title: Daily stressors and adult day service use by family caregivers: effects on depressive symptoms, positive mood, and dehydroepiandrosterone-sulfate.
abstract: OBJECTIVE
  This study examines effects of daily use of adult day service (ADS) programs by caregivers of individuals with dementia (IWD) on a salivary biomarker of stress reactivity, dehydroepiandrosterone-sulfate (DHEA-S), and whether these effects on DHEA-S are associated with daily variability in positive mood and depressive symptoms.
  
  
  METHODS
  We used a daily diary design of 8 consecutive days with alternation of intervention (ADS) and nonintervention days to evaluate within- and between-person effects of the intervention. Family caregivers (N = 151) of IWD who were using ADS were interviewed daily by telephone at home. Saliva samples were collected from caregivers five times a day for 8 consecutive days and were assayed for DHEA-S. Daily telephone interviews assessed daily stressors and mood.
  
  
  RESULTS
  DHEA-S levels were significantly higher on days after ADS use. Daily DHEA-S levels covaried significantly with daily positive mood but not with depressive symptoms.
  
  
  CONCLUSIONS
  These results demonstrate an association of ADS use by family caregivers and higher DHEA-S levels on the next day. Prior research has found that higher DHEA-S levels are protective against the physiologic damaging effects of stressor exposure and may reduce risks of illness. Regular use of ADS may help reduce depletion of DHEA-S and allow the body to mount a protective and restorative response to the physiologic demands of caregiving. To our knowledge, this is the first study to examine DHEA-S levels across the day in connection with an intervention that affected daily exposure to stressors.
authors.affiliation: Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA. Electronic address: szarit@psu.edu.
authors.forename: Steven H
authors.initials: SH
authors.lastname: Zarit
authors.affiliation: Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA; Center for Healthy Aging, The Pennsylvania State University, University Park, PA.
authors.forename: Courtney A
authors.initials: CA
authors.lastname: Whetzel
authors.affiliation: Department of Human Development and Family Sciences, The University of Texas at Austin, Austin, TX.
authors.forename: Kyungmin
authors.initials: K
authors.lastname: Kim
authors.affiliation: Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA.
authors.forename: Elia E
authors.initials: EE
authors.lastname: Femia
authors.affiliation: Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA; Center for Healthy Aging, The Pennsylvania State University, University Park, PA.
authors.forename: David M
authors.initials: DM
authors.lastname: Almeida
authors.affiliation: Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Rovine
authors.affiliation: Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA; Institute of the Neurosciences, The Pennsylvania State University, University Park, PA.
authors.forename: Laura Cousino
authors.initials: LC
authors.lastname: Klein
mesh_terms: D000328:Adult; D000339:Affect / Q000502:physiology*; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000378:metabolism; D017028:Caregivers / Q000523:psychology*; D003631:Day Care, Medical / Q000523:psychology*; D019314:Dehydroepiandrosterone Sulfate / Q000378:metabolism*; D003704:Dementia / Q000451:nursing*; D003863:Depression / Q000378:metabolism*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013315:Stress, Psychological / Q000378:metabolism*
chemical_list: D015415:Biomarkers; D019314:Dehydroepiandrosterone Sulfate
keywords: Caregiving; DHEA-S; adult day services; positive mood; stress