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Gifford RM, Taylor N, Carroll A, Sweeting J, Parsons IT, Stacey MJ, Homer NZM, Tsanas A, Woods DR, Reynolds RM. Assessment of salivary cortisol dynamics in an infantry training exercise: a pilot study. BMJ Mil Health 2024:e002622. [PMID: 38604756 DOI: 10.1136/military-2023-002622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 02/26/2024] [Indexed: 04/13/2024]
Abstract
INTRODUCTION Measuring cortisol during military training offers insights into physiological responses to stress. We attempted precisely timed, cortisol awakening response (CAR) and pre-sleep cortisol (PSC), and diurnal slope (peak morning minus evening cortisol), during a British Army exercise. We aimed to understand cortisol dynamics and evaluate the feasibility of CAR and PSC in this environment. METHOD Setting: high-intensity, 10-day infantry exercise. Participants: regular infantry soldiers exercising (EX, n=25) or headquarters-based (HQ, n=6). Participants undertook PSC and WAKE and WAKE+30 min samples after 1-2 days, 5-6 days and 9-10 days. Wrist-worn GENEActiv accelerometers were used to assess sleep duration in EX only. Samples taken ±15 min from prespecified time points were deemed adherent. Validated questionnaires were used to measure resilience and perceived stress. Cortisol and cortisone were measured simultaneously by liquid chromatography tandem mass spectrometry. RESULTS From adherent participants' samples, CAR was positive and tended to decrease as the exercise progressed. From all available data, HQ demonstrated greater diurnal slope than EX (F=7.68, p=0.02), reflecting higher morning cortisol (F=4.72, p=0.038) and lower PSC (p=0.04). No differences were seen in cortisol:cortisone ratio. 26.1% of CAR samples were adherent, with moderately strong associations between adherence and stress (r=0.41, p=0.009) but no association between adherence and day of exercise (χ2=0.27, p=0.8), sleep duration (r=-0.112, p=0.43) or resilience (r=-0.79, p=0.75). Test-retest reliability ratings for CAR were Cronbach's α of 0.48, -11.7 and 0.34 for the beginning, middle and end of the exercise, respectively. CONCLUSIONS We observed a reduction in morning cortisol and decreased diurnal slope during a high-intensity military exercise, compared with the HQ comparator cohort in whom diurnal slope was preserved. A carefully timed CAR was not feasible in this setting.
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Affiliation(s)
- Robert M Gifford
- British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
- Academic Department of Military Medicine, Royal Centre for Defence Medicine, Birmingham, UK
| | - N Taylor
- Academic Department of Military General Practice, Royal Centre for Defence Medicine, Birmingham, UK
| | - A Carroll
- Royal Centre for Defence Medicine, Birmingham, UK
| | - J Sweeting
- Royal Centre for Defence Medicine, Birmingham, UK
| | - I T Parsons
- Academic Department of Military Medicine, Royal Centre for Defence Medicine, Birmingham, UK
| | - M J Stacey
- Academic Department of Military Medicine, Royal Centre for Defence Medicine, Birmingham, UK
| | - N Z M Homer
- British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - A Tsanas
- Usher Institute, Edinburgh Medical School, University of Edinburgh, Edinburgh, UK
| | - D R Woods
- Academic Department of Military Medicine, Royal Centre for Defence Medicine, Birmingham, UK
| | - R M Reynolds
- British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
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Wu Q, Fang G, Zhao J, Liu J. Effect of Transcranial Pulsed Current Stimulation on Fatigue Delay after Medium-Intensity Training. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127042. [PMID: 35742289 PMCID: PMC9222574 DOI: 10.3390/ijerph19127042] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 06/02/2022] [Accepted: 06/07/2022] [Indexed: 02/04/2023]
Abstract
The purpose of this study was to investigate the effect of transcranial pulsed current stimulation (tPCS) on fatigue delay after medium-intensity training. Materials and Methods: Ninety healthy college athletes were randomly divided into an experimental group (n = 45) and control group (n = 45). The experimental group received medium-intensity training for a week. After each training, the experimental group received true stimulation of tPCS (continuous 15 min 1.5 mA current intensity stimulation). The control group received sham stimulation. The physiological and biochemical indicators of participants were tested before and after the experiment, and finally 30 participants in each group were included for data analysis. Results: In the experimental group, creatine kinase (CK), cortisol (C), time-domain heart rate variability indices root mean square of the successive differences (RMSSD), standard deviation of normal R-R intervals (SDNN), and frequency domain indicator low frequency (LF) all increased slowly after the intervention. Among these, CK, C, and SDNN values were significantly lower than those in the control group (p < 0.05). Testosterone (T), T/C, and heart rate variability frequency domain indicator high frequency (HF) in the experimental group decreased slowly after the intervention, and the HF value was significantly lower than that in the control group (p < 0.05). The changes in all of the indicators in the experimental group were smaller than those in the control group. Conclusion: The application of tPCS after medium-intensity training enhanced the adaptability to training and had a significant effect on the maintenance of physiological state. The application of tPCS can significantly promote the recovery of autonomic nervous system function, enhance the regulation of parasympathetic nerves, and delay the occurrence of fatigue.
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Affiliation(s)
- Qingchang Wu
- College of Sports Science, Nantong University, Nantong 226019, China;
| | - Guoliang Fang
- China Institute of Sport Science, Beijing 100061, China; (G.F.); (J.Z.)
| | - Jiexiu Zhao
- China Institute of Sport Science, Beijing 100061, China; (G.F.); (J.Z.)
| | - Jian Liu
- College of Sports Science, Nantong University, Nantong 226019, China;
- Correspondence:
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Abstract
Frailty is a complex syndrome affecting a growing sector of the global population as medical developments have advanced human mortality rates across the world. Our current understanding of frailty is derived from studies conducted in the laboratory as well as the clinic, which have generated largely phenotypic information. Far fewer studies have uncovered biological underpinnings driving the onset and progression of frailty, but the stage is set to advance the field with preclinical and clinical assessment tools, multiomics approaches together with physiological and biochemical methodologies. In this article, we provide comprehensive coverage of topics regarding frailty assessment, preclinical models, interventions, and challenges as well as clinical frameworks and prevalence. We also identify central biological mechanisms that may be at play including mitochondrial dysfunction, epigenetic alterations, and oxidative stress that in turn, affect metabolism, stress responses, and endocrine and neuromuscular systems. We review the role of metabolic syndrome, insulin resistance and visceral obesity, focusing on glucose homeostasis, adenosine monophosphate-activated protein kinase (AMPK), mammalian target of rapamycin (mTOR), and nicotinamide adenine dinucleotide (NAD+ ) as critical players influencing the age-related loss of health. We further focus on how immunometabolic dysfunction associates with oxidative stress in promoting sarcopenia, a key contributor to slowness, weakness, and fatigue. We explore the biological mechanisms involved in stem cell exhaustion that affect regeneration and may contribute to the frailty-associated decline in resilience and adaptation to stress. Together, an overview of the interplay of aging biology with genetic, lifestyle, and environmental factors that contribute to frailty, as well as potential therapeutic targets to lower risk and slow the progression of ongoing disease is covered. © 2022 American Physiological Society. Compr Physiol 12:1-46, 2022.
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Affiliation(s)
- Laís R. Perazza
- Department of Physical Therapy and Athletic Training, Boston University, Boston, Massachusetts, USA
| | - Holly M. Brown-Borg
- Department of Biomedical Sciences, University of North Dakota, Grand Forks, North Dakota, USA
| | - LaDora V. Thompson
- Department of Physical Therapy and Athletic Training, Boston University, Boston, Massachusetts, USA
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A Review of Biophysiological and Biochemical Indicators of Stress for Connected and Preventive Healthcare. Diagnostics (Basel) 2021; 11:diagnostics11030556. [PMID: 33808914 PMCID: PMC8003811 DOI: 10.3390/diagnostics11030556] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 03/14/2021] [Accepted: 03/17/2021] [Indexed: 12/05/2022] Open
Abstract
Stress is a known contributor to several life-threatening medical conditions and a risk factor for triggering acute cardiovascular events, as well as a root cause of several social problems. The burden of stress is increasing globally and, with that, is the interest in developing effective stress-monitoring solutions for preventive and connected health, particularly with the help of wearable sensing technologies. The recent development of miniaturized and flexible biosensors has enabled the development of connected wearable solutions to monitor stress and intervene in time to prevent the progression of stress-induced medical conditions. This paper presents a review of the literature on different physiological and chemical indicators of stress, which are commonly used for quantitative assessment of stress, and the associated sensing technologies.
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Watermeyer T, Robb C, Gregory S, Udeh-Momoh C. Therapeutic implications of hypothalamic-pituitaryadrenal-axis modulation in Alzheimer's disease: A narrative review of pharmacological and lifestyle interventions. Front Neuroendocrinol 2021; 60:100877. [PMID: 33045258 DOI: 10.1016/j.yfrne.2020.100877] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 09/28/2020] [Accepted: 10/05/2020] [Indexed: 12/17/2022]
Abstract
With disease-modifying treatments for Alzheimer's disease (AD) still elusive, the search for alternative intervention strategies has intensified. Growing evidence suggests that dysfunction in hypothalamic-pituitaryadrenal-axis (HPAA) activity may contribute to the development of AD pathology. The HPAA, may therefore offer a novel target for therapeutic action. This review summarises and critically evaluates animal and human studies investigating the effects of pharmacological and non-pharmacological intervention on HPAA modulation alongside cognitive performance. The interventions discussed include glucocorticoid receptor antagonists and 11β-hydroxysteroid dehydrogenase inhibitors as well as lifestyle treatments such as physical activity, diet, sleep and contemplative practices. Pharmacological HPAA modulators improve pathology and cognitive deficit in animal AD models, but human pharmacological trials are yet to provide definitive support for such benefits. Lifestyle interventions may offer promising strategies for HPAA modification and cognitive health, but several methodological caveats across these studies were identified. Directions for future research in AD studies are proposed.
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Affiliation(s)
- Tamlyn Watermeyer
- Department of Psychology, Faculty of Health and Life Sciences, Northumbria University, Newcastle, UK; Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Catherine Robb
- Ageing Epidemiology Research Unit, School of Public Health, Faculty of Medicine, The Imperial College of Science, Technology and Medicine, London, UK
| | - Sarah Gregory
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Chinedu Udeh-Momoh
- Ageing Epidemiology Research Unit, School of Public Health, Faculty of Medicine, The Imperial College of Science, Technology and Medicine, London, UK; Translational Health Sciences, School of Clinical Sciences, University of Bristol, Bristol, UK.
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Lever-van Milligen BA, Lamers F, Smit JH, Penninx BWJH. Physiological stress markers, mental health and objective physical function. J Psychosom Res 2020; 133:109996. [PMID: 32229341 DOI: 10.1016/j.jpsychores.2020.109996] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 03/13/2020] [Accepted: 03/14/2020] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The observed poorer physical function in persons with mental disorders could partly be due to dysregulation in physiological stress systems. However, an integrated picture of the role of physiological stress systems on objective physical function is lacking. This study examined the association of multiple physiological stress systems with objective physical function, and explored whether these stress systems contribute to the relationship between depression/anxiety and poorer physical function. METHODS Data of 2860 persons of the Netherlands Study of Depression and Anxiety was used. Physical function was indicated by hand grip strength assessed using a hand-held dynamometer and lung function assessed using a peak flow meter. Inflammatory markers (CRP, IL-6, TNF-α), salivary cortisol (cortisol awakening response (AUCg, AUCi), evening cortisol) and ANS markers (heartrate, PEP, RSA) were determined. Depression/anxiety disorders were determined using psychiatric interviews. Linear regression analyses were adjusted for sociodemographics, health and lifestyle factors. RESULTS Higher inflammation levels were associated with lower hand grip strength (BCRP = -0.21(SE = 0.06), p < .001) and lower lung function (BCRP = -2.07(SE = 0.66), p = .002), BTNF-α = -3.35(SE = 1.42), p = .022). Higher salivary cortisol levels were associated with lower lung function (Bevening cortisol = -2.22(SE = 0.59), p < .001). The association, in women, between depression/anxiety disorders and poorer physical function did not significantly diminish after adjustment for physiological stress markers. CONCLUSION This large cohort study showed that stress system dysfunction (especially the immune-inflammatory system and HPA-axis) contributes to poorer objective physical function. Stress system dysfunction did not explain the poorer physical function observed in persons with depression/anxiety disorders, suggesting that other pathways are involved to explain that association.
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Affiliation(s)
- Bianca A Lever-van Milligen
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry and GGZ inGeest, Amsterdam Public Health Research Institute, the Netherlands.
| | - Femke Lamers
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry and GGZ inGeest, Amsterdam Public Health Research Institute, the Netherlands
| | - Johannes H Smit
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry and GGZ inGeest, Amsterdam Public Health Research Institute, the Netherlands
| | - Brenda W J H Penninx
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry and GGZ inGeest, Amsterdam Public Health Research Institute, the Netherlands
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7
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Gardner M, Lightman S, Kuh D, Comijs H, Deeg D, Gallacher J, Geoffroy MC, Kivimaki M, Kumari M, Power C, Hardy R, Richards M, Ben-Shlomo Y. Dysregulation of the hypothalamic pituitary adrenal (HPA) axis and cognitive capability at older ages: individual participant meta-analysis of five cohorts. Sci Rep 2019; 9:4555. [PMID: 30872618 PMCID: PMC6418174 DOI: 10.1038/s41598-019-40566-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 02/19/2019] [Indexed: 01/04/2023] Open
Abstract
Evidence on the association between functioning of the hypothalamic pituitary adrenal (HPA) axis and cognitive capability at older ages is mixed. We undertook a systematic review (until October 2016) and individual participant data (IPD) meta-analysis to test if dysregulation of the HPA axis is associated with worse cognitive capability. Five cohort studies were included in the IPD meta-analysis of diurnal cortisol patterns with crystallised and fluid cognitive ability. Higher night time cortisol was associated with worse fluid ability (standardised coefficient per SD increase −0.063, 95% CI −0.124, −0.002, P = 0.04; I2 = 79.9%; age and gender adjusted). A larger diurnal drop was associated with better fluid ability (standardised coefficient per SD increase 0.037, 95% CI 0.008, 0.065, P = 0.01; I2 = 49.2%; age and gender adjusted). A bigger cortisol awakening response (CAR) was weakly associated with better fluid (P = 0.09; I2 = 0.0%; age and gender adjusted) and crystallised (P = 0.10; I2 = 0.0%; age and gender adjusted) ability. There is weak evidence that a greater diurnal decline of the HPA axis and a larger CAR are associated with improvements in cognition at older ages. As associations are cross-sectional, we cannot rule out reverse causation.
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Affiliation(s)
- Michael Gardner
- Nuffield Department of Population Health, University of Oxford, Oxford, UK.
| | - Stafford Lightman
- Henry Wellcome Laboratories for Integrative Neuroscience and Endocrinology, Bristol, UK
| | - Diana Kuh
- MRC Unit for Lifelong Health and Ageing at UCL, London, UK
| | - Hannie Comijs
- Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Dorly Deeg
- Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - John Gallacher
- Department of Psychiatry, University of Oxford, Oxford, UK
| | | | - Mika Kivimaki
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Meena Kumari
- Department of Epidemiology and Public Health, University College London, London, UK.,ISER, University of Essex, Essex, UK
| | - Chris Power
- Population, Policy and Practice, UCL, Great Ormond Street, Institute of Child Health, University College London, London, UK
| | - Rebecca Hardy
- MRC Unit for Lifelong Health and Ageing at UCL, London, UK
| | | | - Yoav Ben-Shlomo
- Department of Population Health Sciences, University of Bristol, Canynge Hall, Bristol, UK
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8
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Tortosa-Martínez J, Manchado C, Cortell-Tormo JM, Chulvi-Medrano I. Exercise, the diurnal cycle of cortisol and cognitive impairment in older adults. Neurobiol Stress 2018; 9:40-47. [PMID: 30450372 PMCID: PMC6234274 DOI: 10.1016/j.ynstr.2018.08.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 08/05/2018] [Accepted: 08/11/2018] [Indexed: 12/31/2022] Open
Abstract
Exercise has been shown to reduce the risk of developing Mild Cognitive Impairment and Alzheimer's disease as well as to improve cognition in healthy and cognitively impaired individuals. However, the mechanisms of these benefits are not well understood. The stress hypothesis suggests that the cognitive benefits attributed to exercise may partially be mediated by changes in the cortisol secretion pattern. Chronic stress may increase the risk of AD and exacerbate the cognitive deficits and brain pathology characteristic of the condition while physical activity has been shown to attenuate most of stress consequences and risk factors for AD. Initially, research on the effects of cortisol on cognition and physical activity focused on cortisol levels at one time point but the circadian pattern of cortisol secretion is complex and it is still unclear which aspects are most closely associated with cognitive function. Thus, the aim of this review was to analyze the exercise/stress/cognition hypothesis focusing on the effects of the diurnal cycle of cortisol on cognitive function and physical activity in older adults with and without cognitive impairment.
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Affiliation(s)
- J Tortosa-Martínez
- University of Alicante, Facultad de Educación, Carretera San Vicente del Raspeig s/n, 03690, San Vicente del Raspeig, Alicante, Spain
| | - C Manchado
- University of Alicante, Facultad de Educación, Carretera San Vicente del Raspeig s/n, 03690, San Vicente del Raspeig, Alicante, Spain
| | - J M Cortell-Tormo
- University of Alicante, Facultad de Educación, Carretera San Vicente del Raspeig s/n, 03690, San Vicente del Raspeig, Alicante, Spain
| | - I Chulvi-Medrano
- University of Alicante, Facultad de Educación, Carretera San Vicente del Raspeig s/n, 03690, San Vicente del Raspeig, Alicante, Spain
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9
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Anderson T, Wideman L. Exercise and the Cortisol Awakening Response: A Systematic Review. SPORTS MEDICINE - OPEN 2017; 3:37. [PMID: 29019089 PMCID: PMC5635140 DOI: 10.1186/s40798-017-0102-3] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 09/26/2017] [Indexed: 11/21/2022]
Abstract
BACKGROUND The cortisol awakening response (CAR) has been used as a biomarker of stress response in a multitude of psychological investigations. While a myriad of biochemical responses have been proposed to monitor responses to exercise training, the use of CAR within the exercise and sports sciences is currently limited and is a potentially underutilized variable. Therefore, the purpose of this review was to collate studies that incorporate both exercise and CAR, in an effort to better understand (a) whether CAR is a useful marker for monitoring exercise stress and (b) how CAR may be most appropriately used in future research. METHODS A systematic review of the literature was conducted, following PRISMA guidelines. Searches were conducted using PubMed, SportDISCUS, Scopus, and PsychInfo databases, using search terms related toCAR and exercise and physical activity. RESULTS 10,292 articles were identified in the initial search, with 32 studies included in the final analysis. No studies investigated the effects of laboratory-controlled exercise on CAR. Variable effects were observed, possibly due to inconsistencies in study design, methodology, population, and CAR analysis. The available literature suggests a threshold of exercise may be required to alter the HPA axis and affect CAR. Moreover, CAR may represent a combination of previous exercise load and upcoming stress, making current interpretation of field-based observational research challenging. CONCLUSIONS More research is needed to fully elucidate the influence of exercise on CAR and address a number of gaps in the literature, including controlling exercise load, consistent sample collection, and CAR calculation and analysis.
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Affiliation(s)
- Travis Anderson
- University of North Carolina at Greensboro, Greensboro, NC 27412 USA
| | - Laurie Wideman
- University of North Carolina at Greensboro, Greensboro, NC 27412 USA
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10
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Cortisol and physical performance in older populations: Findings from the international mobility in aging study (IMIAS). Arch Gerontol Geriatr 2017; 71:50-58. [DOI: 10.1016/j.archger.2017.03.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 03/02/2017] [Accepted: 03/05/2017] [Indexed: 01/19/2023]
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Pulopulos MM, Puig-Perez S, Hidalgo V, Villada C, Salvador A. Cortisol Awakening Response and Walking Speed in Older People. PLoS One 2016; 11:e0152071. [PMID: 27191847 PMCID: PMC4871454 DOI: 10.1371/journal.pone.0152071] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 03/07/2016] [Indexed: 11/18/2022] Open
Abstract
In older people, less diurnal variability in cortisol levels has been consistently related to worse physical performance, especially to slower walking speed (WS). The cortisol awakening response (CAR) is a discrete component of the hypothalamic-pituitary-adrenal axis that has been related to several health problems, such as cardiovascular disease and/or worse performance on executive function and memory. The relationship between the CAR and physical performance in older people is poorly understood. In this study, in 86 older people (mean age = 64.42, SD = 3.93), we investigated the relationship between the CAR and WS, a commonly used measure of physical performance in the older population that has also been related to health problems, such as cardiovascular disease and executive function performance in older people. Additionally, we studied whether the relationship between the CAR and WS was independent from cortisol levels on awakening and several possible confounders. Results showed that a CAR of reduced magnitude (measured with 3 samples each day, for two consecutive days, and calculated as the area under the curve with respect to the increase), but not cortisol levels on awakening, was related to slower WS. In addition, this relationship was independent from cortisol levels on awakening. It is possible that a CAR of reduced magnitude would contribute to less diurnal cortisol variability, affecting physical performance. Additionally, it is possible that a CAR of reduced magnitude affects WS through a possible negative effect on executive function, or that the association between the CAR and WS is due to the fact that both are related to similar health problems and to changes in cognitive performance in older people.
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Affiliation(s)
- Matias M. Pulopulos
- Laboratory of Social Cognitive Neuroscience, Department of Psychobiology and IDOCAL, Universitat de València, Valencia, Spain
- * E-mail:
| | - Sara Puig-Perez
- Laboratory of Social Cognitive Neuroscience, Department of Psychobiology and IDOCAL, Universitat de València, Valencia, Spain
| | - Vanesa Hidalgo
- Laboratory of Social Cognitive Neuroscience, Department of Psychobiology and IDOCAL, Universitat de València, Valencia, Spain
| | - Carolina Villada
- Laboratory of Social Cognitive Neuroscience, Department of Psychobiology and IDOCAL, Universitat de València, Valencia, Spain
| | - Alicia Salvador
- Laboratory of Social Cognitive Neuroscience, Department of Psychobiology and IDOCAL, Universitat de València, Valencia, Spain
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12
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Pilot study of adrenal steroid hormones in hair as an indicator of chronic mental and physical stress. Sci Rep 2016; 6:25842. [PMID: 27174654 PMCID: PMC4865856 DOI: 10.1038/srep25842] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2015] [Accepted: 04/20/2016] [Indexed: 11/14/2022] Open
Abstract
Currently, the quantitative analysis of moderators affecting the function of the hypothalamus-pituitary-adrenal (HPA)-axis in health and sickness is still unreliable. This is, in particular, due to physiological factors such as pulsatile ultradian and circadian glucocorticoid secretion as well as to methodological limitations of the current techniques for steroid hormone determination. Based on this background, the determination of long-term hair steroid concentrations is an important methodological improvement allowing for the quantitative analysis of chronic HPA axis-activation. In order to determine the relationship between chronic mental and physical stress and a chronic activation of the HPA axis, we performed a cross-sectional pilot-study with 40 healthy students and examined the relationships between physical activity, mental burden(s), subjective stress perceptions, depressiveness, anxiety, physical complaints, sense of coherence, resilience, and the long-term integrated steroid hormone levels in hair. The results showed that the concentrations of cortisol, cortisone, and dehydroepiandrosterone in hair were significantly correlated to mental (p = 0.034) and physical stress (p = 0.001) as well as to subjective stress perception (p = 0.006). We conclude that steroid concentrations in hair are decisive predictors for an increase in the long-term-HPA axis activity. Moreover, this biomarker is suitable for capturing the stresslevel after burdening events and physical activity.
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Ullmann E, Barthel A, Taché S, Bornstein A, Licinio J, Bornstein SR. Emotional and psychological trauma in refugees arriving in Germany in 2015. Mol Psychiatry 2015; 20:1483-4. [PMID: 26527128 DOI: 10.1038/mp.2015.164] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- E Ullmann
- Department of Medicine, University of Dresden, Dresden, Germany.,Center of Developmental Pediatrics, City Hospital Dresden, Dresden, Germany
| | - A Barthel
- Department of Medicine, University of Dresden, Dresden, Germany.,Endokrinologikum Ruhr, Bochum, Germany
| | - S Taché
- German Red Cross, Dresden, Germany
| | - A Bornstein
- Department of Medicine, University of Dresden, Dresden, Germany
| | - J Licinio
- Mind and Brain Theme, South Australian Health and Medical Research Institute, Flinders University, Adelaide, Australia
| | - S R Bornstein
- Department of Medicine, University of Dresden, Dresden, Germany.,Endocrinology and Diabetes, Division of Diabetes & Nutritional Sciences, Rayne Institute, Denmark Hill Campus, Faculty of Life Sciences & Medicine, Kings College London, London, UK
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14
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Lucertini F, Ponzio E, Di Palma M, Galati C, Federici A, Barbadoro P, D’Errico MM, Prospero E, Ambrogini P, Cuppini R, Lattanzi D, Minelli A. High Cardiorespiratory Fitness Is Negatively Associated with Daily Cortisol Output in Healthy Aging Men. PLoS One 2015; 10:e0141970. [PMID: 26529517 PMCID: PMC4631391 DOI: 10.1371/journal.pone.0141970] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Accepted: 10/15/2015] [Indexed: 12/11/2022] Open
Abstract
Physical fitness has salutary psychological and physical effects in older adults by promoting neuroplasticity and adaptation to stress. In aging, however, the effects of fitness on the hypothalamic-pituitary-adrenal (HPA) axis are mixed. We investigated the association between cardiorespiratory fitness and HPA activity in healthy elderly men (n = 22, mean age 68 y; smokers, obese subjects, those taking drugs or reporting recent stressful events were excluded), by measuring in saliva: i) daily pattern of cortisol secretion (6 samples: 30' post-awakening, and at 12.00, 15.00, 18.00, 21.00, 24.00 h); and ii) the cortisol response to a mental challenge. Cardiorespiratory fitness (VO2max) was estimated using the Rockport Walking Test and the participants were assigned to high-fit (HF, ≥60°, n = 10) and low-fit (LF, ≤35°, n = 12) groups according to age-specific percentiles of VO2max distribution in the general population. At all daytimes, basal cortisol levels were lower in the HF than the LF group, most notably in the evening and midnight samples, with a significant main effect of physical fitness for cortisol levels overall; the area-under-the-curve for total daily cortisol output was significantly smaller in the HF group. Among the subjects who responded to mental stress (baseline-to-peak increment >1.5 nmol/L; n = 13, 5 LF, 8 HF), the amplitude of cortisol response and the steepness of recovery decline displayed an increasing trend in the HF subjects, although between-group differences failed to reach the threshold for significance. In conclusion, cardiorespiratory fitness in healthy aging men is negatively correlated with daily cortisol output and contributes to buffering the HPA dysregulation that occurs with advancing age, thus possibly playing a beneficial role in contrasting age-related cognitive and physical decline.
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Affiliation(s)
- Francesco Lucertini
- Department of Biomolecular Sciences, Division of Exercise and Health Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Elisa Ponzio
- Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, Ancona, Italy
| | - Michael Di Palma
- Department of Earth, Life and Environmental Sciences (DiSTeVA), University of Urbino Carlo Bo, Urbino, Italy
| | - Claudia Galati
- Department of Earth, Life and Environmental Sciences (DiSTeVA), University of Urbino Carlo Bo, Urbino, Italy
| | - Ario Federici
- Department of Biomolecular Sciences, Division of Exercise and Health Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Pamela Barbadoro
- Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, Ancona, Italy
| | - Marcello M. D’Errico
- Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, Ancona, Italy
| | - Emilia Prospero
- Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, Ancona, Italy
| | - Patrizia Ambrogini
- Department of Earth, Life and Environmental Sciences (DiSTeVA), University of Urbino Carlo Bo, Urbino, Italy
| | - Riccardo Cuppini
- Department of Earth, Life and Environmental Sciences (DiSTeVA), University of Urbino Carlo Bo, Urbino, Italy
| | - Davide Lattanzi
- Department of Earth, Life and Environmental Sciences (DiSTeVA), University of Urbino Carlo Bo, Urbino, Italy
| | - Andrea Minelli
- Department of Earth, Life and Environmental Sciences (DiSTeVA), University of Urbino Carlo Bo, Urbino, Italy
- * E-mail:
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15
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Abstract
Human aging is associated with increasing frailty and morbidity which can result in significant disability. Dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis may contribute to aging-related diseases like depression, cognitive deficits, and Alzheimer's disease in some older individuals. In addition to neuro-cognitive dysfunction, it has also been associated with declining physical performance possibly due to sarcopenia. This article reviews the pathophysiology of HPA dysfunction with respect to increased basal adrenocorticotropic hormone (ACTH) and cortisol secretion, decreased glucocorticoid (GC) negative feedback at the level of the paraventricular nucleus (PVN) of the hypothalamus, hippocampus (HC), and prefrontal cortex (PFC), and flattening of diurnal pattern of cortisol release. It is possible that the increased cortisol secretion is secondary to peripheral conversion from cortisone. There is a decline in pregnolone secretion and C-19 steroids (DHEA) with aging. There is a small decrease in aldosterone with aging, but a subset of the older population have a genetic predisposition to develop hyperaldosteronism due to the increased ACTH stimulation. The understanding of the HPA axis and aging remains a complex area with conflicting studies leading to controversial interpretations.
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Affiliation(s)
- Deepashree Gupta
- Division of Endocrinology, Saint Louis University, Missouri, St. Louis; Divisions of Endocrinology and Geriatric Medicine, Saint Louis University, Missouri, St. Louis
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16
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Gaysina D, Gardner MP, Richards M, Ben-Shlomo Y. Cortisol and cognitive function in midlife: the role of childhood cognition and educational attainment. Psychoneuroendocrinology 2014; 47:189-98. [PMID: 25001968 PMCID: PMC4103483 DOI: 10.1016/j.psyneuen.2014.05.018] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Revised: 05/20/2014] [Accepted: 05/21/2014] [Indexed: 12/20/2022]
Abstract
Adult cognition and age-related cognitive decline can be influenced by dysregulation of the hypothalamic pituitary adrenal axis with concomitant changes in cortisol levels. However, very little is known about the role of childhood cognition and educational attainment in this relationship. Using data from the British 1946 birth cohort, the present study investigated: (1) associations between cortisol levels and patterns and cognitive function in midlife; (2) direct and interactive effects of childhood cognition, educational attainment and cortisol on cognitive function in midlife. Verbal memory, letter search speed and reaction time were assessed at age 60-64 years. Salivary cortisol samples (wakening, 30 min after wakening and evening) were collected at the same age. Childhood cognitive ability was measured at ages 8, 11, and 15, and educational level was reported at age 26. Associations between cortisol, childhood cognition, educational attainment and cognitive function in midlife were tested using linear regression and structural equation modelling approaches. Higher evening cortisol level was associated with slower reaction time and lower verbal memory. These associations were independent of childhood cognition and education as well as a range of other potential confounders. Childhood cognition and education were not directly associated with evening cortisol. However, there was a significant interaction effect between childhood cognition and evening cortisol on reaction time (p=.002): higher evening cortisol was associated with slower reaction time only among those with low childhood cognitive ability. There was little evidence of associations between the other cortisol measures and cognitive function.
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Affiliation(s)
- Darya Gaysina
- School of Psychology, University of Sussex, Brighton, UK.
| | - Michael P. Gardner
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Marcus Richards
- MRC Unit for Lifelong Health and Ageing, University College London, UK
| | - Yoav Ben-Shlomo
- School of Social and Community Medicine, University of Bristol, Bristol, UK
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17
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Lee J, Fried R, Thayer Z, Kuzawa CW. Preterm delivery as a predictor of diurnal cortisol profiles in adulthood: evidence from Cebu, Philippines. Am J Hum Biol 2014; 26:598-602. [PMID: 24898414 DOI: 10.1002/ajhb.22569] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2013] [Revised: 04/22/2014] [Accepted: 05/16/2014] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES Fetal exposure to elevated maternal cortisol can permanently modify hypothalamic-pituitary-adrenal (HPA) axis function, and thereby have long-term health impacts. Maternal cortisol steadily increases throughout normal pregnancy, but is abnormally high in preterm deliveries (<37 weeks). Prematurity remains a widespread public health problem, yet little is known about its potential long-term effects on adult HPA function. Here we test the hypothesis that diurnal cortisol profiles measured in young adulthood will vary based upon an individual's preterm status. METHODS Diurnal salivary cortisol profiles, a marker of HPA-axis function, were measured in 1,403 young adults (ages 21-23 years) participating in the Cebu Longitudinal Health and Nutrition Survey, located in Metropolitan Cebu City, Philippines. RESULTS Males who had been born preterm exhibited lower morning cortisol and non-significantly elevated evening cortisol, resulting in a more adverse, flatter rate of decline across the day. In contrast, there were no significant differences by preterm status in cortisol measured at any time of day in females. CONCLUSIONS These findings point to potential long-term effects of having been born preterm on adult HPA-axis function, and add to evidence from this and other populations for sex differences in the biological and health impacts of prenatal stress exposure.
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Affiliation(s)
- James Lee
- Department of Anthropology, Northwestern University, Evanston, Illinois, 60208
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18
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Abstract
Research on healthy ageing lacks an agreed conceptual framework and has not adequately taken into account the growing evidence that social and biological factors from early life onwards affect later health. We conceptualise healthy ageing within a life-course framework, separating healthy biological ageing (in terms of optimal physical and cognitive functioning, delaying the onset of chronic diseases, and extending length of life for as long as possible) from changes in psychological and social wellbeing. We summarise the findings of a review of healthy ageing indicators, focusing on objective measures of physical capability, such as tests of grip strength, walking speed, chair rises and standing balance, which aim to capture physical functioning at the individual level, assessing the capacity to undertake the physical tasks of daily living. There is robust evidence that higher scores on these measures are associated with lower rates of mortality, and more limited evidence of lower risk of morbidity, and of age-related patterns of change. Drawing on a research collaboration of UK cohort studies, we summarise what is known about the influences on physical capability in terms of lifetime socioeconomic position, body size and lifestyle, and underlying physiology and genetics; the evidence to date supports a broad set of factors already identified as risk factors for chronic diseases. We identify a need for larger longitudinal studies to investigate age-related change and ethnic diversity in these objective measures, the dynamic relationships between them, and how they relate to other component measures of healthy ageing. Robust evidence across cohort studies, using standardised measures within a clear conceptual framework, will benefit policy and practice to promote healthy ageing.
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Affiliation(s)
- Diana Kuh
- MRC University Unit for Lifelong Health and Ageing at UCL, 33 Bedford Place, London, UK
| | - Sathya Karunananthan
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
| | - Howard Bergman
- Department of Family Medicine, McGill University, Montreal, QC, Canada
| | - Rachel Cooper
- MRC University Unit for Lifelong Health and Ageing at UCL, 33 Bedford Place, London, UK
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19
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Johar H, Emeny RT, Bidlingmaier M, Reincke M, Thorand B, Peters A, Heier M, Ladwig KH. Blunted diurnal cortisol pattern is associated with frailty: a cross-sectional study of 745 participants aged 65 to 90 years. J Clin Endocrinol Metab 2014; 99:E464-8. [PMID: 24564322 DOI: 10.1210/jc.2013-3079] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND The role of neuroendocrine alterations in the etiology of frailty syndrome is still poorly understood. Hypothalamic-pituitary-adrenal axis dysregulation is a plausible candidate pathway contributing to frailty. Thus, we sought to examine the associations of diurnal cortisol secretion with frailty in older adults. METHODS A cross-sectional analysis was conducted among 745 study participants (age 65-90 years, mean age 75.1 years) of the population-based KORA Age study. Associations between salivary cortisol measures at awakening (morning 1 [M1]), 30 minutes after awakening (M2), and evening (E) and frailty criteria were determined. RESULTS Lower cortisol levels in the first morning sample (M1) (P = .18) and M2 (P = .14) and increased E levels (P = .004) were observed in prefrail (35.17%, n = 262) and frail (3.36%, n = 25) individuals, in a dose-response manner. Frailty was strongly associated with smaller ratios of morning to evening levels; M1 to E ratio (P = .02) and M2 to E ratio (P = .003). Higher evening cortisol levels were associated with a 24% increased risk of a prefrail state (odds ratio, 1.22; 95% confidence interval, 1.03-1.44). A smaller morning to evening ratio was associated with an increased risk of low grip strength (1.42, 1.09-1.86) and gait speed (1.31, 1.02-1.68). CONCLUSION Frailty status is associated with blunted cortisol reactivity as demonstrated by lower morning and higher evening salivary cortisol levels.
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Affiliation(s)
- Hamimatunnisa Johar
- Institute of Epidemiology II (H.J., R.T.E., B.T., A.P., M.H., K.-H.L.), Helmholtz Zentrum München, German Research Centre for Environmental Health, 85764 Neuherberg, Germany; Medizinische Klinik und Poliklinik IV (M.B., M.R.), Klinikum der Ludwig-Maximilians-Universität München, 80336 Munich, Germany; and Department of Psychosomatic Medicine and Psychotherapy (K.-H.L.), Klinikum rechts der Isar, Technische Universität München, 81675 Munich, Germany
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20
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Kilgour AHM, Gallagher IJ, MacLullich AMJ, Andrew R, Gray CD, Hyde P, Wackerhage H, Husi H, Ross JA, Starr JM, Chapman KE, Fearon KCH, Walker BR, Greig CA. Increased skeletal muscle 11βHSD1 mRNA is associated with lower muscle strength in ageing. PLoS One 2013; 8:e84057. [PMID: 24391882 PMCID: PMC3877148 DOI: 10.1371/journal.pone.0084057] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Accepted: 11/18/2013] [Indexed: 12/25/2022] Open
Abstract
Background Sarcopenia, the loss of muscle mass and function with age, is associated with increased morbidity and mortality. Current understanding of the underlying mechanisms is limited. Glucocorticoids (GC) in excess cause muscle weakness and atrophy. We hypothesized that GC may contribute to sarcopenia through elevated circulating levels or increased glucocorticoid receptor (GR) signaling by increased expression of either GR or the GC-amplifying enzyme 11beta-hydroxysteroid dehydrogenase type 1 (11βHSD1) in muscle. Methods There were 82 participants; group 1 comprised 33 older men (mean age 70.2years, SD 4.4) and 19 younger men (22.2years, 1.7) and group 2 comprised 16 older men (79.1years, 3.4) and 14 older women (80.1years, 3.7). We measured muscle strength, mid-thigh cross-sectional area, fasting morning plasma cortisol, quadriceps muscle GR and 11βHSD1 mRNA, and urinary glucocorticoid metabolites. Data were analysed using multiple linear regression adjusting for age, gender and body size. Results Muscle strength and size were not associated with plasma cortisol, total urinary glucocorticoids or the ratio of urinary 5β-tetrahydrocortisol +5α-tetrahydrocortisol to tetrahydrocortisone (an index of systemic 11βHSD activity). Muscle strength was associated with 11βHSD1 mRNA levels (β -0.35, p = 0.04), but GR mRNA levels were not significantly associated with muscle strength or size. Conclusion Although circulating levels of GC are not associated with muscle strength or size in either gender, increased cortisol generation within muscle by 11βHSD1 may contribute to loss of muscle strength with age, a key component of sarcopenia. Inhibition of 11βHSD1 may have therapeutic potential in sarcopenia.
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Affiliation(s)
- Alixe H. M. Kilgour
- Centre for Cognitive Ageing and Cognitive Epidemiology, Geriatric Medicine Unit, University of Edinburgh, Edinburgh, United Kingdom
- * E-mail:
| | - Iain J. Gallagher
- Department of Clinical and Surgical Sciences, Division of Health Sciences, School of Clinical Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Alasdair M. J. MacLullich
- Centre for Cognitive Ageing and Cognitive Epidemiology, Geriatric Medicine Unit, University of Edinburgh, Edinburgh, United Kingdom
- Department of Clinical and Surgical Sciences, Division of Health Sciences, School of Clinical Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Ruth Andrew
- Endocrinology Unit, Centre for Cardiovascular Science, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Calum D. Gray
- Clinical Research Imaging Centre, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Philippa Hyde
- Department of Clinical and Surgical Sciences, Division of Health Sciences, School of Clinical Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Henning Wackerhage
- School of Medical Sciences, University of Aberdeen, Aberdeen, United Kingdom
| | - Holger Husi
- Department of Clinical and Surgical Sciences, Division of Health Sciences, School of Clinical Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - James A. Ross
- Department of Clinical and Surgical Sciences, Division of Health Sciences, School of Clinical Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - John M. Starr
- Centre for Cognitive Ageing and Cognitive Epidemiology, Geriatric Medicine Unit, University of Edinburgh, Edinburgh, United Kingdom
| | - Karen E. Chapman
- Endocrinology Unit, Centre for Cardiovascular Science, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Kenneth C. H. Fearon
- Department of Clinical and Surgical Sciences, Division of Health Sciences, School of Clinical Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Brian R. Walker
- Endocrinology Unit, Centre for Cardiovascular Science, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Carolyn A. Greig
- Department of Clinical and Surgical Sciences, Division of Health Sciences, School of Clinical Sciences, University of Edinburgh, Edinburgh, United Kingdom
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21
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Stafford M, Gardner M, Kumari M, Kuh D, Ben-Shlomo Y. Social isolation and diurnal cortisol patterns in an ageing cohort. Psychoneuroendocrinology 2013; 38:2737-45. [PMID: 23920224 PMCID: PMC3820041 DOI: 10.1016/j.psyneuen.2013.07.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Revised: 07/01/2013] [Accepted: 07/10/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND Social isolation may operate as a psychosocial stressor which disrupts functioning of the hypothalamic-pituitary-adrenocortical axis. METHODS Using data from the MRC National Survey of Health and Development, we tested whether living alone, not being married and social network size were associated with diurnal cortisol patterns at 60-64 years. We hypothesised that recent onset compared with long-term isolation would be more strongly associated with cortisol awakening response, cortisol decline over the day and evening cortisol. Models were adjusted for sex, smoking, body mass index, alcohol intake, psychological distress and financial difficulties. RESULTS Those widowed within the last three years had a 36% (95%CI 6%, 73%) higher night time cortisol than those who were currently married. Those newly living alone also had a higher night time cortisol and flatter diurnal slope than those living with others. CONCLUSION Independently of multiple behavioural and psychosocial correlates, recent onset of social isolation is related to diurnal cortisol patterns that increase the risk of morbidity and mortality.
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Affiliation(s)
- Mai Stafford
- MRC Unit for Lifelong Health and Ageing, London, UK.
| | - Mike Gardner
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Meena Kumari
- Department of Epidemiology and Public Health, UCL, London, UK
| | - Diana Kuh
- MRC Unit for Lifelong Health and Ageing, London, UK
| | - Yoav Ben-Shlomo
- School of Social and Community Medicine, University of Bristol, Bristol, UK
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22
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Gardner MP, Lightman S, Sayer AA, Cooper C, Cooper R, Deeg D, Ebrahim S, Gallacher J, Kivimaki M, Kumari M, Kuh D, Martin RM, Peeters G, Ben-Shlomo Y. Dysregulation of the hypothalamic pituitary adrenal (HPA) axis and physical performance at older ages: an individual participant meta-analysis. Psychoneuroendocrinology 2013; 38:40-9. [PMID: 22658392 PMCID: PMC3533133 DOI: 10.1016/j.psyneuen.2012.04.016] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2012] [Revised: 04/26/2012] [Accepted: 04/29/2012] [Indexed: 11/03/2022]
Abstract
The association between functioning of the hypothalamic pituitary adrenal (HPA) axis and physical performance at older ages remains poorly understood. We carried out meta-analyses to test the hypothesis that dysregulation of the HPA axis, as indexed by patterns of diurnal cortisol release, is associated with worse physical performance. Data from six adult cohorts (ages 50-92 years) were included in a two stage meta-analysis of individual participant data. We analysed each study separately using linear and logistic regression models and then used meta-analytic methods to pool the results. Physical performance outcome measures were walking speed, balance time, chair rise time and grip strength. Exposure measures were morning (serum and salivary) and evening (salivary) cortisol. Total sample sizes in meta-analyses ranged from n=2146 for associations between morning Cortisol Awakening Response and balance to n=8448 for associations between morning cortisol and walking speed. A larger diurnal drop was associated with faster walking speed (standardised coefficient per SD increase 0.052, 95% confidence interval (CI) 0.029, 0.076, p<0.001; age and gender adjusted) and a quicker chair rise time (standardised coefficient per SD increase -0.075, 95% CI -0.116, -0.034, p<0.001; age and gender adjusted). There was little evidence of associations with balance or grip strength. Greater diurnal decline of the HPA axis is associated with better physical performance in later life. This may reflect a causal effect of the HPA axis on performance or that other ageing-related factors are associated with both reduced HPA reactivity and performance.
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Affiliation(s)
- Michael P. Gardner
- School of Social and Community Medicine, University of Bristol, Canynge Hall, Bristol, UK
| | - Stafford Lightman
- Henry Wellcome Laboratories for Integrative Neuroscience and Endocrinology, Bristol, UK
| | - Avan Aihie Sayer
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, UK
| | - Cyrus Cooper
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, UK
| | - Rachel Cooper
- MRC Unit for Lifelong Health and Ageing, University College London, UK
| | - Dorly Deeg
- EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Shah Ebrahim
- London School of Hygiene & Tropical Medicine, London, UK
| | - John Gallacher
- Department of Primary Care and Public Health, Cardiff University, UK
| | - Mika Kivimaki
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Meena Kumari
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Diana Kuh
- MRC Unit for Lifelong Health and Ageing, University College London, UK
| | - Richard M. Martin
- School of Social and Community Medicine, University of Bristol, Canynge Hall, Bristol, UK
| | - Geeske Peeters
- The University of Queensland, Schools of Human Movement Studies and Population Health, Brisbane, Australia
| | - Yoav Ben-Shlomo
- School of Social and Community Medicine, University of Bristol, Canynge Hall, Bristol, UK,Corresponding author at: School of Social and Community Medicine, University of Bristol, 39 Whatley Road, Canynge Hall, BS8 2PS, UK. Tel.: +44 0117 928 7206; fax: +44 0117 928 7325.
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23
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Abstract
BACKGROUND Cortisol levels may be altered in childhood in association with maltreatment (neglect, abuse and witnessing abuse) and other adversities, yet little is known about whether effects on cortisol persist into later life. AIMS To establish whether childhood psychosocial adversities predict cortisol levels in mid-adulthood. METHOD Childhood psychosocial adversities were ascertained in the 1958 British birth cohort and cortisol was measured in two saliva samples, one 45 min after awaking (T(1)) and the other 3 h later the same day (T(2)), from 6524 participants aged 45 years. RESULTS No association was seen for abuse or household dysfunction in childhood and adult cortisol levels. In women but not men, T(1) cortisol was lowered by 7.9% per unit increase in childhood neglect score (range 0-3); T(1) to T(2) cortisol decline was less steep. High levels of maltreatment (abuse, neglect, witnessed abuse) were associated with >25% lower T(1) cortisol in both men and women, and 24% higher T(2) cortisol for men after adjustment for concurrent depressive/anxiety symptoms. CONCLUSIONS In a non-clinical population, cumulative maltreatments in childhood were associated with flattened morning cortisol secretion in mid-adult life.
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Affiliation(s)
- Chris Power
- Medical Research Council (MRC) Centre of Epidemiology for Child Health/Centre for Paediatric Epidemiology and Biostatistics, University College London (UCL) Institute of Child Health, London, UK.
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24
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Kuh D, Cooper R, Richards M, Gale C, von Zglinicki T, Guralnik J. A life course approach to healthy ageing: the HALCyon programme. Public Health 2012; 126:193-195. [PMID: 22326597 DOI: 10.1016/j.puhe.2012.01.025] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Healthy ageing across the life course (HALCyon) is an interdisciplinary research collaboration that harnesses the power of nine UK cohort studies to discover life course influences on physical and cognitive capability, social and psychological well-being, and underlying biology. In this symposium, HALCyon co-investigators reported the first wave of findings from five of the eight work packages.
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Affiliation(s)
- D Kuh
- MRC Unit for Lifelong Health and Ageing, London, UK.
| | - R Cooper
- MRC Unit for Lifelong Health and Ageing, London, UK.
| | - M Richards
- MRC Unit for Lifelong Health and Ageing, London, UK
| | - C Gale
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - T von Zglinicki
- Institute for Ageing and Health, Newcastle University, Newcastle, UK
| | - J Guralnik
- University of Maryland School of Medicine, Baltimore, Maryland, USA
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