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Low morning, high evening cortisol levels tied to frailty in elderly
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Lower morning cortisol reactivity and higher evening salivary cortisol levels may indicate frailty in older patients, according to data.
“Cortisol typically follows a distinct daily pattern with the highest level in the morning and the lowest basal level at night,” Karl-Heinz Ladwig, PhD, MD, of Helmholtz Zentrum München in Neuherberg, Germany, said in a press release. “Our findings showed dysregulated cortisol secretion, as featured by a smaller morning to evening cortisol level ratio, was significantly associated with frailty status.”
Patients (n=745; mean age, 75.1 years) were previously enrolled in the population-based KORA Age study. In a cross-sectional analysis, the researchers observed lower cortisol levels in the first morning sample (P=.18) and 30 minutes after awakening (P=.14), in addition to increased evening levels (P=.004) among patients categorized as prefrailty (35.17%; n=262) and frail (3.36%; n=25).
Additional data indicate frailty was significantly associated with smaller ratios of morning to evening levels (P=.02) and 30 minutes after awakening-to-evening ratio (P=.003). Moreover, high evening cortisol levels were linked to a 24% increased risk for a prefrailty status (OR=1.22; 95% CI, 1.03-1.44). Similarly, a smaller morning-to-evening ratio was tied to an increased risk for low grip strength (OR=1.42; 95% CI, 1.09-1.86) and gait speed (OR=1.31; 95% CI, 1.02-1.68), researchers wrote.
“Our results suggest a link between disrupted cortisol regulation and loss of muscle mass and strength, as the underlying pathophysiology of frailty,” Hamimatunnisa Johar, a PhD student at Helmholtz Zentrum München, said in a press release. “In a clinical setting assessment of frailty can be time-consuming, and our findings show measurements of cortisol may offer a feasible alternative.”
Disclosure: The researchers report no relevant financial disclosures.
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