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

Lookup NU author(s): Professor Rachel CooperORCiD



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© 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.

Publication metadata

Author(s): Stafford M, Ben-Shlomo Y, Cooper C, Gale C, Gardner MP, Geoffroy M-C, Power C, Kuh D, Cooper R

Publication type: Article

Publication status: Published

Journal: BMJ Open

Year: 2017

Volume: 7

Issue: 10

Print publication date: 12/10/2017

Online publication date: 12/10/2017

Acceptance date: 13/07/2017

Date deposited: 20/01/2022

ISSN (electronic): 2044-6055

Publisher: BMJ Publishing Group


DOI: 10.1136/bmjopen-2017-016085

PubMed id: 29025828


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Funder referenceFunder name
Data collection of cortisol in NCDS at 45 years was funded by the United Kingdom Medical Research Council, grant G0000934.
HALCyon was funded by the New Dynamics of Ageing (RES-353-25-0001) and MG was supported by this grant.
MS, RC and DK are supported by the UK Medical Research Council (Programme codes MRC_MC_UU_12019/1; MRC_MC_UU_12019/4;MRC_MC_UU_12019/5).
The MRC National Survey of Health and Development is funded by the UK Medical Research Council.
This research was supported by the National Institute for Health Research Biomedical Research Centre at Great Ormond Street Hospital for Children NHS Foundation Trust and University College London.