The rationale was to explore the efficacy/sensitivity of using morning and
evening cortisol levels as biomarkers for stress reduction in persons with
dementia (PWDs) and their family caregivers (FCGs) participating in a music
intervention program. Thirty-two PWD and their FGC were recruited to an 8-week,
home-based music intervention program. Daily home-based collection of saliva
samples took place at bedtime and upon awakening. Cortisol was analyzed in the
morning and evening saliva samples and DHEA-s in the morning samples. Trends
over 40 workdays (15–40 observations per subject) were assessed using linear
regression analysis. Twenty-three PWD (72% of invited, 16 men and 7 women, age
69–93) and 24 caregivers (75%, 8 men and 16 women, age 37–90) completed the
intervention for at least 6 weeks and were included in the analysis. One-fourth
of the PWD and FCG had decreasing evening cortisol, accompanied by decreasing
morning cortisol levels. In one-fourth of the participants the ratio between
cortisol and DHEA-S in the morning samples was improved, indicating improved
balance between energy mobilization and regeneration. Several participants
showed no significant endocrine change. There was a statistically significant
(two-sided test) correlation within the PWD-caregiver dyads in evening cortisol
trend and a statistically significant decrease (two-sided test) in the
morning-evening cortisol slope for the FCG group. Reduction in stress, as
measured by evening cortisol, was observed in a substantial number of the
participants. Recording endocrine stress is helpful for the unbiased assessment
of the intervention.