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Cortisol profile and depressive symptoms in older adults residing in Brazil and in Canada

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Abstract

Background and aim

How cortisol, a stress biological marker, differs according to depressive symptoms has mostly been examined in high-income countries. Including low- and middle-income countries in research on this matter would allow examining a wider range of exposure to adversity and improving the estimates of the associations between diurnal cortisol and depression. The aim of this study is to compare the profile of diurnal cortisol and depressive symptoms in 65- to 74-year-old residents of Santa Cruz (in an underdeveloped region, northeast Brazil, n = 64) and Saint-Bruno (a suburban area, QC, Canada, n = 60).

Methods

Home interviews included assessments of socioeconomic variables, health behaviors, depressive symptoms (Center for Epidemiologic Studies Depression Scale, CES-D) and Cortisol Awakening Response (CAR: awakening, 30, 60 min afterward), and at 1500 hours and bedtime from saliva collected over 2 days. Mixed linear models were used to estimate the associations between diurnal cortisol and depressive symptoms.

Results

Santa Cruz residents had lower cortisol levels upon awakening (β = −1.24, p = 0.04) and elevated bedtime levels (β = 20.29, p < 0.001) indicating chronic stress compared to Saint-Bruno residents. Elevated depressive symptoms were associated with a blunted CAR (flatter slope, indicative of chronic stress) in Santa Cruz residents (β = −0.19, p = 0.04), while greater diurnal cortisol levels (larger area under the curve), indicative of moderate stress, were observed in Saint-Bruno residents (β = 1.96, p = 0.047).

Conclusion

Adverse living conditions in this remote area of Brazil may lead to a state of chronic stress and a different relationship with elevated depressive symptoms from persons aging in a Canadian suburban area.

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Abbreviations

CAR:

Cortisol awakening response

AUC:

Area under the curve

HPA:

Hypothalamic–pituitary–adrenocortical

SES:

Socioeconomic status

BMI:

Body mass index

CES-D:

Center for Epidemiologic Studies Depression Scale

IPAQ:

International Physical Activity Questionnaire

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Acknowledgments

Funding was provided by CIHR as an operating grant to perform on-site data collection. CIHR does not have any role in study design, in the collection, analysis and interpretation of data, in the writing of the report or in the decision to submit the paper for publication.

Conflict of interest

None to declare.

Author information

Authors and Affiliations

  1. Département de Médecine Sociale et Préventive, Université de Montréal, Montreal, Canada

    Mai Thanh Tu & Maria-Victoria Zunzunegui

  2. Institut de recherche en santé publique de l’Université de Montréal (IRSPUM), P.O. Box 6128, Downtown Station, Montréal, QC, H3C 3J7, Canada

    Mai Thanh Tu & Maria-Victoria Zunzunegui

  3. Unité de santé internationale (USI), Université de Montréal, Montreal, Canada

    Maria-Victoria Zunzunegui

  4. Department of Physiotherapy, Universidade Federal do Rio Grande do Norte, Natal, Brazil

    Ricardo Guerra

  5. Department of Community Health and Epidemiology, Queens University, Kingston, Canada

    Beatriz Alvarado

  6. Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, USA

    Jack M. Guralnik

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  1. Mai Thanh Tu
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  2. Maria-Victoria Zunzunegui
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Correspondence to Mai Thanh Tu.

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Tu, M.T., Zunzunegui, MV., Guerra, R. et al. Cortisol profile and depressive symptoms in older adults residing in Brazil and in Canada. Aging Clin Exp Res 25, 527–537 (2013). https://doi.org/10.1007/s40520-013-0111-0

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  • DOI: https://doi.org/10.1007/s40520-013-0111-0

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