title: Bereavement reduces neutrophil oxidative burst only in older adults: role of the HPA axis and immunesenescence.
abstract: BACKGROUND
  The effect of the chronic stress of bereavement on immunity is poorly understood. Previous studies have demonstrated negative effects on immunity in older adults, and those who report higher depressive symptoms. The aim of the present study was to compare the effect of bereavement on neutrophil function in healthy young and old adults, also assessing serum levels of the stress hormones, cortisol and dehydroepiandrosterone sulphate (DHEAS). 41 young (mean age 32 years) and 52 older adults (mean age 72 years), bereaved and non-bereaved, took part in the study. They completed questionnaires on socio-demographic and health behaviour characteristics, as well as psychosocial variables, and provided a blood sample for analysis of neutrophil function (phagocytosis and reactive oxygen species (ROS) production) and stress hormone analysis.
  
  
  RESULTS
  Bereaved participants in both age groups reported more symptoms of depression and anxiety than controls and scored moderately highly on bereavement-specific questionnaires for these symptoms. Despite this, young bereaved participants showed robust neutrophil function when compared to age-matched non-bereaved controls, and comparable stress hormone levels, while reduced neutrophil ROS production and raised stress hormone levels (cortisol:DHEAS ratio) were seen in the older bereaved group compared to their age-matched controls.
  
  
  CONCLUSIONS
  Reduced neutrophil function among older bereaved participants may be the result of the inability to maintain stress hormone balance, specifically the cortisol:DHEAS ratio.
authors.affiliation: School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK ; MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham, UK.
authors.forename: Ana
authors.initials: A
authors.lastname: Vitlic
authors.affiliation: City Hospital Eye Accident and Emergency Department, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK.
authors.forename: Riyad
authors.initials: R
authors.lastname: Khanfer
authors.affiliation: MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham, UK ; School of Immunity and Infection, University of Birmingham, Birmingham, UK.
authors.forename: Janet M
authors.initials: JM
authors.lastname: Lord
authors.affiliation: School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK.
authors.forename: Douglas
authors.initials: D
authors.lastname: Carroll
authors.affiliation: School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK ; MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham, UK.
authors.forename: Anna C
authors.initials: AC
authors.lastname: Phillips
keywords: Bereavement; Cortisol; DHEAS; Neutrophil function; Social support