HPA axis responses to laboratory psychosocial stress in healthy elderly adults, younger adults, and children: impact of age and gender
Introduction
Although it is known from animal as well as human studies that there exist age-related alterations in hypothalamic–pituitary–adrenal (HPA) axis regulation, it still remains an open question whether stress-related HPA axis functioning alters significantly with age.
While in humans there are only little differences in daytime basal ACTH and cortisol levels (Seeman and Robbins, 1994, Gotthardt et al., 1995, Kudielka et al., 1999, Kudielka et al., 2000), the circadian rhythm seems to advance with age and diurnal amplitudes appear to flatten (Sherman et al., 1985, Van Coevorden et al., 1991, Deuschle et al., 1997). Primarily, cortisol concentrations show age-related changes during night-time at the circadian trough of HPA activity (Van Cauter et al., 1996).
Human studies which apply psychological stress protocols in young and elderly subjects simultaneously are rare. While a study from Gotthardt et al. (1995) report on a significant age effect (with older subjects showing larger cortisol stress responses) two other studies did not show age-related changes in HPA axis functioning neither in men nor in women (Kudielka et al., 1999, Kudielka et al., 2000). In contrast, a fourth study report that the cortisol responses to provoked stress were higher in premenopausal women compared to postmenopausal women (Lindheim et al., 1992), whereas another study only evoked minor HPA axis stress responses in a laboratory setting (Nicolson et al., 1997).
Concerning the impact of gender, human stress studies revealed that there are (a) no significant gender differences or (b) higher cortisol responses in young men compared to young women (Collins and Frankenhaeuser, 1978, Frankenhaeuser et al., 1978, Frankenhaeuser et al., 1980, Forsman and Lundberg, 1982, Lundberg, 1983, Polefrone and Manuck, 1987, Stoney et al., 1987, Kirschbaum et al., 1992, Kirschbaum et al., 1995). In a recent paper, Kirschbaum and coworkers disclosed that the effect of gender is masked in total plasma cortisol stress responses, while significant gender differences emerge for ACTH and free salivary cortisol (Kirschbaum et al., 1999). The study showed that ACTH responses are elevated in men compared to women, regardless of menstrual cycle phase or use of oral contraceptives. Women in the luteal phase have comparable saliva cortisol stress responses compared to men whereas women in the follicular phase or taking oral contraceptives show significantly lower free cortisol responses. These observations point at the necessity to strictly distinguish between the total cortisol secretion and the bioavailable cortisol levels. The same gender effect with higher ACTH and free salivary cortisol emerged for elderly subjects, as shown by Kudielka et al. (1998). In contrast, Seeman et al. (1995) reported on a higher cortisol reactivity in elderly women compared to elderly men employing a driving simulation challenge. Recently, these observations were corroborated using a 30-min cognitive challenge paradigm by the same group (Seeman et al., 2001).
Human studies investigating the impact of age and gender on HPA axis responses after psychological stress are still rare and results remained contradictory. Therefore, the present reanalysis aims to contribute to the question of age and gender effects on HPA axis stress responses including healthy male and female elderly adults, young adults, as well as children.
Section snippets
Subjects
Data for the present reanalysis originally come from five independent studies conducted by Kudielka et al., 1999, Kudielka et al., 2000, Kirschbaum et al., 1999, Buske-Kirschbaum et al., 1997, and Buske-Kirschbaum et al. (unpublished data). All participants had reported to the laboratory at least twice. At a first appointment, all volunteers underwent a medical examination to identify healthy individuals and patients suffering from specific diseases. Volunteers with psychiatric, endocrine,
ACTH (only older and younger adults)
First of all, the applied three-way ANOVA for ACTH resulted in a significant main effect of time (F(3,183)=56.12, p<0.0001) and age (F(1,61)=7.35, p<0.009). Furthermore, the main effect of gender (F(1,61)=3.12, p<0.08) and the two-way interactions ‘age by time’ (F(1.2,72.1)=3.44, p<0.06) and ‘gender by time’ (F(1.2,72.1)=3.11, p<0.08) approached the level of significance.
In order to clarify whether all different groups had a significant ACTH response, one-way repeated measurement ANOVAs for
Discussion
The present data show that the psychosocial stress protocol TSST (Trier Social Stress Test) induced significant HPA axis responses in male and female elderly adults, younger adults, as well as children. Therefore, the TSST as described by Kirschbaum, Pirke, and Hellhammer a decade ago (1993) can be considered as a valid psychosocial stress protocol in laboratory settings in a wide range of age groups in both sexes. This observation is strongly supported by a recently conducted independent
References (54)
- et al.
With aging in humans the activity of the hypothalamus-pituitary-adrenal system increases and its diurnal amplitude flattens
Life Sci.
(1997) - et al.
Consistency in catecholamine and cortisol excretion in males and females
Pharmacol. Biochem. Behav.
(1982) - et al.
Dissociation between sympathetic–adrenal and pituitary–adrenal responses to an achievement situation characterized by high controllability: comparison between type A and type B males and females
Biol. Psychol.
(1980) - et al.
Age-associated changes of pituitary–adrenocortical hormone regulation in humans: importance of gender
Neurobiol. Aging
(1994) - et al.
Hormonal responses to surgical stress in children
J. Pediatr. Surg.
(1993) - et al.
Behavioral stress responses in premenopausal and postmenopausal women and the effects of estrogen
Am. J. Obstet. Gynecol.
(1992) - et al.
Pituitary responses to synthetic corticotropin-releasing hormone: absence of modulatory effects by estrogen and progestin
Am. J. Obstet. Gynecol.
(1987) Sex differences in behaviour pattern and catecholamine and cortisol excretion in 3–6 year old day-care children
Biol. Psychol.
(1983)- et al.
Effects of Alzheimer’s disease and gender on the hypothalamic–pituitary–adrenal axis response to lumbar puncture stress
Psychoneuroendocrinology
(1999) - et al.
Gender differences in patterns of HPA axis response to challenge: MacArthur studies of successful aging
Psychoneuroendocrinology
(1995)
Gender differences in age-related changes in HPA axis reactivity
Psychoneuroendocrinology
Effects of age and gender on pituitary–adrenocortical responsiveness in humans
Eur. J. Endocrinol.
Chronic estrogen-induced alterations in adrenocorticotropin and corticosterone secretion, and glucocorticoid receptor-mediated functions in female rats
Endocrinology
Attenuated free cortisol response to psychosocial stress in children with atopic dermatitis
Psychosom. Med.
The influence of ovarian steroids on hypothalamic–pituitary–adrenal regulation in the female rat
J. Endocrinol.
Stress responses in male and female engineering students
J. Human Stress
Psychophysiological stress responses in postmenopausal women before and after hormonal replacement therapy
Hum. Neurobiol.
Corticotropin releasing hormone stimulation test and nocturnal cortisol levels in normal children
Pediatr. Res.
Brain corticosteroid receptor balance and homeostatic control
Front. Neuroendocrinol.
Brain corticosteroid receptor balance in health and disease
Endocr. Rev.
Acute estradiol and progesterone administration reduced cardiovascular and catecholamine responses to mental stress in menopausal women
Neuroendocrinology
Acute stressors and cortisol reactivity: a meta analytic review
Psychosom. Med.
Different regulation of adrenocorticotropin and cortisol secretion in young, mentally healthy elderly and patients with senile dementia of Alzheimer’s type
J. Clin. Endocrinol. Metab.
Synthesis of a cortisol–biotin conjugate and evaluation as a tracer in an immunoassay for salivary cortisol measurement
J. Steroid Biochem. Mol. Biol.
Sex differences in psychoneuroendocrine reactions to examination stress
Psychosom. Med.
Cortisol, ACTH, and cardiovascular response to a cognitive challenge paradigm in aging and depression
Am. J. Physiol.
On methods in the analysis for profile data
Psychometrica
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