Highlights

• Older adults who feel anxious on Mondays exhibit significantly greater levels of glucocorticoid production.
• This association is very strong at the 90th quantile of the glucocorticoid distribution, indicating HPA-axis dysregulation.
• This association was prevalent among both working and nonworking older adults.

Objective

To investigate whether the association between perceived anxiety and HPA-axis dysregulation is greater on Mondays than on other days of the week.

Design

Observational study with longitudinal data.

Setting

England.

Participants

3511 adults aged 50 years and older living in England from 2012 to 2013 participating at wave 6 of the English Longitudinal Study of Ageing.

Main outcome measures

Levels of hair cortisol and total glucocorticoid production.

Results

This study found strong evidence for an association between reporting anxiety on Mondays and HPA-axis dysregulation. At the 90th quantile of the cortisol distribution, older adults who felt anxious on Mondays had 23 % higher cortisol levels in the hair samples collected up to 2 months later than did their peers who reported anxiety on other days. There were no significant differences in cortisol levels or total glucocorticoid production by feelings of anxiety on other days of the week. The anxious Monday association with HPA-axis dysregulation measured subsequently was evident among both working and nonworking older adults, with no reduction in the association among those not at work. Around three-quarters of the differences in HPA-axis dysregulation between Mondays and other days was due to the differential effects of the characteristics of older adults who reported feeling anxious on Mondays.

Conclusions

HPA-axis dysregulation is pronounced among older adults who report anxiety on Mondays. This association was observed regardless of employment status, suggesting that both working and nonworking older adults are at risk of HPA-axis dysregulation associated with the start of the week.

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