{"id":"https://openalex.org/W2111293437","doi":"https://doi.org/10.1093/gerona/63.2.190","title":"Higher Levels and Blunted Diurnal Variation of Cortisol in Frail Older Women","display_name":"Higher Levels and Blunted Diurnal Variation of Cortisol in Frail Older Women","publication_year":2008,"publication_date":"2008-02-01","ids":{"openalex":"https://openalex.org/W2111293437","doi":"https://doi.org/10.1093/gerona/63.2.190","mag":"2111293437","pmid":"https://pubmed.ncbi.nlm.nih.gov/18314456"},"language":"en","primary_location":{"id":"doi:10.1093/gerona/63.2.190","doi":"https://doi.org/10.1093/gerona/63.2.190","is_oa":false,"landing_page_url":"https://doi.org/10.1093/gerona/63.2.190","pdf_url":null,"source":{"id":"https://openalex.org/S969433497","display_name":"The Journals of Gerontology Series A","issn_l":"1079-5006","issn":["1079-5006","1758-535X"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-b","doyens","erih-plus","jufo-3","ki-jl-2","medline","norway-2","poland-140","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310311648","host_organization_name":"Oxford University Press","host_organization_lineage":["https://openalex.org/P4310311648","https://openalex.org/P4310311647"],"host_organization_lineage_names":["Oxford University Press","University of Oxford"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","raw_type":"journal-article"},"volume":null,"type":"article","indexed_in":["crossref","pubmed"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5073980557","display_name":"Ravi Varadhan","orcid":"https://orcid.org/0000-0002-8434-1034","observed_orcids":["https://orcid.org/0000-0002-8434-1034"]},"institutions":[{"id":"https://openalex.org/I145311948","display_name":"Johns Hopkins University","ror":"https://ror.org/00za53h95","country_code":"US","type":"education","lineage":["https://openalex.org/I145311948"]}],"countries":["US"],"is_corresponding":true,"raw_author_name":"R. Varadhan","raw_affiliation_strings":["Division of Geriatric Medicine and Gerontology, School of Medicine, John Hopkins University, Baltimore, MD, USA. rvaradhan@jhmi.edu","Division of Geriatric Medicine and Gerontology, School of Medicine, John Hopkins University, Baltimore, MD, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Division of Geriatric Medicine and Gerontology, School of Medicine, John Hopkins University, Baltimore, MD, USA. rvaradhan@jhmi.edu","institution_ids":["https://openalex.org/I145311948"]},{"raw_affiliation_string":"Division of Geriatric Medicine and Gerontology, School of Medicine, John Hopkins University, Baltimore, MD, USA","institution_ids":["https://openalex.org/I145311948"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5086987637","display_name":"Jeremy D Walston","orcid":"https://orcid.org/0000-0002-6965-2723","observed_orcids":["https://orcid.org/0000-0002-6965-2723"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"J. Walston","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5056927598","display_name":"Anne Rentoumis Cappola","orcid":"https://orcid.org/0000-0002-0883-9754","observed_orcids":["https://orcid.org/0000-0002-0883-9754"]},"institutions":[{"id":"https://openalex.org/I79576946","display_name":"University of Pennsylvania","ror":"https://ror.org/00b30xv10","country_code":"US","type":"education","lineage":["https://openalex.org/I79576946"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"A. R. Cappola","raw_affiliation_strings":["#N#               * University of Pennsylvania"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"#N#               * University of Pennsylvania","institution_ids":["https://openalex.org/I79576946"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5028559413","display_name":"Michelle C. Carlson","orcid":"https://orcid.org/0000-0003-2465-7421","observed_orcids":["https://orcid.org/0000-0003-2465-7421"]},"institutions":[{"id":"https://openalex.org/I145311948","display_name":"Johns Hopkins University","ror":"https://ror.org/00za53h95","country_code":"US","type":"education","lineage":["https://openalex.org/I145311948"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"M. C. Carlson","raw_affiliation_strings":["Bloomberg School of Public Health"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Bloomberg School of Public Health","institution_ids":["https://openalex.org/I145311948"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5045269183","display_name":"Gary S. Wand","orcid":"https://orcid.org/0000-0001-7877-1057","observed_orcids":["https://orcid.org/0000-0001-7877-1057"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"G. S. Wand","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"last","author":{"id":"https://openalex.org/A5112018215","display_name":"Linda P. Fried","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"L. P. Fried","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":["https://openalex.org/A5073980557"],"corresponding_institution_ids":["https://openalex.org/I145311948"],"apc_list":{"value":4408,"currency":"USD","value_usd":4408},"apc_paid":null,"fwci":4.604,"has_fulltext":false,"cited_by_count":182,"citation_normalized_percentile":{"value":0.9438047,"is_in_top_1_percent":false,"is_in_top_10_percent":true},"cited_by_percentile_year":{"min":98,"max":100},"biblio":{"volume":"63","issue":"2","first_page":"190","last_page":"195"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11011","display_name":"Frailty in Older Adults","score":0.6610999703407288,"subfield":{"id":"https://openalex.org/subfields/2717","display_name":"Geriatrics and Gerontology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11011","display_name":"Frailty in Older Adults","score":0.6610999703407288,"subfield":{"id":"https://openalex.org/subfields/2717","display_name":"Geriatrics and Gerontology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10529","display_name":"Stress Responses and Cortisol","score":0.24050000309944153,"subfield":{"id":"https://openalex.org/subfields/2802","display_name":"Behavioral Neuroscience"},"field":{"id":"https://openalex.org/fields/28","display_name":"Neuroscience"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}},{"id":"https://openalex.org/T12421","display_name":"Adrenal Hormones and Disorders","score":0.020800000056624413,"subfield":{"id":"https://openalex.org/subfields/2712","display_name":"Endocrinology, Diabetes and Metabolism"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/frailty","display_name":"frailty","score":0.9929999709129333},{"id":"https://openalex.org/keywords/salivary-cortisol","display_name":"salivary cortisol","score":0.9390000104904175},{"id":"https://openalex.org/keywords/diurnal-cortisol-rhythm","display_name":"diurnal cortisol rhythm","score":0.7770000100135803},{"id":"https://openalex.org/keywords/diurnal-amplitude","display_name":"diurnal amplitude","score":0.777999997138977},{"id":"https://openalex.org/keywords/older-women","display_name":"older women","score":0.8209999799728394},{"id":"https://openalex.org/keywords/neuroendocrine-function","display_name":"neuroendocrine function","score":0.6930000185966492},{"id":"https://openalex.org/keywords/women-s-health-and-aging-study","display_name":"Women's Health and Aging Study","score":0.8209999799728394}],"concepts":[{"id":"https://openalex.org/C2776476923","wikidata":"https://www.wikidata.org/wiki/Q7725","display_name":"Evening","level":2,"score":0.8697134256362915},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.7153175473213196},{"id":"https://openalex.org/C19720800","wikidata":"https://www.wikidata.org/wiki/Q7722","display_name":"Morning","level":2,"score":0.698042094707489},{"id":"https://openalex.org/C77350462","wikidata":"https://www.wikidata.org/wiki/Q1125472","display_name":"Confounding","level":2,"score":0.5944121479988098},{"id":"https://openalex.org/C167678106","wikidata":"https://www.wikidata.org/wiki/Q5283759","display_name":"Diurnal temperature variation","level":2,"score":0.5785883665084839},{"id":"https://openalex.org/C62913699","wikidata":"https://www.wikidata.org/wiki/Q5173333","display_name":"Cortisol awakening response","level":3,"score":0.577257513999939},{"id":"https://openalex.org/C121446783","wikidata":"https://www.wikidata.org/wiki/Q208353","display_name":"Circadian rhythm","level":2,"score":0.5527582764625549},{"id":"https://openalex.org/C125370674","wikidata":"https://www.wikidata.org/wiki/Q1527480","display_name":"Stressor","level":2,"score":0.5262724161148071},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.43111586570739746},{"id":"https://openalex.org/C2778709874","wikidata":"https://www.wikidata.org/wiki/Q190875","display_name":"Hydrocortisone","level":2,"score":0.42816174030303955},{"id":"https://openalex.org/C74909509","wikidata":"https://www.wikidata.org/wiki/Q10387","display_name":"Gerontology","level":1,"score":0.33230704069137573},{"id":"https://openalex.org/C149923435","wikidata":"https://www.wikidata.org/wiki/Q37732","display_name":"Demography","level":1,"score":0.3242882788181305},{"id":"https://openalex.org/C118552586","wikidata":"https://www.wikidata.org/wiki/Q7867","display_name":"Psychiatry","level":1,"score":0.13541081547737122},{"id":"https://openalex.org/C121332964","wikidata":"https://www.wikidata.org/wiki/Q413","display_name":"Physics","level":0,"score":0.0},{"id":"https://openalex.org/C91586092","wikidata":"https://www.wikidata.org/wiki/Q757520","display_name":"Atmospheric sciences","level":1,"score":0.0},{"id":"https://openalex.org/C144024400","wikidata":"https://www.wikidata.org/wiki/Q21201","display_name":"Sociology","level":0,"score":0.0},{"id":"https://openalex.org/C127313418","wikidata":"https://www.wikidata.org/wiki/Q1069","display_name":"Geology","level":0,"score":0.0},{"id":"https://openalex.org/C1276947","wikidata":"https://www.wikidata.org/wiki/Q333","display_name":"Astronomy","level":1,"score":0.0}],"mesh":[{"descriptor_ui":"D000369","descriptor_name":"Aged, 80 and over","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D002940","descriptor_name":"Circadian Rhythm","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D003430","descriptor_name":"Cross-Sectional Studies","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D005260","descriptor_name":"Female","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006854","descriptor_name":"Hydrocortisone","qualifier_ui":"Q000032","qualifier_name":"analysis","is_major_topic":true},{"descriptor_ui":"D012044","descriptor_name":"Regression Analysis","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D012463","descriptor_name":"Saliva","qualifier_ui":"Q000737","qualifier_name":"chemistry","is_major_topic":false},{"descriptor_ui":"D016330","descriptor_name":"Frail Elderly","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D018709","descriptor_name":"Statistics, Nonparametric","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false}],"locations_count":3,"locations":[{"id":"doi:10.1093/gerona/63.2.190","doi":"https://doi.org/10.1093/gerona/63.2.190","is_oa":false,"landing_page_url":"https://doi.org/10.1093/gerona/63.2.190","pdf_url":null,"source":{"id":"https://openalex.org/S969433497","display_name":"The Journals of Gerontology Series A","issn_l":"1079-5006","issn":["1079-5006","1758-535X"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-b","doyens","erih-plus","jufo-3","ki-jl-2","medline","norway-2","poland-140","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310311648","host_organization_name":"Oxford University Press","host_organization_lineage":["https://openalex.org/P4310311648","https://openalex.org/P4310311647"],"host_organization_lineage_names":["Oxford University Press","University of Oxford"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","raw_type":"journal-article"},{"id":"pmid:18314456","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/18314456","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"The journals of gerontology. Series A, Biological sciences and medical sciences","raw_type":"Journal Article"},{"id":"pmh:oai:CiteSeerX.psu:10.1.1.564.3666","doi":null,"is_oa":false,"landing_page_url":"http://citeseerx.ist.psu.edu/viewdoc/summary?doi=10.1.1.564.3666","pdf_url":null,"source":null,"license":null,"license_id":null,"version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"http://biomedgerontology.oxfordjournals.org/content/63/2/190.full.pdf","raw_type":"text"}],"best_oa_location":null,"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being","score":0.9922999739646912}],"study_designs":[{"id":"https://openalex.org/study-designs/observational-study","display_name":"Observational Study"}],"awards":[{"id":"https://openalex.org/G2871287035","display_name":null,"funder_award_id":"R37-AG19905","funder_id":"https://openalex.org/F4320337337","funder_display_name":"National Institute on Aging"},{"id":"https://openalex.org/G3805184293","display_name":"Pathogenesis of physical disability in Aging women","funder_award_id":"5r37ag019905-10","funder_id":"https://openalex.org/F4320332161","funder_display_name":"National Institutes of Health"},{"id":"https://openalex.org/G9000917273","display_name":"Older Americans Independence Center","funder_award_id":"P30AG021334","funder_id":"https://openalex.org/F4320337337","funder_display_name":"National Institute on Aging"}],"funders":[{"id":"https://openalex.org/F4320332161","display_name":"National Institutes of Health","ror":"https://ror.org/01cwqze88"},{"id":"https://openalex.org/F4320337337","display_name":"National Institute on Aging","ror":"https://ror.org/049v75w11"}],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":36,"referenced_works":["https://openalex.org/W150220388","https://openalex.org/W192512408","https://openalex.org/W1562992882","https://openalex.org/W1748423452","https://openalex.org/W1965658712","https://openalex.org/W1994631256","https://openalex.org/W2008922467","https://openalex.org/W2012411575","https://openalex.org/W2014904735","https://openalex.org/W2015252215","https://openalex.org/W2016595949","https://openalex.org/W2030421130","https://openalex.org/W2035490031","https://openalex.org/W2048958074","https://openalex.org/W2059023753","https://openalex.org/W2065526279","https://openalex.org/W2082491080","https://openalex.org/W2118424059","https://openalex.org/W2120658378","https://openalex.org/W2126487639","https://openalex.org/W2128979836","https://openalex.org/W2132539548","https://openalex.org/W2142644111","https://openalex.org/W2145073776","https://openalex.org/W2152456824","https://openalex.org/W2164059021","https://openalex.org/W2325343629","https://openalex.org/W2334787351","https://openalex.org/W2398790304","https://openalex.org/W3016230452","https://openalex.org/W3023732896","https://openalex.org/W3112717819","https://openalex.org/W4230619375","https://openalex.org/W4233702515","https://openalex.org/W4255304519","https://openalex.org/W4294184534"],"related_works":["https://openalex.org/W2088293270","https://openalex.org/W2153263292","https://openalex.org/W1988541912","https://openalex.org/W2968832071","https://openalex.org/W3157513879","https://openalex.org/W2898613803","https://openalex.org/W2063144932","https://openalex.org/W2605024882","https://openalex.org/W4388728006","https://openalex.org/W2155577996"],"abstract_inverted_index":{"BACKGROUND:":[0],"Frailty":[1,128,203],"is":[2],"an":[3],"important":[4,241],"geriatric":[5],"condition":[6],"with":[7,63,190,211,227],"increased":[8],"vulnerability":[9,265],"to":[10,32,46],"stressors":[11],"(e.g.,":[12],"infection":[13],"and":[14,16,21,53,79,88,107,113,152,163,171,175,254,266],"injury)":[15],"for":[17,95,239],"developing":[18],"functional":[19],"dependence":[20],"mortality.":[22],"Impairments":[23],"in":[24,35,83,193,263,270],"signaling":[25],"pathways,":[26],"including":[27],"neuroendocrine":[28],"alterations,":[29],"are":[30,60],"thought":[31],"be":[33,261],"involved":[34,262],"the":[36,76,139,143,247,264],"etiology":[37],"of":[38,57,115,117,142,205,258],"frailty,":[39],"but":[40],"have":[41],"not":[42,224],"been":[43],"well":[44],"characterized":[45],"date.":[47],"We":[48],"evaluated":[49],"whether":[50],"higher":[51,252],"levels":[52,253],"blunted":[54,255],"diurnal":[55,111,214,256],"variation":[56,257],"salivary":[58],"cortisol":[59,96,118,124,165,178,194,222,259],"cross-sectionally":[61],"associated":[62,189,210,226],"frailty":[64,161,173,185,228],"burden.":[65],"METHODS:":[66],"Two":[67],"hundred":[68],"fourteen":[69],"community-dwelling":[70],"women,":[71],"80-90":[72],"years":[73],"old,":[74],"from":[75],"Women's":[77],"Health":[78],"Aging":[80],"Study":[81],"participated":[82],"this":[84],"study":[85],"between":[86,160,172],"2004":[87],"2005.":[89],"Seven":[90],"saliva":[91],"samples":[92],"were":[93,104,126,158],"collected":[94],"measurement":[97],"over":[98],"a":[99,134,212],"24-hour":[100,176],"period.":[101],"Main":[102],"outcomes":[103],"awakening,":[105],"evening,":[106],"overall":[108],"mean":[109,177],"cortisol;":[110],"amplitude;":[112],"rate":[114],"decline":[116],"level":[119],"during":[120,195],"morning":[121,196],"hours.":[122],"All":[123,235],"concentrations":[125],"log-transformed.":[127],"burden":[129,162,174,186,204,229],"was":[130,187,209,223],"calculated,":[131],"based":[132],"on":[133],"previously":[135],"validated":[136],"tool,":[137],"as":[138],"number":[140],"(0-5)":[141],"following":[144],"criteria":[145],"present:":[146],"weakness,":[147],"exhaustion,":[148],"weight":[149],"loss,":[150],"slowness,":[151],"inactivity.":[153],"RESULTS:":[154],"Significant":[155],"positive":[156],"associations":[157],"found":[159],"evening":[164],"(beta":[166,179,198,216,230],"=":[167,180,199,217,231],"0.11,":[168],"p":[169,182,201,219,233],"=.04),":[170],"0.07,":[181],"=.03).":[183,220],"Increasing":[184],"significantly":[188,225],"smaller":[191,213],"declines":[192],"hours":[197],"0.04,":[200],"=.02).":[202],">":[206],"or":[207],"=2":[208],"amplitude":[215],"-0.34,":[218],"Awakening":[221],"0.01,":[232],"=.8).":[234],"analyses":[236],"included":[237],"adjustments":[238],"several":[240],"confounders.":[242],"CONCLUSIONS:":[243],"Our":[244],"findings":[245],"provide":[246],"first":[248],"epidemiological":[249],"evidence":[250],"that":[251],"may":[260],"clinical":[267],"presentation":[268],"observed":[269],"frail":[271],"older":[272],"women.":[273]},"counts_by_year":[{"year":2026,"cited_by_count":6},{"year":2025,"cited_by_count":10},{"year":2024,"cited_by_count":9},{"year":2023,"cited_by_count":9},{"year":2022,"cited_by_count":8},{"year":2021,"cited_by_count":10},{"year":2020,"cited_by_count":16},{"year":2019,"cited_by_count":16},{"year":2018,"cited_by_count":11},{"year":2017,"cited_by_count":11},{"year":2016,"cited_by_count":11},{"year":2015,"cited_by_count":5},{"year":2014,"cited_by_count":10},{"year":2013,"cited_by_count":9},{"year":2012,"cited_by_count":7}],"updated_date":"2026-10-31T12:09:11.096373","created_date":"2016-06-24T00:00:00"}
