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Illness episodes and cortisol in healthy older adults during a life transition

Abstract

Alterations in neuroendocrine functioning and in the neuroendocrine response to stress have been observed in older adults. Stressful life events have also been associated with increased illness vulnerability. However, effects of natural life stressors on neuroendocrine functioning and health of the elderly have not been well characterized. This research examines relationships among cortisol, dehydroepiandrosterone sulfate (DHEA-S), distress, and illness episodes in an elderly population experiencing the life transition of housing relocation. Thirty older adults moving to congregate living facilities were assessed in their homes 1 month premove and 2 weeks postmove. Twenty-eight nonmoving comparison participants were assessed at similar time points. Assessments included measures of intrusion, cortisol, DHEA-S, and self-reported infectious illness episodes. Movers reported more illness episodes between the two assessments than controls. Significant alterations in neuroendocrine measures were not observed among movers at either time point. Individuals with more intrusive thoughts had higher cortisol levels concurrently and prospectively, but these relationships did not vary by group. Greater intrusion at premove was associated with a greater likelihood of reported illness episodes between the two assessments, but there were no relationships between neuroendocrine factors and illness episodes, and intrusion did not mediate the relationships between group and likelihood of illness. In healthy elders, a temporary life stressor may increase vulnerability to illness but does not appear to pose a risk for sustained alterations in neuroendocrine hormones. However, the presence of intrusive thoughts may be a risk factor for elevations in cortisol.

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References

  1. (1)

    Lupien S, Lecours AR, Schwartz G, et al.: Longitudinal study of basal cortisol levels in healthy elderly subjects: Evidence for subgroups.Neurobiology of Aging. 1996,17:95–105.

    PubMed  Article  CAS  Google Scholar 

  2. (2)

    Roberts E: The importance of being dehydroepiandrosterone sulfate (in the blood of primates) A Longer and healthier life?Biochemical Pharmacology. 1999,57:329–346.

    PubMed  Article  CAS  Google Scholar 

  3. (3)

    Khaw KT: Dehydroepiandrosterone, dehydroepiandrosterone sulphate and cardiovascular disease.Journal of Endocrinology. 1996,150(Suppl.):49–53.

    Google Scholar 

  4. (4)

    Krantz DS, Manuck SB: Acute psychophysiologic reactivity and risk of cardiovascular disease: A review and methodologic critique.Psychological Bulletin. 1984,96:435–464.

    PubMed  Article  CAS  Google Scholar 

  5. (5)

    Munck A, Guyre P. Glucocorticoids and immune function. In Ader R, Felten D, Cohen N (eds),Psychoneuroimmunology (2nd Ed.). New York: Academic, 1991, 447–474.

    Google Scholar 

  6. (6)

    Daynes RA, Araneo BA, Ershler WB, et al.: Altered regulation of IL-6 production with normal aging.Journal of Immunology. 1993,150:5219–5230.

    CAS  Google Scholar 

  7. (7)

    Seeman T, McKewen B: Impact of social environmental characteristics on neuroendocrine regulation.Psychosomatic Medicine. 1996,58:459–471.

    PubMed  CAS  Google Scholar 

  8. (8)

    Deuschle M, Gotthardt U, Schweiger U, et al.: With aging in humans the activity of the hypothalamus-pituitary-adrenal system increases and its diurnal amplitude flattens.Life Sciences. 1997,61:2239–2246.

    PubMed  Article  CAS  Google Scholar 

  9. (9)

    Nicolson N, Storms C, Ponds R, Sulon J: Salivary cortisol levels and stress reactivity in human aging.Journals of Gerontology. Series A, Biological Sciences & Medical Sciences. 1997,52:M68-M75.

    CAS  Google Scholar 

  10. (10)

    Wilkinson CW, Peskind ER, Raskind MA: Decreased hypothalamic — pituitary-adrenal axis sensitivity to cortisol feedback inhibition in human aging.Neuroendocrinology. 1997,65:79–90.

    PubMed  CAS  Google Scholar 

  11. (11)

    Luisi S, Tonetti A, Bernardi F, et al.: Effect of acute corticotropin releasing factor on pituitary-adrenocortical responsiveness in elderly women and men.Journal of Endocrinological Investigation. 1998,21:449–453.

    PubMed  CAS  Google Scholar 

  12. (12)

    Hauger RL, Lorang M, Irwin M, Augilera G: CRF receptor regulation and sensitization of ACTH responses to acute ether stress during chronic intermittent immobilization stress.Brain Research. 1990,532:34–40.

    PubMed  Article  CAS  Google Scholar 

  13. (13)

    Sapolsky RM, Krey LC, McEwen BS: The neuroendocrinology of stress and aging: the glucocorticoid cascade hypothesis.Endocrinology Review. 1986,7:284–301.

    CAS  Google Scholar 

  14. (14)

    Vedhara K, Cox NK, Wilcock GK, et al.: Chronic stress in elderly carers of dementia patients and antibody response to influenza vaccination.Lancet. 1999,353:627–631.

    PubMed  Article  CAS  Google Scholar 

  15. (15)

    Irwin M, Hauger R, Patterson T, et al.: Alzheimer caregiver stress: Basal natural killer cell activity, pituitary-adrenal cortical function, and sympathetic tone.Annals of Behavioral Medicine. 1997,19:83–90.

    PubMed  CAS  Google Scholar 

  16. (16)

    Cohen S, Line S, Manuck SB, et al.: Chronic social stress, social status, and susceptibility to upper respiratory infections in nonhuman primates.Psychosomatic Medicine. 1997,59:213–221.

    PubMed  CAS  Google Scholar 

  17. (17)

    Kalmijn S, Launer LJ, Stolk RP, et al.: A prospective study on cortisol, dehydroepiandrosterone sulfate, and cognitive function in the elderly.Journal of Clinical Endocrinology & Metabolism. 1998,83:3487–3492.

    Article  CAS  Google Scholar 

  18. (18)

    Gatti G, Cavallo R, Sartori ML, et al.: Inhibition of human natural killer cell activity by cortisol.Journal of Steroid Biochemistry. 1987,265:29–58.

    Google Scholar 

  19. (19)

    Resnick NM, Greenspan SL: "Senile" osteoporosis reconsidered.Journal of the American Medical Association. 1989,261:1025–1029.

    PubMed  Article  CAS  Google Scholar 

  20. (20)

    Smyth JM, Ockenfels MC, Gorin AA, et al.: Individual differences in the diurnal cycle of cortisol.Psychoneuroendocrinology. 1997,22:89–105.

    PubMed  Article  CAS  Google Scholar 

  21. (21)

    Regelson W, Loria R, Kalimi M: DHEA-The "mother steroid" I. Immunologic action.Annals of the New York Academy of Sciences. 1994,719:553–563.

    PubMed  Article  CAS  Google Scholar 

  22. (22)

    Kalimi M, Shafagoj Y, Loria R, Padgett D, Regelson W: Anti-glucocorticoid effects of dehydroepiandrosterone (DHEA).Molecular Cell Biology. 1994,131:99–104.

    CAS  Google Scholar 

  23. (23)

    Weksler ME: Immune senescence and adrenal steroids: Immune dysregulation and the action of DHEA in old animals.European Journal of Clinical Pharmacology. 1993,45(Suppl.):S21-S23.

    PubMed  Article  CAS  Google Scholar 

  24. (24)

    Mayer D, Weber E, Bannasch P: Modulation of liver carcinogenesis by dehydroepianderosterone. In Kalmini M, Regelson W (eds), The Biologic Role of Dehydroepiandrosterone (DHEA). New York: deGruyter, 1990, 361–385.

    Google Scholar 

  25. (25)

    Clerici M, Trabattoni D, Piconi S, et al.: A possible role for the cortisol/anticortisols in the progression of human immunodeficiency virus.Psychoneuroendocrinology. 1997,22(Suppl.):27–31.

    Article  Google Scholar 

  26. (26)

    Bastianetto S, Ramassamy D, Poirier J, Quirion R: Dehydroepiandrosterone (DHEA) protects hippocampal cells from oxidative stress-induced damage. Brain Research.Molecular Brain Research. 1999,66:35–41.

    PubMed  Article  CAS  Google Scholar 

  27. (27)

    Casson PR, Andersen RN, Herrod HG, et al.: Oral dehydroepiandrosterone in physiologic doses modulates immune function in postmenopausal women.American Journal of Obstetrics and Gynecology. 1993,169:1536–1539.

    PubMed  CAS  Google Scholar 

  28. (28)

    Berton E, Hoover D, Galloway R, Popp K: Adaptation to chronic stress in military trainees.Annals of the New York Academy of Science. 1995,774:217–231.

    Article  Google Scholar 

  29. (29)

    Oberbeck R, Benschop RJ, Jacobs R, et al.: Endocrine mechanisms of stress-induced DHEA-secretion.Journal of Endocrinological Investigation. 1998,21:148–153.

    PubMed  CAS  Google Scholar 

  30. (30)

    Malarkey WB, Hall JC, Rice RR, et al.: The influence of age on endocrine responses to ultraendurance stress.Journals of Gerontology: Medical Sciences. 1993,48A:M134-M139.

    Google Scholar 

  31. (31)

    Holmes TH, David EM (eds): Life Change, Life Events, and Illness: Selected Papers. New York: Praeger, 1989.

    Google Scholar 

  32. (32)

    Theorell T: Critical life changes and cardiovascular disease. In Cooper C (ed), Handbook of Stress, Medicine, and Health. Boca Raton, FL: CRC Press, 1996, 137–158.

    Google Scholar 

  33. (33)

    Willis L, Goodwin J, Lee KO, et al.: Impact of psychosocial factors on health outcomes in the elderly.Journal of Aging and Health. 1997,9:396–414.

    PubMed  Article  CAS  Google Scholar 

  34. (34)

    Vogt TM: Aging, stress, and Illness: Psychobiological linkages. In Ory MG, Abeles RP, Lipman PD (eds), Aging, Health & Behavior. Newbury Park, CA: Sage, 1992, 207–236.

    Google Scholar 

  35. (35)

    Wayne SJ, Rhyne RL, Garry PJ, Goodwin JS: Cell mediated immunity as a predictor of morbidity and mortality in subjects over sixty.Journals of Gerontology: Medical Science. 1990,45:M45-M48.

    CAS  Google Scholar 

  36. (36)

    Cohen S, Doyle WJ, Skoner DP: Psychological stress, cytokine production, and severity of upper respiratory illness.Psychosomatic Medicine. 1999,61:175–180.

    PubMed  CAS  Google Scholar 

  37. (37)

    Blank TO: Older persons and Their Housing-Today and Tomorrow. Springfield, IL: Thomas, 1988.

    Google Scholar 

  38. (38)

    Merrill J, Hunt ME: Aging in place: A dilemma for retirement housing administratorsJournal of Applied Gerontology. 1990,9:60–76.

    PubMed  Article  CAS  Google Scholar 

  39. (39)

    Monk A, Kaye LW: Congregate Housing for the elderly: Its need, function and perspectives.Journal of Housing for the Elderly. 1991,91:5–19.

    Google Scholar 

  40. (40)

    Siegel JS:A Generation of Change: A Profile of America's Older Population. New York: Russell Sage Foundation, 1993.

    Google Scholar 

  41. (41)

    Schulz R, Brenner G: Relocation of the aged: A review and theoretical analysisJournal of Gerontology. 1977,32:323–333.

    PubMed  CAS  Google Scholar 

  42. (42)

    Fisher BJ: The stigma of relocation to a retirement facility.Journal of Aging Studies. 1990,4:47–59.

    Article  Google Scholar 

  43. (43)

    Golant SM: Matching congregate housing settings with a diverse elderly population: Research and theoretical considerations.Journal of Housing for the Elderly. 1991,9:21–38.

    Article  Google Scholar 

  44. (44)

    Aldrich CK, Mendkoff E: Relocation of the aged and disabled: A mortality study.Journal of the American Geriatric Society. 1963,11:401–408.

    Google Scholar 

  45. (45)

    Lieberman MA: Relationship of mortality rates to entrance to a home for the aged.Geriatrics. 1961,16: 515–519.

    PubMed  CAS  Google Scholar 

  46. (46)

    Armer J: Elderly relocation to a congregate setting: Factors influencing adjustment.Issues in Mental Health Nursing. 1993,14:157–172.

    PubMed  Article  CAS  Google Scholar 

  47. (47)

    Bourestom N: Psychological and physiological manifestations of relocation.Psychiatric Medicine. 1984,2:57–90.

    PubMed  CAS  Google Scholar 

  48. (48)

    Carp FM: Short term and long-term prediction of adjustment to a new environment.Journals of Gerontology. 1974,29:444–453.

    PubMed  CAS  Google Scholar 

  49. (49)

    Smider NA, Essex MJ, Ryff CD: Adaptation of community relocation: The interactive influence of psychological resources and contextual factors.Psychology and Aging. 1996,11:362–372.

    PubMed  Article  CAS  Google Scholar 

  50. (50)

    Horowitz M: Stress response syndromes (2nd Ed.). New York: Aronson, 1986.

    Google Scholar 

  51. (51)

    Horowitz M, Wilner N, Alvarez W: Impact of event scale.Psychosomatic Medicine. 1979,41:209–218.

    PubMed  CAS  Google Scholar 

  52. (52)

    Davidson LM, Baum A: Chronic stress and posttraumatic stress disordersJournal of Consulting and Clinical Psychology. 1986,54:303–308.

    PubMed  Article  CAS  Google Scholar 

  53. (53)

    Baum A, Cohen L, Hall M: Control and intrusive memories as possible determinants of chronic stress.Psychosomatic Medicine. 1993,55:274–286.

    PubMed  CAS  Google Scholar 

  54. (54)

    Baider L, De-Nour AK: Psychological distress and intrusive thoughts in cancer patients.Journal of Nervous & Mental Disease. 1997,185:346–348.

    Article  CAS  Google Scholar 

  55. (55)

    Lutgendorf SK, Vitaliano PP, Tripp-Reimer T, Harvey J, Lubaroff DM: Sense of coherence moderates the relationship between life stress and natural killer cell activity in healthy older adults.Psychology and Aging. 1999,14:552–563.

    PubMed  Article  CAS  Google Scholar 

  56. (56)

    Lutgendorf SK, Tripp-Reimer T, Harvey J, et al.: Psychosocial and immune effects of relocation stress among older adults.Journals of Gerontology: Medical Sciences. 2001,56A:M97-M105.

    Google Scholar 

  57. (57)

    Eward AM: Anticipated relocation by the aged life changes and urinary free cortisol.Dissertation Abstracts International. 1981,41:2568.

    Google Scholar 

  58. (58)

    Kral EA, Grad B, Berenson J: Stress reactions resulting from the relocation of an aged population.Journal of the Canadian Psychiatric Association. 1968,13:201–209.

    CAS  Google Scholar 

  59. (59)

    Brooke V: Your helping hands: How to tailor your approach in each phase of adjustment.Geriatric Nursing. 1989,3:126–128.

    Article  Google Scholar 

  60. (60)

    Jenkins CD, Kraeger BE, Rose RM, Hurst MW: Use of a monthly health review to ascertain illness and injuries.American Journal of Public Health. 1980,70:82–84.

    PubMed  CAS  Article  Google Scholar 

  61. (61)

    LaRue A, Bank L, Jarvik L, Hetland M: Health in old age: How do physicians' ratings and self-ratings compare?Journals of Gerontology. 1979,34:687–691.

    PubMed  CAS  Google Scholar 

  62. (62)

    Orts K, Sheridan JF, Robinson-Whelen S, et al.: The reliability and validity of a structured interview for the assessment of infectious illness symptoms.Journal of Behavioral Medicine. 1995,18:517–529.

    PubMed  Article  CAS  Google Scholar 

  63. (63)

    Sarason IG, Johnson JH, Siegel JM: Assessing the impact of life changes: Development of the Life Experiences Survey.Journal of Consulting and Clinical Psychology. 1978,46:932–946.

    PubMed  Article  CAS  Google Scholar 

  64. (64)

    Kiecolt-Glaser JK, Glaser R: Methodological issues in behavioral immunology research with humans.Brain Behavior and Immunity. 1988,2:67–78.

    Article  CAS  Google Scholar 

  65. (65)

    Diagnostic Products Corporation: EURO/DPC Double Antibody Cortisol Manual. Los Angeles, CA: Author, 1995.

    Google Scholar 

  66. (66)

    Diagnostic Products Corporation: Coat-A-Count: DHEA-SO4 Manual. Los Angeles, CA: Author, 1995.

    Google Scholar 

  67. (67)

    Doumas BT, Biggs HG: Determination of serum albumin.Standard Methods of Clinical Chemistry. 1972,7:175–188.

    CAS  Google Scholar 

  68. (68)

    Mehta C, Patel N:LogXact for Windows (Software). Cambridge, MA: CYTEL Software Corporation, 1998.

    Google Scholar 

  69. (69)

    Mehta C, Patel N:StatXact4 for Windows (Software). Cambridge, MA: CYTEL Software Corporation, 1998.

    Google Scholar 

  70. (70)

    Baron RM, Kenney DA: The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations.Journal of Personality and Social Psychology. 1986,51:1173–1182.

    PubMed  Article  CAS  Google Scholar 

  71. (71)

    Cooper J, Garnder C: Effect of aging on serum albumin.Journal of the American Geriatric Society. 1989,37:1039–1042.

    CAS  Google Scholar 

  72. (72)

    Hellhammer DH, Heib C, Hubert W, Rolf L: Relationships between salivary cortisol release and behavioral coping under examination stress.IRCS Medical Science. 1985,13:1179–1180.

    Google Scholar 

  73. (73)

    Baum A: Stress, intrusive imagery and chronic distress.Health Psychology. 1990,9:653–675.

    PubMed  Article  CAS  Google Scholar 

  74. (74)

    Schulkin J, Gold PW, McEwen BS: Induction of corticotropin-releasing hormone gene expression by glucocorticoids: Implication for understanding the states of fear and anxiety and allostatic load.Psychoneuroendocrinology. 1998,23:219–243.

    PubMed  Article  CAS  Google Scholar 

  75. (75)

    West CD, Brown H, Simons EL, et al.: Adrenocortical function and cortisol metabolism in old age.Journal of Clinical Endocrinology & Metabolism. 1961,21:1197–1207.

    CAS  Article  Google Scholar 

  76. (76)

    Cohen S, Tyrrell D, Smith A: Psychological stress and susceptibility to the common cold.New England Journal of Medicine. 1991,325:606–612.

    PubMed  CAS  Article  Google Scholar 

  77. (77)

    Dohrenwind BS, Dohrenwind BP:Stressful Life Events: Their Nature and Effects. New York: Wiley, 1974.

    Google Scholar 

  78. (78)

    Kaplan GA, Reynolds P: Depression and cancer mortality and morbidity: Prospective evidence from the Alameda County study.Journal of Behavioral Medicine. 1988,11:1–13.

    PubMed  Article  CAS  Google Scholar 

  79. (79)

    Morris PL, Raphael G, Robinson R: Clinical depression is associated with impaired recovery from stroke.Medical Journal of Australia. 1993,157:239–242.

    Google Scholar 

  80. (80)

    Leventhal EA, Hansell S, Diefenbach M, Glass DC: Negative affect and self-report of physical symptoms: Two longitudinal studies of older adults.Health Psychology. 1996,15:193–199.

    PubMed  Article  CAS  Google Scholar 

  81. (81)

    Watson D, Pennebaker J: Health complaints, stress, and distress: Exploring the central role of negative affectivity.Psychological Review. 1989,96:234–254.

    PubMed  Article  CAS  Google Scholar 

  82. (82)

    Cohen S, Doyle WJ, Skoner DP, Fireman P: State and trait negative affect as predictors of objective and subjective symptoms of respiratory viral infections.Journal of Personality and Social Psychology. 1995,68: 159–169.

    PubMed  Article  CAS  Google Scholar 

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Correspondence to Susan K. Lutgendorf Ph.D..

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This study was funded in part by the National Institute on Aging Interdisciplinary Research Training Program on Aging (T32 AG00214) and carried out with support from the Gerontological Nursing Interventions Research Center (NIH No. P30 NR03979 PI: Toni Tripp-Reimer) and with Grant No. RR00059 from the General Clinical Research Centers Program, National Center for Research Resources.

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Lutgendorf, S.K., Reimer, T.T., Schlechte, J. et al. Illness episodes and cortisol in healthy older adults during a life transition. ann. behav. med. 23, 166–176 (2001). https://doi.org/10.1207/S15324796ABM2303_4

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Keywords

  • Cortisol
  • Cortisol Level
  • DHEA
  • Behavioral Medicine
  • Hypothalamic Pituitary Adrenal Axis