Abstract

Despite well-established evidence on marriage as a psychosocial support for adults, there are studies that indicate loneliness may affect even married adults. Loneliness provokes a dysregulation of the hypothalamic-pituitary-adrenocortical (HPA) axis. Thus, the study aims to examine the sex-specific association of loneliness and cortisol levels in the married older population. A cross-sectional analysis was conducted among 500 married participants (316 male and 184 female) aged 65–90 years (mean age = 73.8 ± 6.4 years) of the population-based KORA (Cooperative Health Research in the Region of Augsburg) – Age study. Linear regression analyses were employed to examine the association between cortisol measurements (salivary cortisol upon waking (M1), 30 min after awakening (M2), late night (LNSC), cortisol awakening response (CAR), diurnal cortisol slope (DCS)) and loneliness (assessed by UCLA Loneliness Scale) in married participants with adjustments for potential confounders. In total sample population, lonely married participants displayed a significantly flatter DCS after M2 peak than their not lonely counterparts. In sex-specific analyses, lonely married men showed flatter DCS and reduced CAR than non-lonely counterparts. The association between loneliness and DCS was robust even after adjustment for lifestyle and psychosocial factors. In married women, no significant associations between loneliness and cortisol levels were observed. These findings suggest a differential impact of loneliness on HPA axis dynamics in lonely married men. Our findings highlight the importance to address loneliness even in married people.

摘要

尽管有充分的证据表明婚姻是对成年人的社会心理支持，但有研究表明，孤独感甚至可能影响已婚成年人。孤独感引起下丘脑-垂体-肾上腺皮质（HPA）轴的失调。因此，该研究旨在检验已婚老年人群中性别与孤独感和皮质醇水平的相关性。在年龄为65-90岁（平均年龄= 73.8±6.4岁）的以人群为基础的KORA（奥格斯堡地区合作医疗研究）的500名已婚参与者（316名男性和184名女性）中进行了横断面分析研究。线性回归分析用于检查皮质醇测量值之间的关联（醒来时唾液皮质醇（M1），醒后30分钟（M2），深夜（LNSC），皮质醇觉醒反应（CAR），已婚参与者的每日皮质醇斜率（DCS）和孤独感（由UCLA孤独感量表评估），并对潜在的混杂因素进行了调整。在总样本人群中，孤独婚姻参与者在M2高峰之后表现出比非孤独参与者显着平坦的DCS。在按性别进行的分析中，已婚男子与非孤独男子相比，DCS平坦，CAR降低。即使在调整生活方式和社会心理因素后，孤独感与DCS之间的关联仍然很牢固。在已婚妇女中，没有发现孤独感和皮质醇水平之间的显着关联。这些发现表明，孤独对已婚男性的HPA轴动力学有不同的影响。我们的发现强调了即使在已婚者中也要解决孤独的重要性。