmar, M. (2012) · Experimental Gerontology · doi:10.1016/j.exger.2012.04.009 · Cited by 11 · see citing works
“Themean cortisol level at T30 of our older women of 14.6 nmol/L is intermediate between the value of 9.6 nmol/L by Lai et al. (2010) and the value of 20.5 nmol/L by Lederbogen et al. (2010) and of 23.8 nmol/L by Kumari et al. (2010).”
InfluentialChandola, T., Rouxel, P. L., Marmot, M. G., & Meena Kumari, B. (2017) · The Journals of Gerontology Series B · doi:10.1093/geronb/gbx058 · Cited by 9 · see citing works
Role of Stress and Hormones of the Hypothalamic-Pituitary-Adrenal (HPA) Axis in Aging
Gupta, A. (2019) · Springer eBooks · doi:10.1007/978-981-13-3585-3_12 · Cited by 8 · see citing works
Psychosocial Stress and Salivary Cortisol in Older People: A Brief Review
Lai, J. C. L. (2014) · Journal of Aging Science · doi:10.4172/2329-8847.1000120 · Cited by 7 · see citing works
Carlson, S. C., Allen, A., Allen, S. S., & al'Absi, M. (2017) · Experimental and clinical psychopharmacology · doi:10.1037/pha0000142 · Cited by 9 · see citing works
Zhao, X., Hu, W., Liu, Y., Guo, K., Liu, Y., & Yang, J. (2023) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2023.106059 · Cited by 8 · see citing works
Oei, N. Y. L., Jansen, S. W. M., Veer, I. M., Slagboom, P. E., van der Grond, J., & van Heemst, D. (2018) · Biological Psychology · doi:10.1016/j.biopsycho.2018.02.018 · Cited by 7 · see citing works
“…2013), whereas high basal cortisol levels have been associated with several age-related features of ill health, such as high blood pressure, insulin resistance and physical frailty (Kumari et al., 2010; Wallerius, Rosmond, Ljung, Holm, & Bjorntorp, 2003; Chrousos, AC CE PT ED M AN US CR IP T 2000).”
BackgroundEarly Life Origins of Adult Health and Aging
Kuh, D. J., & Ben‐Shlomo, Y. (2015) · Elsevier eBooks · doi:10.1016/b978-0-12-417235-7.00005-6 · Cited by 6 · see citing works
Sanchís-Soler, G., Tortosa‐Martínez, J., Manchado, C., & Cortell-Tormo, J. M. (2020) · International review of neurobiology · doi:10.1016/bs.irn.2020.01.002 · Cited by 6 · see citing works
de Feijter, M., Tiemensma, J., Ikram, M. A., Stricker, B. H. C., & Luik, A. I. (2022) · Sleep Health · doi:10.1016/j.sleh.2022.03.002 · Cited by 6 · see citing works
Racial Provocation Induces Cortisol Responses in African-Americans*
Weinstein, A. A., Termini, A., Kazman, J. B., Zeno, S. A., Abraham, P. A., & Deuster, P. A. (2013) · Open Journal of Medical Psychology · doi:10.4236/ojmp.2013.24023 · Cited by 5 · see citing works
Jansen, S. W. M., van Heemst, D., van der Grond, J., Westendorp, R. G. J., & Oei, N. Y. L. (2015) · Stress · doi:10.3109/10253890.2015.1105213 · Cited by 5 · see citing works
Social Network Cultivation and Diurnal Cortisol Profiles in Healthy Chinese Elders
Lai, J. C. L., Evans, P. D., & Chong, A. M. L. (2017) · Neuropsychiatry · doi:10.4172/neuropsychiatry.1000303 · Cited by 4 · see citing works
A Portrait of Resilience in Caregiving
Ewen, H. H., Chahal, J. K., & Fenster, E. S. (2014) · Research in Gerontological Nursing · doi:10.3928/19404921-20141111-01 · Cited by 4 · see citing works
Vaz, F. D. C., Molina, G. E., Porto, L. G. G., & Porto, A. L. A. (2013) · Brasília Médica · doi:10.14242/2236-5117.2013v50n2a20p143 · Cited by 3 · see citing works
Application of the Model of Allostasis to Older Women’s Relocation to Senior Housing
Ewen, H. H., & Kinney, J. M. (2013) · Biological Research For Nursing · doi:10.1177/1099800412474682 · Cited by 3 · see citing works
“The key times to collect cortisol samples as an indicator of the degree of stress an individual is experiencing are within 1 hr of awakening and bedtime (Kumari et al., 2010).”
BackgroundFrailty and pituitary surgery: a systematic review
Castle‐Kirszbaum, M., McCormack, A. I., Ovenden, C. D., Kam, J. K. T., King, J. A. J., Wang, Y. Y., & Goldschlager, T. (2025) · Pituitary · doi:10.1007/s11102-025-01507-2 · Cited by 4 · see citing works
Ross, S. M. (2025) · Holistic Nursing Practice · doi:10.1097/hnp.0000000000000739 · Cited by 2 · see citing works
Nakae, A., Bu-Omer, H. M., Kishimoto, C., Chang, W., & Sumioka, H. (2025) · Life · doi:10.3390/life15020222 · Cited by 1 · see citing works
“This method has been widely applied to identify distinct physiological profiles in previous research [28].”
Linnenbringer, E. L. (2014) · Deep Blue (University of Michigan) · Cited by 1 · see citing works
Early-life adversity and adulthood psychological distress: The role of biological stress reactivity
Goldman-Mellor, S. J. (2012) · eScholarship (California Digital Library)
Football society players over the age of 55: how stressful can a match be?
Vieira, J. L. L., da Silva, F. T., de Souza, V. D. F. M., Amorim, A. C., & Ferreira, L. (2021) · Acta Scientiarum Health Sciences · doi:10.4025/actascihealthsci.v43i1.53357
“…to stressful practice (football society) to the research field due to the increase in salivary cortisol seen during the match, since some studies (Haneishi et al., 2007; Kumari et al., 2010) have shown that healthy elderly people with higher salivary cortisol showed lower physical performance.”
BackgroundEndocrine Factors Related to Frailty
Urano, T. (2022) · Nihon Naika Gakkai Zasshi · doi:10.2169/naika.111.618
Meena Kumari, B., Booker, C. L., & Chandola, T. (2023) · Springer eBooks · doi:10.1007/978-1-4614-6625-3_23-1
Changes in hair cortisol during retirement transition: the Finnish retirement and aging study
Kuusento, K., Kortesluoma, S., Myllyntausta, S., Vahtera, J., Karlsson, L., & Stenholm, S. (2025) · Comprehensive Psychoneuroendocrinology · doi:10.1016/j.cpnec.2025.100325
“Aging can also result in HPA axis dysregulation manifesting as a flatter diurnal cortisol pattern [47].”
DOES SOCIAL STATUS PREDICT INDIVIDUAL DIFFERENCES IN HYPOTHALAMIC-PITUITARY-ADRENOCORTICAL ACTIVITY?
Miller, K. (2014) · D-Scholarship@Pitt (University of Pittsburgh)
Hernández, B., Scarlett, S., Moriarty, F., Romero-Ortuno, R., Kenny, R. A., & Reilly, R. B. (2022) · Figshare · doi:10.6084/m9.figshare.21077439
Profiles of risk and resilience, and diurnal cortisol rhythms in Mexican-origin mothers
Ku, S., Boyer, C. J., Mahmodi, M., & Hibel, L. C. (2026) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2026.107814
- Authors
- Kumari, M., Badrick, E., Sacker, A., Kirschbaum, C., Marmot, M., & Chandola, T.
- Affiliations
- Queen Mary University of London (GB)
- University of Essex (GB)
- Technische Universität Dresden (DE)
- University College London (GB)
- Venue
- Psychoneuroendocrinology
- Publisher
- Elsevier BV
- Published
- 2010-08
- Volume
- 35
- Issue
- 7
- Pages
- 1091-1099
- ISSN
- 0306-4530 (ISSN-L)
- OpenAlex
- W2134491025
- Cited by
- 92
- References
- 49
- Citations by year
- 2026: 1 · 2025: 6 · 2023: 3 · 2022: 7 · 2021: 2 · 2020: 6 · 2019: 2 · 2018: 6 · 2017: 7 · 2016: 6 · 2015: 3 · 2014: 12 · 2013: 10 · 2012: 11
- FWCI
- 4.16
- Type
- journal article
- Language
- en
- Open access
- Licence
- Locations
- Psychoneuroendocrinology (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Research Explorer (The University of Manchester) (submittedVersion, other-oa)
- Funders
- National Institute for Health and Care Research
- British Heart Foundation (RG/02/005, PG/03/029, RG/07/008/23674)
- University College London
- Agency for Healthcare Research and Quality (HS06516)
- Economic and Social Research Council (RES518285001, ES/H00811X/1, ES/G002452/1)
- National Institute on Aging (AG 13196)
- National Heart, Lung, and Blood Institute (HL36310, R01HL036310)
- Topics
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
- Keywords
- older adults, cortisol awakening response, hypothalamic-pituitary-adrenal axis, negative feedback, sleep duration, walking speed, stress, smoking, sex differences, Whitehall II study
- MeSH terms
- Aged, Aging, Female, Humans, Hydrocortisone, Male, Middle Aged, Pituitary-Adrenal System, Saliva, Sex Factors, Sleep, Smoking, Wakefulness, Cohort Studies, Walking
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
