Diurnal cortisol rhythm is associated with increased risky decision-making in older adults.

Although past research has suggested a link between chronic stress and both physical and mental well-being in older adults, less is known about the degree to which neuroendocrine markers of stress are associated with higher-order cognitive processes such as decision-making. In a sample of healthy older adults (55-85 years), we tested the degree to which variation in the diurnal cortisol rhythm, an index of hypothalamic-adrenal-pituitary axis dynamics, was related to differences in risky decision-making. We found that diurnal cortisol fall predicted performance on the Cups Task, a risky decision-making task that independently tests risk-taking to achieve gains and risk-taking to avoid losses. For potential gains, we found that greater risk-taking was associated with lower diurnal cortisol fall, independent of age or sex of the participant. For risks to avoid potential losses, we found that lower diurnal fall was associated with suboptimal decision-making for men only. Compared with males with more typical diurnal fall, those who displayed lower diurnal fall made more risky choices and demonstrated lower sensitivity to the expected value of the risky choice. We integrate these results with the extant literature on the effects of stress on decision-making and cognitive aging.