Feasibility of Hair Cortisol as a Biomarker of Chronic Stress in People With Dementia

Hair cortisol concentrations (HCC) are an innovative way to measure chronic stress relying on a small sample of hair. To date, there are no studies that have studied HCC as a biomarker of chronic stress in individuals with dementia. Given the vulnerability to chronic stress in people with dementia, using HCC as an objective measure of physiological stress in those with dementia has potential to enhance our understanding of this population. The goal of this exploratory, multidisciplinary, pilot study was to establish feasibility of HCC testing in people with dementia as a biomarker of chronic stress. HCC was examined over a 6-month period to assess physiological stress response during a transition to memory care. Newly admitted memory care residents (n = 13, mean age = 82) were followed over 6 months. Residents' hair samples and health information were collected at 3-month intervals. HCC levels significantly changed during the transition to memory care, which may reflect chronic physiological stress. Participants with frequent behavioral and psychological symptoms of dementia (BPSD) had significantly lower HCC at baseline and exhibited a blunted cortisol reactivity at follow-up. Based on detected changes in HCC, participants likely experienced stress reactions during the transition to memory care, providing preliminary evidence that HCC may be a useful, non-invasive measure of physiological stress in this population. This approach may also be applied to understanding the significance of person-centered care environments on minimizing chronic stress for people with dementia.