Anticipating an easier day: Effects of adult day services on daily cortisol and stress

Laura Klein, Kyungmin Kim, David Almeida, Elia E. Femia, Michael J. Rovine, Steven H. Zarit

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Purpose of the Study: Family caregivers experience high levels of stress that place them at risk for poor health outcomes. We explore whether an intervention which lowers caregivers' daily exposure to stressors, adult day services (ADS), leads to improved regulation of the stress hormone, cortisol, which has implications for health and well-being. Design and Methods: Participants (N = 158) were family caregivers of individuals with dementia (IWD) who were using ADS. Eligibility included: the IWD had a dementia diagnosis, IWD used ADS at least twice a week, and IWD and caregiver lived in the same household. A within-subject treatment design was used to compare caregivers' diurnal cortisol responses on days they received the intervention (ADS use by the IWD) and days they did not. Participants completed daily interviews over eight consecutive days and provided five saliva samples on each of those days. Primary outcomes were salivary cortisol awakening response (CAR) and cortisol area under the curve with respect to ground (AUC-G). Results: Caregivers with a "burned-out" or flattened CAR, and associated low AUC-G on non-ADS days displayed a more normative CAR and AUC-G response on ADS days. Restored cortisol regulation was also observed on ADS days among caregivers with the highest CAR and AUC-G levels on non-ADS days. Implications: Results indicate that ADS use improves caregivers' cortisol regulation, which could enhance long-term health outcomes. Effects may be due to caregivers' anticipation of an easier day when the IWD attends ADS.

Original languageEnglish (US)
Pages (from-to)303-312
Number of pages10
JournalGerontologist
Volume56
Issue number2
DOIs
StatePublished - Apr 1 2016

Fingerprint

Caregivers
Hydrocortisone
Dementia
Area Under Curve
Health
Saliva
Hormones
Interviews

All Science Journal Classification (ASJC) codes

  • Gerontology
  • Geriatrics and Gerontology

Cite this

Klein, Laura ; Kim, Kyungmin ; Almeida, David ; Femia, Elia E. ; Rovine, Michael J. ; Zarit, Steven H. / Anticipating an easier day : Effects of adult day services on daily cortisol and stress. In: Gerontologist. 2016 ; Vol. 56, No. 2. pp. 303-312.
@article{91037c7473fb4c149302badc1798b13d,
title = "Anticipating an easier day: Effects of adult day services on daily cortisol and stress",
abstract = "Purpose of the Study: Family caregivers experience high levels of stress that place them at risk for poor health outcomes. We explore whether an intervention which lowers caregivers' daily exposure to stressors, adult day services (ADS), leads to improved regulation of the stress hormone, cortisol, which has implications for health and well-being. Design and Methods: Participants (N = 158) were family caregivers of individuals with dementia (IWD) who were using ADS. Eligibility included: the IWD had a dementia diagnosis, IWD used ADS at least twice a week, and IWD and caregiver lived in the same household. A within-subject treatment design was used to compare caregivers' diurnal cortisol responses on days they received the intervention (ADS use by the IWD) and days they did not. Participants completed daily interviews over eight consecutive days and provided five saliva samples on each of those days. Primary outcomes were salivary cortisol awakening response (CAR) and cortisol area under the curve with respect to ground (AUC-G). Results: Caregivers with a {"}burned-out{"} or flattened CAR, and associated low AUC-G on non-ADS days displayed a more normative CAR and AUC-G response on ADS days. Restored cortisol regulation was also observed on ADS days among caregivers with the highest CAR and AUC-G levels on non-ADS days. Implications: Results indicate that ADS use improves caregivers' cortisol regulation, which could enhance long-term health outcomes. Effects may be due to caregivers' anticipation of an easier day when the IWD attends ADS.",
author = "Laura Klein and Kyungmin Kim and David Almeida and Femia, {Elia E.} and Rovine, {Michael J.} and Zarit, {Steven H.}",
year = "2016",
month = "4",
day = "1",
doi = "10.1093/geront/gnu060",
language = "English (US)",
volume = "56",
pages = "303--312",
journal = "The Gerontologist",
issn = "0016-9013",
publisher = "Oxford University Press",
number = "2",

}

Anticipating an easier day : Effects of adult day services on daily cortisol and stress. / Klein, Laura; Kim, Kyungmin; Almeida, David; Femia, Elia E.; Rovine, Michael J.; Zarit, Steven H.

In: Gerontologist, Vol. 56, No. 2, 01.04.2016, p. 303-312.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Anticipating an easier day

T2 - Effects of adult day services on daily cortisol and stress

AU - Klein, Laura

AU - Kim, Kyungmin

AU - Almeida, David

AU - Femia, Elia E.

AU - Rovine, Michael J.

AU - Zarit, Steven H.

PY - 2016/4/1

Y1 - 2016/4/1

N2 - Purpose of the Study: Family caregivers experience high levels of stress that place them at risk for poor health outcomes. We explore whether an intervention which lowers caregivers' daily exposure to stressors, adult day services (ADS), leads to improved regulation of the stress hormone, cortisol, which has implications for health and well-being. Design and Methods: Participants (N = 158) were family caregivers of individuals with dementia (IWD) who were using ADS. Eligibility included: the IWD had a dementia diagnosis, IWD used ADS at least twice a week, and IWD and caregiver lived in the same household. A within-subject treatment design was used to compare caregivers' diurnal cortisol responses on days they received the intervention (ADS use by the IWD) and days they did not. Participants completed daily interviews over eight consecutive days and provided five saliva samples on each of those days. Primary outcomes were salivary cortisol awakening response (CAR) and cortisol area under the curve with respect to ground (AUC-G). Results: Caregivers with a "burned-out" or flattened CAR, and associated low AUC-G on non-ADS days displayed a more normative CAR and AUC-G response on ADS days. Restored cortisol regulation was also observed on ADS days among caregivers with the highest CAR and AUC-G levels on non-ADS days. Implications: Results indicate that ADS use improves caregivers' cortisol regulation, which could enhance long-term health outcomes. Effects may be due to caregivers' anticipation of an easier day when the IWD attends ADS.

AB - Purpose of the Study: Family caregivers experience high levels of stress that place them at risk for poor health outcomes. We explore whether an intervention which lowers caregivers' daily exposure to stressors, adult day services (ADS), leads to improved regulation of the stress hormone, cortisol, which has implications for health and well-being. Design and Methods: Participants (N = 158) were family caregivers of individuals with dementia (IWD) who were using ADS. Eligibility included: the IWD had a dementia diagnosis, IWD used ADS at least twice a week, and IWD and caregiver lived in the same household. A within-subject treatment design was used to compare caregivers' diurnal cortisol responses on days they received the intervention (ADS use by the IWD) and days they did not. Participants completed daily interviews over eight consecutive days and provided five saliva samples on each of those days. Primary outcomes were salivary cortisol awakening response (CAR) and cortisol area under the curve with respect to ground (AUC-G). Results: Caregivers with a "burned-out" or flattened CAR, and associated low AUC-G on non-ADS days displayed a more normative CAR and AUC-G response on ADS days. Restored cortisol regulation was also observed on ADS days among caregivers with the highest CAR and AUC-G levels on non-ADS days. Implications: Results indicate that ADS use improves caregivers' cortisol regulation, which could enhance long-term health outcomes. Effects may be due to caregivers' anticipation of an easier day when the IWD attends ADS.

UR - http://www.scopus.com/inward/record.url?scp=84963582763&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84963582763&partnerID=8YFLogxK

U2 - 10.1093/geront/gnu060

DO - 10.1093/geront/gnu060

M3 - Article

C2 - 24996408

AN - SCOPUS:84963582763

VL - 56

SP - 303

EP - 312

JO - The Gerontologist

JF - The Gerontologist

SN - 0016-9013

IS - 2

ER -