Dysregulation of the hypothalamic pituitary adrenal (HPA) axis and physical performance at older ages: an individual participant meta-analysis

Mike P Gardner, Stafford L Lightman, A Aihie Sayer, C Cooper, R Cooper, D Deeg, Shah B J Ebrahim, J Gallacher, M Kivimaki, M Kumari, D Kuh, Richard M Martin, G Peeters, Yoav Ben-Shlomo, the HALCyon Study Team

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

42 Citations (Scopus)
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Abstract

The association between functioning of the hypothalamic pituitary adrenal (HPA) axis and physical performance at older ages remains poorly understood. We carried out meta-analyses to test the hypothesis that dysregulation of the HPA axis, as indexed by patterns of diurnal cortisol release, is associated with worse physical performance. Data from six adult cohorts (ages 50-92 years) were included in a two stage meta-analysis of individual participant data. We analysed each study separately using linear and logistic regression models and then used meta-analytic methods to pool the results. Physical performance outcome measures were walking speed, balance time, chair rise time and grip strength. Exposure measures were morning (serum and salivary) and evening (salivary) cortisol. Total sample sizes in meta-analyses ranged from N=2,146 for associations between morning Cortisol Awakening Response and balance to N=8,448 for associations between morning cortisol and walking speed. A larger diurnal drop was associated with faster walking speed (standardised coefficient per SD increase 0.054, 95% confidence interval (CI) 0.029, 0.081, p <0.001; age and gender adjusted) and a quicker chair rise time (standardised coefficient per SD increase -0.075, 95% CI -0.116, -0.034, p <0.001; age and gender adjusted). There was little evidence of associations with balance or grip strength. Greater diurnal decline of the HPA axis is associated with better physical performance in later life. This may reflect a causal effect of the HPA axis on performance or that other ageing-related factors are associated with both reduced HPA reactivity and performance.
Translated title of the contributionDysregulation of the hypothalamic pituitary adrenal (HPA) axis and physical performance at older ages: an individual participant meta-analysis
Original languageEnglish
Pages (from-to)40-49
Number of pages10
JournalPsychoneuroendocrinology
Volume38
Issue number1
Early online date31 May 2012
DOIs
Publication statusPublished - Jan 2013

Keywords

  • HPA axis
  • Physical capability
  • Healthy ageing

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