We examined the relation between stress reactivity and 24？h glycemic control in 17 inactive, healthy older people (≥60 years) under both a novel psychophysical stress and a seated control condition. Plasma cortisol was measured over the course of the stress and recovery periods. Glycemic control was determined over the subsequent 3？h from an oral glucose tolerance test (OGTT) and over 24？h via continuous glucose monitoring (CGM). We observed significant ( ？？ < 0 . 0 5 ) elevations in perceived stress, cardiovascular activity, and peak cortisol response at 30？min ( 1 0 . 6 ± 3 . 1 versus 8 . 6 ± 2 . 6 ？μg·dL？1, resp.) during the stress compared with the control condition; however, 3？h OGTT glucose and insulin responses were similar between conditions. The CGM data suggested a 30–40？min postchallenge delay in peak glucose response and attenuated glucose clearance over the 6？h following the stress condition, but these alterations were not statistically significant. Healthy older people may demonstrate minimal disruption in metabolic resiliency following everyday psychological stress. 1. Introduction “Stress” is a common and adaptive component of our interaction with the environment [1], and allostasis refers to the body’s ability to reestablish stability (i.e., homeostasis) when confronted by various environmental challenges through the activation of neural, neuroendocrine, and neuroendocrine-immune responses [2]. There is some evidence from animal models that aging per se alters allostatic ability, although the data in humans are inconclusive [3]. Nonetheless, older age is characterized by diminished physical capabilities (e.g., vision, strength, and reaction time), which may make normal everyday experiences and challenges (like driving an automobile or crossing the street) more stressful [4]. Thus, older people may have more frequent exposures to stressful situations, along with a compromised ability to respond appropriately to them. There are significant individual differences in how individuals cope with environmental challenges, however, and this may be due to the interaction of heredity, development, education, and life experiences [5, 6]. Furthermore, there is substantial heterogeneity with regard to patterns of aging [7] such that some older people appear more resilient than others to the physiological consequences of various environmental challenges. Resiliency to psychophysical stress therefore may be considered an important indicator of successful aging. To date, much of the experimental study of stress reactivity and health has focused on
References
[1]
K. E. Habib, P. W. Gold, and G. P. Chrousos, “Neuroendocrinology of stress,” Endocrinology and Metabolism Clinics of North America, vol. 30, no. 3, pp. 695–728, 2001.
[2]
P. Sterling and J. Eyer, “Allostasis: a new paradigm to explain arousal pathology,” in Handbook of Life Stress, Cognition, and Health, S. Fisher and J. Reason, Eds., pp. 629–649, John Wiley & Sons, New York, NY, USA, 1988.
[3]
B. M. Kudielka, A. K. Schmidt-Reinwald, D. H. Hellhammer, T. Schürmeyer, and C. Kirschbaum, “Psychosocial stress and HPA functioning: no evidence for a reduced resilience in healthy elderly men,” Stress, vol. 3, no. 3, pp. 229–240, 2000.
[4]
W. W. Spirduso, “Aging and motor control,” in Prospectives in Exercise Science and Sports Medicine, D. R. Lamb, C. V. Gisolfi, and E. R. Nadel, Eds., vol. 8 of Exercise in Older Adults, pp. 53–114, Cooper Publishing, Carmel, Indiana, 1995.
[5]
B. McEwen, T. E. Seeman, and The Allostatic Load Working Group, “Allostatic load and allostasis,” MacArthur Research Network on Socioeconomic Status and Health, The John D. and Catherine T. MacArthur Foundation, 1999, http://www.macses.ucsf.edu/research/allostatic/.
[6]
Y. Chida and M. Hamer, “An association of adverse psychosocial factors with diabetes mellitus: a meta-analytic review of longitudinal cohort studies,” Diabetologia, vol. 51, no. 12, pp. 2168–2178, 2008.
[7]
J. W. Rowe and R. L. Kahn, “Human aging: usual and successful,” Science, vol. 237, no. 4811, pp. 143–149, 1987.
[8]
C. Kirschbaum, E. G. Bono, N. Rohleder et al., “Effects of fasting and glucose load on free cortisol responses to stress and nicotine,” Journal of Clinical Endocrinology and Metabolism, vol. 82, no. 4, pp. 1101–1105, 1997.
[9]
P. Wiesli, C. Schmid, O. Kerwer et al., “Acute psychological stress affects glucose concentrations in patients with type 1 diabetes following food intake but not in the fasting state,” Diabetes Care, vol. 28, no. 8, pp. 1910–1915, 2005.
[10]
G. Seematter, E. Guenat, P. Schneiter, C. Cayeux, E. Jéquier, and L. Tappy, “Effects of mental stress on insulin-mediated glucose metabolism and energy expenditure in lean and obese women,” American Journal of Physiology, vol. 279, pp. E799–E805, 2000.
[11]
A. Inui, H. Kitaoka, M. Majima et al., “Effect of the Kobe earthquake on stress and glycemic control in patients with diabetes mellitus,” Archives of Internal Medicine, vol. 158, no. 3, pp. 274–278, 1998.
[12]
E. Pfeiffer, “A short portable mental status questionnaire for the assessment of organic brain deficit in elderly patients,” Journal of the American Geriatrics Society, vol. 23, no. 10, pp. 433–441, 1975.
[13]
L. S. Radloff, “The CES-D scale: a self-report depression scale for research in the general population,” Applied Psychological Measurement, vol. 1, pp. 385–401, 1977.
[14]
S. Cohen and G. M. Williamson, “Perceived stress in a probability sample of the United States,” in The Social Psychology of Health, S. Spacapan and S. Oskamp, Eds., pp. 31–67, Sage, Newbury Park, Calif, USA, 1988.
[15]
T. Rankinen, S.-Y. Kim, L. Pérusse, J. P. Després, and C. Bouchard, “The prediction of abdominal visceral fat level from body composition and anthropometry: ROC analysis,” International Journal of Obesity, vol. 23, no. 8, pp. 801–809, 1999.
[16]
A. S. McKnight and A. J. McKnight, “The automated psychophysical test (APT) for assessing age-diminished capabilities,” Behavior Research Methods, Instruments, & Computers, vol. 26, pp. 187–191, 1994.
[17]
A. S. McKnight and A. J. McKnight, “Multivariate analysis of age-related driver ability and performance deficits,” Accident Analysis and Prevention, vol. 31, no. 5, pp. 445–454, 1999.
[18]
National Diabetes Study Group , “Report of the expert committee on the diagnosis and classification of diabetes mellitus,” Diabetes Care, vol. 20, no. 7, pp. 1183–1197, 1997.
[19]
J. J. Mastrototaro, “The MiniMed continuous glucose monitoring system (CGMS),” Journal of Pediatric Endocrinology and Metabolism, vol. 12, no. 3, pp. 751–758, 1999.
[20]
J. J. Mastrototaro and T. M. Gross, “Reproducibility of the continuous glucose monitoring system matches previous reports and the intended use of the product,” Diabetes Care, vol. 26, no. 1, pp. 256–257, 2003.
[21]
T. E. Seeman, L. F. Berkman, B. I. Gulanski et al., “Self-esteem and neuroendocrine response to challenge: MacArthur studies of successful aging,” Journal of Psychosomatic Research, vol. 39, no. 1, pp. 69–84, 1995a.
[22]
T. E. Seeman, B. Singer, and P. Charpentier, “Gender differences in patterns of HPA axis response to challenge: MacArthur studies of successful aging,” Psychoneuroendocrinology, vol. 20, no. 7, pp. 711–725, 1995b.
[23]
T. E. Seeman and R. J. Robbins, “Aging and hypothalamic-pituitary-adrenal response to challenge in humans,” Endocrine Reviews, vol. 15, no. 2, pp. 233–260, 1994.
[24]
R. R. Wing, L. H. Epstein, E. Blair, and M. P. Nowalk, “Psychologic stress and blood glucose levels in nondiabetic subjects,” Psychosomatic Medicine, vol. 47, no. 6, pp. 558–564, 1985.
[25]
P. Z. Zimmet, J. R. Wall, R. Rome, L. Stimmler, and R. J. Jarrett, “Diurnal variation in glucose tolerance: associated changes in plasma insulin, growth hormone, and non-esterified fatty acids,” British Medical Journal, vol. 1, no. 906, pp. 485–488, 1974.
[26]
K. S. Polonsky, B. D. Given, L. J. Hirsch et al., “Abnormal patterns of insulin secretion in non-insulin-dependent diabetes mellitus,” New England Journal of Medicine, vol. 318, no. 19, pp. 1231–1239, 1988.
[27]
J. R. Kramer, J. Ledolter, G. N. Manos, and M. L. Bayless, “Stress and metabolic control in diabetes mellitus: methodological issues and an illustrative analysis,” Annals of Behavioral Medicine, vol. 22, no. 1, pp. 17–28, 2000.
