A recent article in this newsletter reviewed the remarkable value of saliva as a biomarker for health and diseases. At the Office for Studies on Aging (OSA), we are using saliva to capture cortisol, a biomarker for stress. Using saliva is the least invasive approach to measurement and this measures hold up reliably against blood and urinary assays. Obtaining samples involves chewing cotton wads (salivettes) and extracting from them cortisol for analysis
At OSA, we have been studying stress in employed caregivers by comparing salivary cortisol profiles, a highly sensitive and at times unpredictable measure, with other indicators of perceived and actual health. Because of the profound impact of stress on physical and mental health, we have been attempting to pin down which of many measures best capture the stress caregivers experience as they move through the workday, home in the evening and on weekends. Our goal in this work is to find a way to identify caregivers at greater risk for health breakdown. The premise is that some combination of paper-and-pencil, physical, and cortisol measures can target those in greater or more immediate need of preventive interventions.
Results from our pilot research (N=31) are tantalizing. They show that:
- Cortisol profiles (within and across days) are specific to each individual and need to be interpreted only within the context of that individual’s experiences pattern of responses.
- Employed caregivers had much greater variability in cortisol responses than did non-caregivers – on all days and on all measures.
- Few relationships existed between psychosocial and cortisol measures for the employed non-caregivers.
- Intriguing relationships were observed for the employed caregivers. For example;
- As the work week progressed for the caregivers, the higher the sense of mastery experienced at work, the lower the overall cortisol levels.
- Caregivers’s SF36 scores were highly negatively correlated with total cortisol produced on Sundays, presumably a pivot day between caregiving and work focus.
- Caregivers with higher scores on Purpose in Life on the Psychological Well Being Scale had lower overall cortisol values.
Clearly we have only scratched the surface with this pilot work. However, we believe salivary cortisol is a biomarker that holds promise for better understanding the needs and risk status of the increasing numbers of informal caregivers to older persons.