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      Hair cortisol as a risk marker for increased depressive symptoms among older adults during the Covid-19 pandemic

      research-article
      Author(s): a , 1 , a , b
      Publication date (Electronic):
      Journal: Psychoneuroendocrinology
      Publisher: The Author(s). Published by Elsevier Ltd.
      Keywords: Cortisol, stress, depression, COVID-19

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          Abstract

          Determining pre-existing biological risk markers of incident depression and other mental health sequelae after exposure to a new stressor would help identify vulnerable individuals and mechanistic pathways. This study investigated primarily whether hair cortisol predicted elevated depressive symptoms in middle-aged and older adults during the COVID-19 pandemic, 6 years later. A secondary aim was to deduce whether any association differed by sex.

          Methods

          We studied 1025 adults aged 50 and older (75% female) as part of The Irish Longitudinal Study on Ageing. Hair cortisol samples were collected at 2014 (Wave 3) and depressive symptoms were assessed using the 8-item Center for Epidemiological Studies Depression Scale in 2014 (Wave 3), 2016 (Wave 4), 2018 (Wave 5) and again in 2020 as part of TILDA’s Covid-19 Study. Hierarchical mixed effects logistic regression models were applied to investigate the association between cortisol levels and clinically significant depressive symptoms before and during the Covid-19 pandemic.

          Results

          In a full covariate adjusted model there was a significant interaction between cortisol and wave on depressive symptoms (χ2 = 8.5, p =.03). Cortisol was positively and significantly associated with elevated depressive symptoms during the Covid-19 Study (OR =1.3, 95% CI 1.11, 1.56, p =.003), and was associated with an increased likelihood of reporting clinically significant depressive symptoms during first year of the Covid-19 pandemic, when compared with before, OR =1.4, 95% CI 1.05, 1.9, p =.015. There was no evidence of effect modification by sex.

          Conclusions

          Higher hair cortisol, assessed 6 years previously, predicted clinically significant depressive symptoms among middle-aged and older adults during (but not before) the pandemic. Findings suggest a biological phenotype which denotes increased susceptibility to the negative impact of environmental stress on psychological health.

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          Most cited references51

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          The psychological impact of quarantine and how to reduce it: rapid review of the evidence

          Samantha K. Brooks, Rebecca K Webster, Louise E. Smith … (2022)
          Summary The December, 2019 coronavirus disease outbreak has seen many countries ask people who have potentially come into contact with the infection to isolate themselves at home or in a dedicated quarantine facility. Decisions on how to apply quarantine should be based on the best available evidence. We did a Review of the psychological impact of quarantine using three electronic databases. Of 3166 papers found, 24 are included in this Review. Most reviewed studies reported negative psychological effects including post-traumatic stress symptoms, confusion, and anger. Stressors included longer quarantine duration, infection fears, frustration, boredom, inadequate supplies, inadequate information, financial loss, and stigma. Some researchers have suggested long-lasting effects. In situations where quarantine is deemed necessary, officials should quarantine individuals for no longer than required, provide clear rationale for quarantine and information about protocols, and ensure sufficient supplies are provided. Appeals to altruism by reminding the public about the benefits of quarantine to wider society can be favourable.
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            The CES-D Scale: A Self-Report Depression Scale for Research in the General Population

            L Radloff (1977)
            Article 0 comments Cited 4283 times – based on 0 reviews     Review now
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              Mental health before and during the COVID-19 pandemic: a longitudinal probability sample survey of the UK population

              Matthias Pierce, Holly F Hope, Tamsin Ford … (2020)
              Summary Background The potential impact of the COVID-19 pandemic on population mental health is of increasing global concern. We examine changes in adult mental health in the UK population before and during the lockdown. Methods In this secondary analysis of a national, longitudinal cohort study, households that took part in Waves 8 or 9 of the UK Household Longitudinal Study (UKHLS) panel, including all members aged 16 or older in April, 2020, were invited to complete the COVID-19 web survey on April 23–30, 2020. Participants who were unable to make an informed decision as a result of incapacity, or who had unknown postal addresses or addresses abroad were excluded. Mental health was assessed using the 12-item General Health Questionnaire (GHQ-12). Repeated cross-sectional analyses were done to examine temporal trends. Fixed-effects regression models were fitted to identify within-person change compared with preceding trends. Findings Waves 6–9 of the UKHLS had 53 351 participants. Eligible participants for the COVID-19 web survey were from households that took part in Waves 8 or 9, and 17 452 (41·2%) of 42 330 eligible people participated in the web survey. Population prevalence of clinically significant levels of mental distress rose from 18·9% (95% CI 17·8–20·0) in 2018–19 to 27·3% (26·3–28·2) in April, 2020, one month into UK lockdown. Mean GHQ-12 score also increased over this time, from 11·5 (95% CI 11·3–11·6) in 2018–19, to 12·6 (12·5–12·8) in April, 2020. This was 0·48 (95% CI 0·07–0·90) points higher than expected when accounting for previous upward trends between 2014 and 2018. Comparing GHQ-12 scores within individuals, adjusting for time trends and significant predictors of change, increases were greatest in 18–24-year-olds (2·69 points, 95% CI 1·89–3·48), 25–34-year-olds (1·57, 0·96–2·18), women (0·92, 0·50–1·35), and people living with young children (1·45, 0·79–2·12). People employed before the pandemic also averaged a notable increase in GHQ-12 score (0·63, 95% CI 0·20–1·06). Interpretation By late April, 2020, mental health in the UK had deteriorated compared with pre-COVID-19 trends. Policies emphasising the needs of women, young people, and those with preschool aged children are likely to play an important part in preventing future mental illness. Funding None.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Psychoneuroendocrinology
                Journal ID (iso-abbrev): Psychoneuroendocrinology
                Title: Psychoneuroendocrinology
                Publisher: The Author(s). Published by Elsevier Ltd.
                ISSN (Print): 0306-4530
                ISSN (Electronic): 1873-3360
                Publication date PMC-release: 22 June 2022
                Publication date (Electronic): 22 June 2022
                Electronic Location Identifier: 105847
                Affiliations
                [a ]The Irish longitudinal Study on Ageing, Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Ireland
                [b ]Mercer’s Institute for Successful Ageing, St. James’s Hospital, Trinity College Dublin, Ireland
                Author notes
                [1]

                The Irish Longitudinal Study on Ageing (TILDA), 152-160 Pearse Street, Trinity Central, Trinity College Dublin, Dublin 2, Ireland

                Article
                Publisher Item ID: S0306-4530(22)00188-3 Publisher ID: 105847
                DOI: 10.1016/j.psyneuen.2022.105847
                PMC ID: 9221173
                PubMed ID: 35779340
                SO-VID: a32aa822-1196-415b-a91f-87663ea9d5ab
                Copyright © © 2022 The Authors
                License:

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                Date received : 8 February 2022
                Date revision received : 20 June 2022
                Date accepted : 20 June 2022
                Categories
                Subject: Article

                ScienceOpen disciplines: Endocrinology & Diabetes
                Keywords: cortisol,stress,depression,covid-19
                Data availability:
                ScienceOpen disciplines: Endocrinology & Diabetes
                Keywords: cortisol, stress, depression, covid-19

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