Journal article
Associations among diurnal cortisol, melatonin, and agitation in people living with cognitive impairment
Journal of Alzheimer's disease, Vol.104(4), pp.1045-1052
04/2025
DOI: 10.1177/13872877251322206
PMID: 40116653
Abstract
BackgroundWhile the underlying mechanisms of agitation are not fully understood in people with Alzheimer's disease and related disorders, research suggests that dysregulated neuroendocrine processes, including the hypothalamic-pituitary-adrenal axis, may play a role.ObjectiveThis study aimed to explore the associations between salivary cortisol, melatonin at baseline, and agitation both at baseline and at post-intervention.MethodsThis study was a secondary analysis of a two-group, randomized, parallel designed clinical trial of 210 people living with cognitive impairment. Agitation, salivary cortisol, and salivary melatonin were measured at baseline and four weeks. Salivary cortisol and melatonin indicators were generated through three timepoints of cortisol and melatonin collection across the two consecutive days. Presence of agitation was measured using the Neuropsychiatric Inventory. Logistic regressions were conducted to achieve the aim.ResultsA significant association was found at baseline between diurnal cortisol slope and agitation (OR = 0.03,
= 0.029), there were no relationships between all other cortisol or melatonin indicators with agitation. Cortisol awaking response (OR = 0.16,
= 0.048), its percentage (OR = 0.27,
= 0.021) and its increase higher than 50% (OR = 0.09,
= 0.009), were significant with agitation at four weeks.ConclusionsGiven the potential link between cortisol and agitation, exploring cortisol-lowering interventions like minimizing environmental stressors, smoothing transitions to different situations, stress-reduction techniques, and behavioral therapies may aid in managing agitation in older adults with cognitive impairment.
Details
- Title: Subtitle
- Associations among diurnal cortisol, melatonin, and agitation in people living with cognitive impairment
- Creators
- Fanghong Dong - Washington University in St. Louis School of MedicineAlison R Anderson - University of IowaNancy A Hodgson - University of Pennsylvania
- Resource Type
- Journal article
- Publication Details
- Journal of Alzheimer's disease, Vol.104(4), pp.1045-1052
- DOI
- 10.1177/13872877251322206
- PMID
- 40116653
- NLM abbreviation
- J Alzheimers Dis
- ISSN
- 1875-8908
- eISSN
- 1875-8908
- Publisher
- SAGE PUBLICATIONS LTD
- Grant note
- National Institutes of Health: NR01522601
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was supported by the National Institutes of Health grant NR01522601. The funding resources had no further role in writing of this paper.
- Language
- English
- Electronic publication date
- 03/21/2025
- Date published
- 04/2025
- Academic Unit
- Nursing
- Record Identifier
- 9984801838902771
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