title: Modeling Cortisol Daily Rhythms of Family Caregivers of Individuals With Dementia: Daily Stressors and Adult Day Services Use.
abstract: The study examined the typical diurnal cortisol trajectory and its differential associations with an intervention, the adult day services (ADS) use, among a sample of family caregivers who experienced high levels of daily stress.
  
  
  
  On hundred and sixty-five caregivers of individuals with dementia completed an 8-day diary on daily stressors, positive events, sleep quality, and ADS use. The caregivers also provided five saliva samples on each diary day. Daily cortisol trajectories were modeled as a function of time elapsed since awakening, and three spline growth curve models were fit to the cortisol data. Based on the best-fitting linear spline model, the effect of daily ADS use was examined at both daily and person levels. Covariates included daily experiences and other caregiving characteristics.
  
  
  
  On ADS days, caregivers had a steeper cortisol awakening response (CAR) slope and a steeper morning decline. ADS use remained significant after controlling for covariates at both daily and person levels.
  
  
  
  The findings suggested potential biophysiological benefits of daily ADS use for a sample that was under chronic stress and high levels of daily stress.
authors.affiliation: Center for Healthy Aging, The Pennsylvania State University, State College.
authors.forename: Yin
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Center for Healthy Aging, The Pennsylvania State University, State College.|Department of Human Development and Family Studies, The Pennsylvania State University, State College.
authors.forename: David M
authors.initials: DM
authors.lastname: Almeida
authors.affiliation: Human Development and Quantitative Methods Division, Graduate School of Education, University of Pennsylvania, Philadelphia.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Rovine
authors.affiliation: Department of Human Development and Family Studies, The Pennsylvania State University, State College.
authors.forename: Steven H
authors.initials: SH
authors.lastname: Zarit
mesh_terms: D000328:Adult; D000069537:Adult Day Care Centers / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology* / Q000706:statistics & numerical data; D002940:Circadian Rhythm / Q000502:physiology; D003704:Dementia / Q000628:therapy*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis* / Q000502:physiology; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data; D012463:Saliva / Q000737:chemistry; D012890:Sleep; D013315:Stress, Psychological / Q000453:epidemiology* / Q000209:etiology
chemical_list: D006854:Hydrocortisone