Daily stressors and adult day service use by family caregivers: Effects on depressive symptoms, positive mood, and dehydroepiandrosterone-sulfate

Steven H. Zarit, Courtney A. Whetzel, Kyungmin Kim, Elia E. Femia, David M. Almeida, Michael J. Rovine, Laura Cousino Klein

Research output: Contribution to journalArticlepeer-review

30 Scopus citations


Objective This study examines effects of daily use of adult day service (ADS) programs by caregivers of individuals with dementia (IWD) on a salivary biomarker of stress reactivity, dehydroepiandrosterone-sulfate (DHEA-S), and whether these effects on DHEA-S are associated with daily variability in positive mood and depressive symptoms. Methods We used a daily diary design of 8 consecutive days with alternation of intervention (ADS) and nonintervention days to evaluate within-and between-person effects of the intervention. Family caregivers (N = 151) of IWD who were using ADS were interviewed daily by telephone at home. Saliva samples were collected from caregivers five times a day for 8 consecutive days and were assayed for DHEA-S. Daily telephone interviews assessed daily stressors and mood. Results DHEA-S levels were significantly higher on days after ADS use. Daily DHEA-S levels covaried significantly with daily positive mood but not with depressive symptoms. Conclusion These results demonstrate an association of ADS use by family caregivers and higher DHEA-S levels on the next day. Prior research has found that higher DHEA-S levels are protective against the physiologic damaging effects of stressor exposure and may reduce risks of illness. Regular use of ADS may help reduce depletion of DHEA-S and allow the body to mount a protective and restorative response to the physiologic demands of caregiving. To our knowledge, this is the first study to examine DHEA-S levels across the day in connection with an intervention that affected daily exposure to stressors.

Original languageEnglish (US)
Pages (from-to)1592-1602
Number of pages11
JournalAmerican Journal of Geriatric Psychiatry
Issue number12
StatePublished - Dec 1 2014

All Science Journal Classification (ASJC) codes

  • Geriatrics and Gerontology
  • Psychiatry and Mental health


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