Temporal patterns of anxiety disorders and cortisol activity in older adults

Studies focusing on anxiety temporal patterns and cortisol activity in older adults are scarce. The objectives of this study were to examine in older adults the relationship between anxiety temporal patterns and cortisol activity and ascertain the presence of sex differences.

Data were retrieved from the Étude sur la santé des ainés - Services study in Quebec and included N = 762 community living adults aged ≥ 65 years having participated in interviews at baseline (T₁) and at 4 years follow-up (T₂). A standardized questionnaire, based on DSM-5 criteria, was used to ascertain in the past 6 months the presence of anxiety (absence, remission, incidence, persistence). Cortisol activity during the interview and cortisol concentration on a regular day (at T₂) were the dependent variables. Adjusted multivariable linear regression models, stratified by sex, were used.

Results showed higher cortisol activity during the interview in participants with anxiety in remission (Beta: 2.59; 95% CI: 0.62 , 4.57), specifically in males, and lower activity in participants with persistent anxiety (Beta: -3.97; 95% CI: -7.05, -0.88). Cortisol concentration on a regular day was higher in males reporting incident anxiety (Beta: 8.07; 95% CI: 2.39 , 13.76).

The convenience sample with losses to follow-up may have led to a potential selection bias.

Anxiety temporal patterns were associated with cortisol activity profiles in older adults with sex being a significant moderator. Future studies are recommended to ascertain the longitudinal changes in cortisol activity and anxiety temporal patterns, which may further inform personalized treatment of anxiety.