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Stress

Can a short stress course help older adults cope and lower cortisol?

Richer MJ, Grenier S, Lupien S, et al. · Frontiers in psychology · 2024

Open access · cc by · source: Europe PMC

A six-week group stress-management course gave older adults a short-term boost in problem-solving coping, a drop in anxiety and lower daily cortisol, but most of these gains faded by three months.

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Study at a glance

Design
RCT — Cluster randomized trial: retirement residences and community-organization programs were randomly assigned to a 6-week group stress-management program (O'stress) or a waitlist; outcomes at baseline, 3 weeks after the program and 3-month follow-up
N
N=170 · 170 participants consented and completed baseline; 107 completed all three assessments, and each repeated-measures analysis used only participants with complete data on that outcome
Population
French-speaking community-dwelling older adults (aged 55+, mean age mid-70s, mostly women, about three-quarters living in private retirement residences) in Québec who wanted to manage stress better
Outcome
Proactive coping and strategic planning (Proactive Coping Inventory), perceived stress (PSS), anxiety and depression (HADS), and diurnal salivary cortisol (cortisol awakening response and total daily output, AUCg)

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Key findings

Three weeks after the course, the program group increased proactive coping and strategic planning more than the waitlist group, showed a larger drop in anxiety, and had a larger drop in total daily cortisol, all with small-to-medium effect sizes. Perceived stress and depression did not differ between groups at 3 weeks, and the morning cortisol rise did not change differently. By 3 months the coping and anxiety advantages had faded, cortisol partly rebounded, and the only new group difference was that perceived stress worsened in the waitlist group while staying stable in the program group.

Methodology

Residences and community programs in Québec were randomly assigned either to run a six-workshop group course on stress (O'stress) or to a waitlist. The course taught how the stress hormone system works, what makes situations stressful (novelty, unpredictability, threat to ego, low sense of control), breathing and problem-solving strategies, and how stress spreads between people ('stress contagion'). The 170 older adults who enrolled completed questionnaires and gave saliva samples four times a day on two days, before the course, 3 weeks after it and 3 months later.

Limitations

The control group received nothing (a waitlist), so the benefits could come from simply meeting in a supportive group rather than from the specific stress content, as the authors acknowledge. Only 107 of 170 participants completed all assessments, attrition was higher in the program group at 3 weeks, and people who dropped out were more anxious and depressed at baseline, which could bias results. Groups differed in age and functional autonomy at baseline, and covariates were chosen by a backward-elimination procedure, while many outcomes were tested without correction, so some significant effects may be fragile. About three-quarters of the sample lived in high-end private residences, which limits generalization.

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