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Cited by 182Frailty in Older AdultsStress Responses and CortisolAdrenal Hormones and Disorders

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
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Abstract

BACKGROUND: Frailty is an important geriatric condition with increased vulnerability to stressors (e.g., infection and injury) and for developing functional dependence and mortality. Impairments in signaling pathways, including neuroendocrine alterations, are thought to be involved in the etiology of frailty, but have not been well characterized to date. We evaluated whether higher levels and blunted diurnal variation of salivary cortisol are cross-sectionally associated with frailty burden. METHODS: Two hundred fourteen community-dwelling women, 80-90 years old, from the Women's Health and Aging Study participated in this study between 2004 and 2005. Seven saliva samples were collected for cortisol measurement over a 24-hour period. Main outcomes were awakening, evening, and overall mean cortisol; diurnal amplitude; and rate of decline of cortisol level during morning hours. All cortisol concentrations were log-transformed. Frailty burden was calculated, based on a previously validated tool, as the number (0-5) of the following criteria present: weakness, exhaustion, weight loss, slowness, and inactivity. RESULTS: Significant positive associations were found between frailty burden and evening cortisol (beta = 0.11, p =.04), and between frailty burden and 24-hour mean cortisol (beta = 0.07, p =.03). Increasing frailty burden was significantly associated with smaller declines in cortisol during morning hours (beta = 0.04, p =.02). Frailty burden of > or =2 was associated with a smaller diurnal amplitude (beta = -0.34, p =.03). Awakening cortisol was not significantly associated with frailty burden (beta = 0.01, p =.8). All analyses included adjustments for several important confounders. CONCLUSIONS: Our findings provide the first epidemiological evidence that higher levels and blunted diurnal variation of cortisol may be involved in the vulnerability and clinical presentation observed in frail older women.

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  • A cross-sectional study of 214 participants found frailty independently linked to persistently high daytime cortisol.

    “One cross sectional study (n=214) reported that frailty was independently associated with chronically elevated diurnal cortisol levels (48).”

    From Frailty in elderly people (2013) · cites this paper as [48]

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Authors
Varadhan, R., Walston, J., Cappola, A. R., Carlson, M. C., Wand, G. S., & Fried, L. P.
Affiliations
  • Johns Hopkins University (US)
  • University of Pennsylvania (US)
Corresponding author
Varadhan, R.
ORCID
Venue
The Journals of Gerontology Series A: Biological Sciences and Medical Sciences
Publisher
Oxford University Press (OUP)
Published
2008-02-01
Volume
63
Issue
2
Pages
190-195
ISSN
  • 1079-5006 (ISSN-L)
  • 1758-535X
DOI
10.1093/gerona/63.2.190
OpenAlex
W2111293437
Cited by
182
References
36
Citations by year
2026: 6 · 2025: 10 · 2024: 9 · 2023: 9 · 2022: 8 · 2021: 10 · 2020: 16 · 2019: 16 · 2018: 11 · 2017: 11 · 2016: 11 · 2015: 5 · 2014: 10 · 2013: 9 · 2012: 7
FWCI
4.60
Type
journal article
Language
en
Open access
closed
Locations
  • The Journals of Gerontology Series A (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (5r37ag019905-10)
  • National Institute on Aging (R37-AG19905, P30AG021334)
Topics
  • Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
  • Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
Keywords
frailty, salivary cortisol, diurnal cortisol rhythm, diurnal amplitude, older women, neuroendocrine function, Women's Health and Aging Study
MeSH terms
Aged, 80 and over, Circadian Rhythm, Cross-Sectional Studies, Female, Humans, Hydrocortisone, Regression Analysis, Saliva, Frail Elderly, Statistics, Nonparametric

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