scholarly journals Salivary Cortisol Patterns in People Living With Dementia

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 437-437
Author(s):  
Fanghong Dong ◽  
Liming Huang ◽  
Subhash Aryal ◽  
G Adriana Perez ◽  
Nancy Hodgson ◽  
...  

Abstract Salivary cortisol has a well-documented circadian pattern in older adults. Yet, the pattern of salivary cortisol in persons living with dementia (PLWD) due to circadian rhythm disturbances is unknown. This study examined diurnal salivary cortisol patterns in 176 PLWD (mean age 73.6±8.8, 33.3% male, clinical dementia rating >=0.5) by collecting saliva at waking (AM1), 30 minutes after waking (AM2) and bedtime (PM) over two consecutive days. Cortisol awakening response (CAR) was calculated as the change between AM2 and AM1 cortisol levels. The mean baseline salivary cortisol levels (ug/dl) were 0.35 (SD:0.3) at AM1, 0.40 (SD:0.39) at AM2, and 0.19 (SD:0.4) at PM. On average, cortisol levels decreased from morning to evening, with 58% exhibiting a positive CAR (mean 0.05; SD:0.34). There were no significant associations between cortisol levels with age, sex, obesity, and comorbidities. The findings demonstrated that diurnal cortisol rhythms are maintained in PLWD with a flattened CAR.

2021 ◽  
pp. 1-8
Author(s):  
Anna P. McLaughlin ◽  
Naghmeh Nikkheslat ◽  
Caitlin Hastings ◽  
Maria A. Nettis ◽  
Melisa Kose ◽  
...  

Abstract Background Depression and overweight are each associated with abnormal immune system activation. We sought to disentangle the extent to which depressive symptoms and overweight status contributed to increased inflammation and abnormal cortisol levels. Methods Participants were recruited through the Wellcome Trust NIMA Consortium. The sample of 216 participants consisted of 69 overweight patients with depression; 35 overweight controls; 55 normal-weight patients with depression and 57 normal-weight controls. Peripheral inflammation was measured as high-sensitivity C-Reactive Protein (hsCRP) in serum. Salivary cortisol was collected at multiple points throughout the day to measure cortisol awakening response and diurnal cortisol levels. Results Overweight patients with depression had significantly higher hsCRP compared with overweight controls (p = 0.042), normal-weight depressed patients (p < 0.001) and normal-weight controls (p < 0.001), after controlling for age and gender. Multivariable logistic regression showed that comorbid depression and overweight significantly increased the risk of clinically elevated hsCRP levels ⩾3 mg/L (OR 2.44, 1.28–3.94). In a separate multivariable logistic regression model, overweight status contributed most to the risk of having hsCRP levels ⩾3 mg/L (OR 1.52, 0.7–2.41), while depression also contributed a significant risk (OR 1.09, 0.27–2). There were no significant differences between groups in cortisol awakening response and diurnal cortisol levels. Conclusion Comorbid depression and overweight status are associated with increased hsCRP, and the coexistence of these conditions amplified the risk of clinically elevated hsCRP levels. Overweight status contributed most to the risk of clinically elevated hsCRP levels, but depression also contributed to a significant risk. We observed no differences in cortisol levels between groups.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 215-215
Author(s):  
Darina Petrovsky ◽  
Shana Roan ◽  
Nalaka Gooneratne ◽  
Joke Bradt ◽  
Laura Gitlin ◽  
...  

Abstract Sleep disruption in older adults living with Alzheimer’s disease and related dementias (ADRD) is debilitating and contributes to increased institutionalization, reduced cognitive function, and accelerated disease progression. Given the potential harmful effects of pharmacologic treatment, non-pharmacologic approaches, such as music, may provide a safer alternative to improve sleep quality in this vulnerable population. No empirically validated music protocol exists to address sleep disruption in older adults with ADRD living at home. Therefore, the specific aims of this wait-list randomized controlled trial were to examine the 1) feasibility; 2) acceptability; and 3) preliminary efficacy of a tailored music intervention in home-dwelling older adults with ADRD with sleep disruption and their caregivers. This presentation focuses on baseline characteristics of dyads, which included persons with ADRD and their caregivers who have completed the clinical trial so far (N=28). The mean age of persons with ADRD was 71.6 (SD: 7.6). The mean age of caregivers was 58.7 (SD: 16.7). Sixty-eight percent (n=19) of persons with ADRD were female. Similarly, the majority of caregivers were female (n=20, 71.4%). Seventy-four percent of persons with ADRD scored 0.5 on the Clinical Dementia Rating instrument, indicative of very mild dementia. The majority of dyads identified themselves as non-Hispanic (&gt;92%). Seventy-nine percent of persons with ADRD identified themselves as Black or African-American (n=22, 79%), while 82.1% of caregivers identified themselves as Black or African American. Preliminary analysis of qualitative data indicates high acceptability of the intervention. Results from this research study will inform a future efficacy trial.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S874-S874
Author(s):  
Eunji Kwon ◽  
Eunhee Cho

Abstract Demented older adults experience many internal and external stress inducers that are thought to be a source of behavioral and psychological symptoms of dementia(BPSD). The purpose of this study was to compare the stress index among older adults through salivary cortisol levels and physical stress index. This study was cross-sectional design, including 139 participants who recruited until May of this year(104 demented older adults who visited hospital outpatient neurology and 35 non-demented older adults as control group). The physical stress index was measured by heart rate variability and salivary cortisol levels(4 samples/day, 1 days). Salivary cortisol levels were measured at four times after wake up, after breakfast, before dinner and after dinner. The data were analyzed using independent t-test and generalized estimating equations. In salivary cortisol levels measured after wake up, the demented older adults reported about 1.5 times higher than non-demented older adults(p=.042). And the salivary cortisol levels measured after breakfast were about 2.3 times higher in the demented older adults than in control groups(p=.002). Accordingly, the results can be concluded that demented older adults have higher stress levels than control groups in the morning. Also the physical stress index through heart rate variability(HRV) in the demented older adults(6.30±0.65) had higher than control groups(6.00±0.55, t=2.45, p=.016). There are significant differences in salivary cortisol levels and physical stress index between demented older adults and control groups. As stress inducers affects BPSD for the demented older adults, nursing intervention should be tailored to proper way based on their stress inducers.


2011 ◽  
Vol 52 (3) ◽  
pp. 435 ◽  
Author(s):  
Il-young Shin ◽  
Ryun-sup Ahn ◽  
Sae-il Chun ◽  
Young-jin Lee ◽  
Min-soo Kim ◽  
...  

2017 ◽  
Vol 19 (6) ◽  
pp. 440-449 ◽  
Author(s):  
Ilse Wielaard ◽  
Roxanne Schaakxs ◽  
Hannie C. Comijs ◽  
Max L. Stek ◽  
Didi Rhebergen

2014 ◽  
Vol 99 (3) ◽  
pp. E464-E468 ◽  
Author(s):  
Hamimatunnisa Johar ◽  
Rebecca T. Emeny ◽  
Martin Bidlingmaier ◽  
Martin Reincke ◽  
Barbara Thorand ◽  
...  

Background: The role of neuroendocrine alterations in the etiology of frailty syndrome is still poorly understood. Hypothalamic-pituitary-adrenal axis dysregulation is a plausible candidate pathway contributing to frailty. Thus, we sought to examine the associations of diurnal cortisol secretion with frailty in older adults. Methods: A cross-sectional analysis was conducted among 745 study participants (age 65–90 years, mean age 75.1 years) of the population-based KORA Age study. Associations between salivary cortisol measures at awakening (morning 1 [M1]), 30 minutes after awakening (M2), and evening (E) and frailty criteria were determined. Results: Lower cortisol levels in the first morning sample (M1) (P = .18) and M2 (P = .14) and increased E levels (P = .004) were observed in prefrail (35.17%, n = 262) and frail (3.36%, n = 25) individuals, in a dose-response manner. Frailty was strongly associated with smaller ratios of morning to evening levels; M1 to E ratio (P = .02) and M2 to E ratio (P = .003). Higher evening cortisol levels were associated with a 24% increased risk of a prefrail state (odds ratio, 1.22; 95% confidence interval, 1.03–1.44). A smaller morning to evening ratio was associated with an increased risk of low grip strength (1.42, 1.09–1.86) and gait speed (1.31, 1.02–1.68). Conclusion: Frailty status is associated with blunted cortisol reactivity as demonstrated by lower morning and higher evening salivary cortisol levels.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 436-437
Author(s):  
Nancy Hodgson ◽  
Fanghong Dong

Abstract Circadian rhythm disturbances (CRD) are commonly seen in people living with dementia. A clear understanding of the role of CRD in dementia etiology will be beneficial by exploring the exogenous factors (externally influence the duration of sleep hours, such as light/dark cycles) and endogenous factors (internal biological rhythm, such as diurnal cortisol pattern). This symposium will apply a chronobiological approach to study exogenous and endogenous factors that influence circadian rhythm and their effects on sleep and neuropsychiatric symptoms in persons living with dementia (PLWD). Four paper presentations will use secondary data analysis of data from the Healthy Patterns Clinical Trial (NCT03682185), a randomized controlled trial of a home-based activity intervention designed to improve circadian rhythm disorders in PLWD. We will first describe the circadian rhythm pattern reflected by endogenous factors (salivary cortisol), then examine salivary cortisol (endogenous) and white light intensity (exogenous) and on subjective sleep and neuropsychiatric symptoms (including depression) in PLWD, respectively. In session 1, we will present cortisol diurnal rhythm pattern in PLWD using a cross-sectional design. In session 2, we will discuss the relationship between salivary cortisol indicators and depressive symptoms. In session 3, we focus on the association between diurnal cortisol slope and neuropsychiatric symptoms using the baseline data. In session 4, we describe the association between evening white light exposure and subjective sleep. The discussant will describe how these findings build on our understanding the nature of circadian rhythm disturbance in dementia and inform future research and treatment approaches.


2019 ◽  
Vol 21 (3) ◽  
pp. 318-334 ◽  
Author(s):  
Jennifer M. Hulett ◽  
Kristen L. Fessele ◽  
Margaret F. Clayton ◽  
Linda H. Eaton

Salivary cortisol is a commonly used biomarker in cancer survivorship research; however, variations in sampling protocols and parameter reporting limit comparisons across studies. Standardized practices to provide rigor and reproducibility of diurnal salivary cortisol sampling and reporting are not well established. Previous systematic reviews examining relationships between diurnal salivary cortisol and clinical outcomes have resulted in mixed findings. It remains unclear which sampling protocols and reporting parameters offer the greatest utility for clinical research. This review examines diurnal salivary cortisol sampling protocols and reporting parameters to evaluate whether a standardized approach is recommended. A comprehensive search of intervention studies among adult cancer survivors including diurnal salivary cortisol resulted in 30 articles for review. Sampling protocols ranged from 1 to 4 days with the majority of studies sampling cortisol for 2 days. Sampling instances ranged from 2 to 7 times per day, with the majority collecting at 4 time points per day. Diurnal cortisol slope and cortisol awakening response (CAR) were the most commonly reported parameters associated with clinical outcomes. Flattened cortisol slopes, blunted CARs, and elevated evening cortisol concentrations were associated with poorer psychosocial and physiological outcomes. Based on our review, we propose that a rigorous, standardized diurnal salivary cortisol sampling protocol should include sampling at key diurnal times across ≥3 consecutive days to report diurnal cortisol parameters (i.e., CAR and slope) and objective measures of participant protocol adherence. Diminishing budgetary resources and efforts to minimize participant burden dictate the importance of standardized cortisol sampling protocols and reporting parameters.


2011 ◽  
Vol 14 (6) ◽  
pp. 553-561 ◽  
Author(s):  
Per A. Gustafsson ◽  
Per E. Gustafsson ◽  
Henrik Anckarsäter ◽  
Paul Lichtenstein ◽  
Therese Ljung ◽  
...  

Background: The normal development of cortisol regulation during childhood is thought to be influenced by a complex interplay between environmental and genetic factors. Method: The aim of this study was to estimate genetic and environmental influences on basal cortisol levels in a sample of 151 twin pairs aged 9–16 years. Salivary cortisol was collected on two consecutive days when the children attended school — immediately after awakening, 30 min post-awakening and at bedtime. Results: Heritability was highest (60%) for cortisol levels about 30 min after awakening. For samples taken immediately at awakening heritability was less pronounced (28%) and in the evening low (8%). Conclusion: The limited genetic influence on evening levels, moderate on cortisol at awakening and high on awakening response, might imply two genetic regulation patterns, one specifically for awakening response and one for the circadian rhythm proper. These findings could explain divergent results in previous studies and highlight the importance of taking the circadian rhythm into account in studies of cortisol levels in children.


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