Several studies have demonstrated that a dysregulated hypothalamic-pituitary-adrenal (HPA) axis is related to worse health status (e.g., depression, posttraumatic stress, or diabetes, among others). However, less is known about the association between the individual's perception of their own health status and HPA-axis functioning in healthy older people. The aim of the present study was to examine the relationship between HPA-axis functioning and health-related quality of life (HRQoL) in healthy older people. To do this, 140 healthy older people (69 men and 71 women) from 56 to 76 years old collected eight saliva samples on two consecutive weekdays to measure the diurnal cortisol cycle (i.e. awakening cortisol levels, cortisol awakening response (CAR), overall morning cortisol levels, change in the cortisol levels during the day, and bedtime cortisol levels). In addition, they completed the SF-36 questionnaire to obtain a measure of HRQoL (i.e. reflecting physical and mental functional health status). Results showed that higher awakening and bedtime cortisol levels and the CAR were associated with a better perception of both physical and mental health. In addition, the wake-to-bed cortisol slope was only positively related to physical health. No sex differences were found. These findings suggest that the awakening and bedtime cortisol levels and the CAR are the most relevant indices of diurnal cortisol secretion for understanding the relationship between HPA-axis functioning and HRQoL status in older people.

几项研究表明，失调的下丘脑-垂体-肾上腺 (HPA) 轴与较差的健康状况（例如，抑郁、创伤后压力或糖尿病等）有关。然而，人们对个人对自身健康状况的看法与健康老年人的 HPA 轴功能之间的关联知之甚少。本研究的目的是检查健康老年人的 HPA 轴功能与健康相关生活质量 (HRQoL) 之间的关系。为此，140 名 56 至 76 岁的健康老年人（69 名男性和 71 名女性）在连续两个工作日收集了 8 份唾液样本，以测量昼夜皮质醇循环（即觉醒皮质醇水平、皮质醇觉醒反应 (CAR)、整个早晨皮质醇水平，白天皮质醇水平的变化，和睡前皮质醇水平）。此外，他们完成了 SF-36 问卷以获得 HRQoL 的衡量标准（即反映身心功能健康状况）。结果表明，较高的觉醒和就寝时间皮质醇水平以及 CAR 与更好的身心健康感知相关。此外，睡前皮质醇斜率仅与身体健康呈正相关。没有发现性别差异。这些发现表明，觉醒和睡前皮质醇水平以及 CAR 是了解老年人 HPA 轴功能与 HRQoL 状态之间关系的昼夜皮质醇分泌最相关的指标。结果表明，较高的觉醒和就寝时间皮质醇水平以及 CAR 与更好的身心健康感知相关。此外，睡前皮质醇斜率仅与身体健康呈正相关。没有发现性别差异。这些发现表明，觉醒和睡前皮质醇水平以及 CAR 是了解老年人 HPA 轴功能与 HRQoL 状态之间关系的昼夜皮质醇分泌最相关的指标。结果表明，较高的觉醒和就寝时间皮质醇水平以及 CAR 与更好的身心健康感知相关。此外，睡前皮质醇斜率仅与身体健康呈正相关。没有发现性别差异。这些发现表明，觉醒和睡前皮质醇水平以及 CAR 是了解老年人 HPA 轴功能与 HRQoL 状态之间关系的昼夜皮质醇分泌最相关的指标。