FEASIBILITY OF HAIR CORTISOL AS A BIOMARKER OF WELL-BEING IN OLDER ADULTS WITH DEMENTIA
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Hair cortisol concentrations (HCC) are an innovative way to measure chronic stress by analyzing a small sample of hair. Although studies have validated HCC as a reliable indicator of chronic stress across different age groups and have demonstrated the impact of HCC on human well-being (Stalder & Kirschbaum, 2012), to date, there are no studies that have studied hair cortisol as a biomarker of chronic stress in relation to the quality of life (QOL) of older adults with dementia. Because chronic stress has adverse impacts on the QOL for people with dementia, using hair cortisol as an objective marker of chronic stress has potential to enhance our understanding of well-being in dementia. The primary goal of this study was to establish feasibility of HCC testing in people with dementia as a biomarker of chronic stress. To do so, HCC over a 9-month period were examined in order to assess chronic stress during the transition to memory care. Newly admitted memory care residents (N = 13, mean age = 82) were followed over six months. Residents’ hair samples and health information were collected at three-month intervals. Transition to memory care was associated with diminished HCC (β = -.70, p < .001). Depression (β = -.32, p < .05) and psychotropic medication use (β = -.20, p < .01) related to HCC decline during transition. Furthermore, the magnitude of HCC alterations during transition was associated with elevated HCC levels (β = .048, p < .05). HCC levels in individuals with dementia (16.29 pg/mg) were lower than older adults without dementia (range: 30.48–57.8 pg/mg), implying altered hypothalamic-pituitary-adrenal axis stress reactivity in those with dementia. In addition, HCC were associated with well-being in dementia. Elevated HCC were related to functional disabilities (β = 8.31, p < .05), low social engagement (β = -6.01, p < 05), and poor perceived QOL (β = -3.61, p < .01) in those with dementia. These results underscore the significance of positive care environments that minimize chronic stress in individuals with dementia and indicate that HCC may be a useful stress measure in this population.