Cortisol and Wake Time in Nursing Home Residents With Behavioral Symptoms of Dementia

Alterations in sleep and behavioral symptoms are consistently reported among nursing home residents with dementia. Disregulation in the hypothalamic-pituitary-adrenal axis (HPA), indexed by basal cortisol levels, offers one explanation. The purpose of this study is to examine the relationship between wake time and cortisol slope in residents with behavioral symptoms. The study included 27 residents aged 71 to 84 years with dementia and behavioral symptoms. Using a within-subject longitudinal design, the researchers documented wake time and collected saliva samples for 4 consecutive days upon waking and at 30 min, 6 hr, and 12 hr after waking. Within-person cortisol slopes were categorized into zero-positive and negative slopes. The zero—positives (35%) exhibited an earlier wake time than the negatives (65%). These preliminary results suggest both a relationship between wake time and HPA diurnal profile and an association between the sleep-wake cycle and cortisol secretion among nursing home residents with dementia.

在患有痴呆症的养老院居民中，睡眠改变和行为症状一直有相关报道。以基础皮质醇水平为指标的下丘脑 - 垂体 - 肾上腺轴（HPA）失调提供了一种解释。本研究的目的是检验有行为症状的居民的清醒时间与皮质醇斜率之间的关系。该研究纳入了27名年龄在71至84岁之间患有痴呆症和行为症状的居民。采用个体内纵向设计，研究人员记录了清醒时间，并在醒来时以及醒来后30分钟、6小时和12小时连续4天收集唾液样本。个体内皮质醇斜率被分为零正斜率和负斜率。零正斜率组（35%）比负斜率组（65%）表现出更早的清醒时间。这些初步结果表明，在患有痴呆症的养老院居民中，清醒时间与HPA日节律曲线之间存在关系，并且睡眠 - 清醒周期与皮质醇分泌之间也存在关联。