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Behavioral Problems in Dementia Patients and Salivary Cortisol Patterns in Caregivers

Received December 19, 2002; revised October 9, 2003; accepted October 13, 2003. From the Department of Psychiatry and Neuropsychology, Brain and Behavior Institute, University of Maastricht, Maastricht, the Netherlands. Address correspondence to Professor Verhey, Department of Psychiatry and Neuropsychology, University Hospital of Maastricht, PO Box 616, 6200 MD Maastricht, the Netherlands; F.verhey{at}np.unimaas.nl (E-mail).

This study examines cortisol profiles in caregivers of dementia patients and their relationship to patients’ behavioral problems. Salivary cortisol profiles and cortisol response to awakening were measured in 57 caregivers and 55 noncaregiver comparison subjects. Caregivers showed significantly higher levels of cortisol at the time of morning awakening than did comparison subjects, with a smaller increase after awakening. A higher cortisol awakening response was found in caregivers of patients with high versus low levels of behavioral and psychological symptoms of dementia (BPSD). Elevated morning cortisol levels could predispose caregivers to negative health consequences, with caregivers of patients with BPSD at greater risk.

Key Words: dementia • behavior • caregivers • stress • cortisol

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