title: Salivary cortisol is associated with diagnosis and severity of late-life generalized anxiety disorder.
abstract: Age-associated alterations in hypothalamic-pituitary-adrenal (HPA) axis functioning may make individuals more susceptible to HPA dysregulation in the context of mood and anxiety disorders. Little to no research has been done to examine HPA axis function in generalized anxiety disorder (GAD), particularly in late-life GAD, the most prevalent anxiety disorder in the elderly. The study sample consisted of 71 GAD subjects and 40 nonanxious comparison subjects over 60 years of age. We examined the hypotheses that elderly individuals with GAD will have elevated salivary cortisol levels compared to nonanxious subjects, and that elevated cortisol levels in GAD will be associated with measures of symptom severity. We report that late-life GAD is characterized by elevated basal salivary cortisol levels, with higher peak cortisol levels and larger areas under the curve, compared to nonanxious subjects. Additionally, severity of GAD as measured by the GAD Severity Scale and the Penn State Worry Questionnaire are positively correlated with cortisol levels. These data demonstrate HPA axis dysfunction in late-life GAD and suggest the need for additional research on the influence of aging on HPA axis function in mood and anxiety disorders.
authors.affiliation: Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA. mantellarc@upmc.edu
authors.forename: Rose C
authors.initials: RC
authors.lastname: Mantella
authors.forename: Meryl A
authors.initials: MA
authors.lastname: Butters
authors.forename: Janet A
authors.initials: JA
authors.lastname: Amico
authors.forename: Sati
authors.initials: S
authors.lastname: Mazumdar
authors.forename: Bruce L
authors.initials: BL
authors.lastname: Rollman
authors.forename: Amy E
authors.initials: AE
authors.lastname: Begley
authors.forename: Charles F
authors.initials: CF
authors.lastname: Reynolds
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Lenze
mesh_terms: D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000175:diagnosis*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D012463:Saliva / Q000737:chemistry*; D012720:Severity of Illness Index
chemical_list: D006854:Hydrocortisone