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Psychosocial predictors of salivary cortisol among older adults with depression

Published online by Cambridge University Press:  15 April 2014

Jason M. Holland*
Department of Psychology, University of Nevada, Las Vegas, Nevada, USA
Johanna Rengifo
Palo Alto University, Palo Alto, California, USA
Joseph M. Currier
University of South Alabama, Mobile, Alabama, USA
Ruth O’Hara
Stanford University School of Medicine, Stanford, California, USA
Keith Sudheimer
Stanford University School of Medicine, Stanford, California, USA
Dolores Gallagher-Thompson
Stanford University School of Medicine, Stanford, California, USA
Correspondence should be addressed to: Jason M. Holland, Department of Psychology, University of Nevada, Las Vegas, 4505 S. Maryland Parkway, Box 455030, Las Vegas, Nevada 89154-5030, USA. Phone: +702-895-3703; Fax: +702-895-0195. Email:



Previous studies have identified a number of psychosocial risk factors of dysregulated cortisol (frequently referred to as the “stress hormone”) among older adults with depression. However, these studies have typically only examined a handful of risk factors at a time and have sometimes yielded inconsistent results.


This study aims to address this gap in the literature by simultaneously examining a range of relevant psychosocial predictors of diurnal cortisol among 54 older adults with a depressive disorder. Salivary cortisol was assessed upon awakening, at 5 PM, and at 9 PM across two consecutive days. Participants also completed measures of global psychosocial stress, current psychiatric symptomatology, pervasive distress (e.g. history of past depression), and protective factors (e.g. social support, resiliency, extent to which one has “made sense” of a significant stressor).


High levels of current depressive symptoms, psychiatric comorbidities, past depressive episodes, trait anxiety, and poorer ability to make sense of one's stress were found to be associated with flatter (more abnormal) cortisol slopes. However, when all of these variables were entered simultaneously in a multiple regression analysis, only history of past depression and the degree of sense made of stress emerged as unique predictors of cortisol in the model.


These findings have important implications for identifying depressed elderly individuals with dysregulated cortisol patterns who may be most at risk for health complications. Treatments that aim to limit the chronicity of depression and help to increase the sense made of stress could potentially have a positive impact on health.

Research Article
Copyright © International Psychogeriatric Association 2014 

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