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

Stafford, M, Ben-Shlomo, Y, Cooper, C, Gale, C, Gardner, MP, Geoffroy, MC, Power, C, Kuh, D and Cooper, R ORCID: https://orcid.org/0000-0003-3370-5720 (2017) Diurnal cortisol and mental well-being in middle and older age: Evidence from four cohort studies. BMJ Open, 7 (10).

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Abstract

© 2017 Article author(s). 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 â'0.47 (95% CI â'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.