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

BMJ Open. 2017 Oct 12;7(10):e016085. doi: 10.1136/bmjopen-2017-016085.

Abstract

Objectives: We conducted an individual participant meta-analysis to test the hypothesis that cortisol patterns indicative of dysregulated hypothalamic-pituitary-adrenal axis functioning would be prospectively associated with poorer well-being at follow-up.

Setting: Four large UK-based cohort studies.

Participants: Those providing valid salivary or serum cortisol samples (n=7515 for morning cortisol; n=1612 for cortisol awakening response) at baseline (age 44-82) and well-being data on the Warwick Edinburgh Mental Wellbeing Scale at follow-up (0-8 years) were included.

Results: Well-being was not associated with morning cortisol, diurnal slope or awakening response though a borderline association with evening cortisol was found. Adjusting for sex and follow-up time, each 1 SD increase in evening cortisol was associated with a -0.47 (95% CI -1.00 to 0.05) point lower well-being. This was attenuated by adjustment for body mass index, smoking and socioeconomic position. Between-study heterogeneity was low.

Conclusions: This study does not support the hypothesis that diurnal cortisol is prospectively associated with well-being up to 8 years later. However, replication in prospective studies with cortisol samples over multiple days is required.

Keywords: individual participant data; meta-analysis; positive psychology.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Circadian Rhythm*
  • Female
  • Humans
  • Hydrocortisone / blood*
  • Male
  • Mental Health*
  • Middle Aged

Substances

  • Hydrocortisone