A Cortisol dynamics in the elderly: Systematic Review

The elderly are defined as individuals aged ≥65 years, increasing rapidly in the United States and are expected to reach 84 million by 2050. One of the main biological processes of systemic damage that contributes to the development of organ dysfunction in aging is immunosenescence (gradual decline in age-related protective immunity) and inflammation (chronic subclinical systemic inflammation). Cortisol, a steroid hormone, is synthesized from cholesterol. Cortisol release is under the control of the hypothalamic-pituitary-adrenal (HPA) axis. Corticotropin-releasing hormone (CRH) is released by the paraventricular nucleus (PVN) of the hypothalamus. Normal aging is associated with multiple endocrine changes, including those related to changes in the structure and function of the adrenal glands. A literature search was carried out using three main databases, namely ScienceDirect, Google Scholar and PubMed in journals covering the last ten years (2013-2023) using PRISMA guidelines. Based on the analysis of inclusion and exclusion criteria, there are 8 reference journals that match the research topic. The results of this study show that there is a dynamic regulation of cortisol in the elderly with an increase in cortisol levels in the elderly and these levels are higher in individuals with comorbidities. Based on the systematic review carried out in this study, it was concluded that there are changes in the dynamics of cortisol secretion in the elderly with a significant increase in secretion in certain groups of elderly which is related to the level of stress and comorbidities status.