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

Mai Stafford, Yoav Ben-Shlomo, Cyrus Cooper, Catharine Gale, Michael P Gardner, Marie-Claude Geoffroy, Chris Power, Diana Kuh, Rachel Cooper

Research output: Contribution to journalArticle (Academic Journal)peer-review

10 Citations (Scopus)


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 -0.47 (95% CI -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.

Original languageEnglish
Pages (from-to)e016085
JournalBMJ Open
Issue number10
Publication statusPublished - 12 Oct 2017


  • Journal Article


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