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Blunted Diurnal Cortisol Pattern Tied to Frailty in Elderly

Smaller ratios of morning to evening cortisol levels linked to frailty, low grip strength, gait speed

WEDNESDAY, Feb. 26, 2014 (HealthDay News) -- In older adults, blunted diurnal cortisol patterns are associated with frailty, according to a study published online Feb. 24 in the Journal of Clinical Endocrinology & Metabolism.

Hamimatunnisa Johar, from the German Research Centre for Environmental Health in Munich, and colleagues examined the correlation between diurnal cortisol secretion with frailty in a cohort of 745 older adults (mean age, 75.1 years). Salivary cortisol was measured at awakening (morning 1 [M1]), 30 minutes after awakening (M2), and evening (E), and correlations with frailty were determined.

The researchers found that prefrail (35.17 percent) and frail (3.36 percent) individuals had lower cortisol levels in M1 (P = 0.18) and M2 (P = 0.14) and significantly increased levels in the evening (P = 0.004), in a dose-response manner. Smaller ratios of morning to evening levels were associated with frailty (M1:E ratio, P = 0.02 and M2:E ratio, P = 0.003). The risk of a prefrail state was significantly increased with higher evening levels of cortisol (odds ratio, 1.22). There was also an association between small morning to evening ratio with an increased risk of lower grip strength and gait speed (odds ratios, 1.42 and 1.31).

"Frailty status is associated with blunted cortisol reactivity as demonstrated by lower morning and higher evening salivary cortisol levels," the authors write.

Abstract
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