Daily Social Interactions and HPA Axis Activity Among Midlife and Older Adults.

BACKGROUND AND OBJECTIVES: Older people experience fewer negative interactions and report less stress in response to interpersonal tensions. Less is known, however, about the implications of daily social interactions for biological stress responses. We evaluated links between daily positive and negative interactions and 2 key biomeasures of the hypothalamic-pituitary-adrenal axis: salivary cortisol and dehydroepiandrosterone sulfate (DHEA-S). We also considered the moderating effects of age. RESEARCH DESIGN AND METHODS: Participants included a random sample of 93 individuals aged 40-95 who completed 14 days of daily diary interviews and provided saliva samples during 4 of those days. RESULTS: Three-level piecewise models showed that individuals had higher sustained DHEA-S levels on days after reporting more positive interactions. Young-old adults (60-79) had lower overall DHEA-S on days when they had more negative interactions than oldest-old adults (80 and older). Oldest-old adults showed a flatter decline in DHEA-S on days after they reported more negative interactions compared to midlife adults (40-59). Daily social interactions were not significantly associated with cortisol. DISCUSSION AND IMPLICATIONS: Strategies to increase positive interactions may help to build physiological resilience to stress, particularly among midlife and young-old adults.

Routine Support to Parents and Stressors in Everyday Domains: Associations With Negative Affect and Cortisol.

Objectives: Adult children are involved a myriad of roles including providing routine (non-caregiving) support to a parent. Yet we know little about whether providing routine support to a parent is stressful and whether it has any associations with stressors in other life domains. Methods: We use daily diary data (N = 127; Study Days = 424) from the National Study of Daily Experiences to determine whether providing routine support to an older parent is associated with higher negative affect and salivary cortisol. Results: Results confirm that providing routine support and experiencing stressors at work were independently associated with negative affect and greater cortisol output. Stress reactions were not amplified, however, on days when adult children concurrently provided support to a parent and reported work stressors. Cutting back usual activities at work or home elevated negative affect but were not associated with an upsurge of cortisol production. Discussion: Findings lend support to the caregiving career framework for understanding even casual routine assistance provided to a parent.

Modeling Cortisol Daily Rhythms of Family Caregivers of Individuals With Dementia: Daily Stressors and Adult Day Services Use.

Objectives: The study examined the typical diurnal cortisol trajectory and its differential associations with an intervention, the adult day services (ADS) use, among a sample of family caregivers who experienced high levels of daily stress. Method: On hundred and sixty-five caregivers of individuals with dementia completed an 8-day diary on daily stressors, positive events, sleep quality, and ADS use. The caregivers also provided five saliva samples on each diary day. Daily cortisol trajectories were modeled as a function of time elapsed since awakening, and three spline growth curve models were fit to the cortisol data. Based on the best-fitting linear spline model, the effect of daily ADS use was examined at both daily and person levels. Covariates included daily experiences and other caregiving characteristics. Results: On ADS days, caregivers had a steeper cortisol awakening response (CAR) slope and a steeper morning decline. ADS use remained significant after controlling for covariates at both daily and person levels. Discussion: The findings suggested potential biophysiological benefits of daily ADS use for a sample that was under chronic stress and high levels of daily stress.

Daily Social Interactions and the Biological Stress Response: Are There Age Differences in Links Between Social Interactions and Alpha-Amylase?

Background and Objectives: According to the strength and vulnerability integration (SAVI) model, older people are better able to avoid negative social interactions than younger people, but when they do experience negative interactions, they are equally or more emotionally and physiologically reactive than younger people. Less is known about the links between daily negative and positive social encounters and the sympathetic adrenal medullary system (a key stress pathway) and whether there are age differences in these links. This study considers whether negative and positive social interactions are associated with diurnal alpha-amylase (a measure of the sympathetic adrenal medullary system) and whether there are differences in these links by age. Research Design and Methods: Participants were from the Daily Health, Stress, and Relationship Study, which includes a random sample of 89 individuals (aged 40-95) who completed 14 days of daily diary interviews and provided saliva samples four times a day (wake, 30 min after wake, lunch, and bedtime) for four of those days that were assayed for alpha-amylase. Results: Days in which people reported more negative interactions were associated with flatter morning declines in alpha-amylase, indicating greater stress. Links between positive interactions and diurnal alpha-amylase varied by age group. Discussion and Implications: Findings are consistent with the SAVI model indicating that older adults respond differently to social stimuli than younger people.

Everyday Support to Aging Parents: Links to Middle-Aged Children's Diurnal Cortisol and Daily Mood.

Purpose of the Study: Middle-aged adults are often called upon to support aging parents. However, providing support to an aging parent with health problems and disability may be a stressful experience. This study asked whether giving everyday support to parents in the context of health problems and disability has implications for middle-aged children's diurnal cortisol and daily mood. Design and Methods: During four consecutive days, 148 middle-aged adults (mean age = 55) reported the support they gave to their parents and provided saliva 4 times a day (wake, 30 min post-wake, lunchtime, and bedtime). Multilevel models estimated within-person differences in positive affect (PA) and negative affect (NA), cortisol awakening response and area under the curve with respect to ground (AUC-G) as a function of giving same-day and previous-day support. We examined whether these associations are exacerbated when a parent has health problems or activities of daily living (ADL) needs. Results: Middle-aged children had significantly higher next-day AUC-G on days after they gave support to parents with ADL needs. When participants gave support to parents with ADL needs, they had significantly greater same-day PA and lower next-day NA. Giving support to parents with health problems was associated with significantly higher next-day NA. Implications: Giving support to parents is an ambiguous experience with implications for biological stress and daily mood. A biopsychosocial approach reveals under what conditions giving support to parents may become detrimental to health and well-being; this knowledge is essential for the development and implementation of interventions.

Daily interactions with aging parents and adult children: Associations with negative affect and diurnal cortisol.

Midlife adults report greater investment in their children than in their parents, and these ties have important implications for well-being. To date, little research has addressed daily experiences in these ties. The present study examines daily experiences (negative and positive) with aging parents and adult children and their associations with daily negative affect and diurnal cortisol rhythms. Participants were middle-aged adults (N = 156; 56% women) from Wave 2 of the Family Exchanges Study, conducted in 2013, who completed a 7-day daily diary study, which included assessments of daily negative and positive social encounters and negative affect, and 4 days of saliva collection, which was collected 3 times a day (upon waking, 30 min after waking, and at bedtime) and assayed for cortisol. Multilevel models revealed that individuals were more likely to have contact with adult children than with parents but more likely to have negative experiences (negative interactions, avoidance, negative thoughts) with parents than with adult children. Nevertheless, contact and negative experiences with adult children were more consistently associated with negative affect and daily cortisol patterns than were interactions with parents. Findings are consistent with the intergenerational stake hypothesis, which suggests that individuals have a greater stake in their children than in their parents. Indeed, negative experiences with adult children may be more salient because tensions with adult children occur less frequently than do tensions with parents. (PsycINFO Database Record

Diurnal salivary alpha-amylase dynamics among dementia family caregivers.

OBJECTIVE: The study examined diurnal regulation of salivary alpha-amylase (sAA) in association with daily stressors, adult day services (ADS) use, and other caregiving characteristics. METHOD: A sample of 165 family caregivers of individuals with dementia (IWD) completed an 8-day diary study. Caregivers provided 5 saliva samples across the 8 days. On some days, caregivers provided all or most of the care. On other days, their relative attended ADS for part of the day. A 3-level unconditional linear spline model was fit to describe the typical sAA diurnal rhythms. Predictors were then added to the unconditional model to test the hypotheses on ADS use and daily stressors. RESULTS: Daily ADS use did not have an effect on diurnal sAA regulation. However, controlling for daily ADS use, greater ADS use over the 8 days was associated with a more prominent rise between 30 min after wake-up and before lunch, and a more prominent decline between before lunch and late afternoon. Fewer ADS days were associated with a more flattened sAA diurnal rhythm. Additionally, greater daily care-related stressor exposures had a within-person association with lower sAA levels in the late afternoon. Care-related stressor exposures had significant within- and between-person associations with sAA diurnal slopes. Furthermore, daily positive experiences had a significant between-person association with sAA diurnal slopes. CONCLUSIONS: Caring for a disabled family member may heighten the vulnerability to potential physiological conditions. Respite from care stressors from ADS use may have some biobehavioral benefits on sAA regulations. (PsycINFO Database Record

Daily interactions in the parent-adult child tie: Links between children's problems and parents' diurnal cortisol rhythms.

Studies have established that grown children's problems affect parental well-being, but a dearth of research has addressed daily interactions and biological systems that may underlie these associations. This study examined whether parents have different types of daily interactions with adult children who have problems and whether those interactions are associated with variations in parents' diurnal cortisol rhythms. Middle-aged parents (n=197) reported their interactions with adult children for seven consecutive days and provided saliva, analyzed for cortisol, three times a day (wake, 30 min after wake, bedtime) for four of those days. Parents were more likely to report negative encounters but not less likely to report positive interactions or contact with adult children who suffered from problems. Interactions with adult children who had physical-emotional problems had more immediate same day associations with cortisol whereas interactions with adult children who had lifestyle-behavioral problems had more delayed, or next day associations with cortisol. Daily interactions and their associations with the hypothalamic-pituitary-adrenal-axis may be important mechanisms by which adult children with problems negatively affect parental well-being.

Anticipating an Easier Day: Effects of Adult Day Services on Daily Cortisol and Stress.

PURPOSE OF THE STUDY: Family caregivers experience high levels of stress that place them at risk for poor health outcomes. We explore whether an intervention which lowers caregivers' daily exposure to stressors, adult day services (ADS), leads to improved regulation of the stress hormone, cortisol, which has implications for health and well-being. DESIGN AND METHODS: Participants (N = 158) were family caregivers of individuals with dementia (IWD) who were using ADS. Eligibility included: the IWD had a dementia diagnosis, IWD used ADS at least twice a week, and IWD and caregiver lived in the same household. A within-subject treatment design was used to compare caregivers' diurnal cortisol responses on days they received the intervention (ADS use by the IWD) and days they did not. Participants completed daily interviews over eight consecutive days and provided five saliva samples on each of those days. Primary outcomes were salivary cortisol awakening response (CAR) and cortisol area under the curve with respect to ground (AUC-G). RESULTS: Caregivers with a "burned-out" or flattened CAR, and associated low AUC-G on non-ADS days displayed a more normative CAR and AUC-G response on ADS days. Restored cortisol regulation was also observed on ADS days among caregivers with the highest CAR and AUC-G levels on non-ADS days. IMPLICATIONS: Results indicate that ADS use improves caregivers' cortisol regulation, which could enhance long-term health outcomes. Effects may be due to caregivers' anticipation of an easier day when the IWD attends ADS.

Depressive Mood, Anger, and Daily Cortisol of Caregivers on High- and Low-Stress Days.

OBJECTIVES: This study examines the association of daily cortisol with depressive mood and anger. METHOD: Depressive mood, anger and 2 markers of cortisol, area under the curve (AUC), and cortisol awakening response (CAR) were examined for caregivers (N = 164) of individuals with dementia (IWDs) across 8 days, some of which IWDs attended an adult day service (ADS) program. Caregivers were primarily female (86.7%) with a mean age of 61.99. First, multilevel models were run with CAR and AUC each as separate covariates of anger and depressive mood. A second set of models examined contextual factors of caregivers (i.e., care-related stressors and amount of ADS use) were added to the models for anger and depressive mood (Model 2). RESULTS: On days where caregivers had AUCs below their average they expressed higher anger scores. However in Model 2, anger was associated with more care-related stressors, but not ADS use or daily cortisol. Caregivers who on average had smaller CARs were more likely to be depressed. In Model 2, depressed mood was associated with more care-related stressors and a low average CAR. DISCUSSION: We found that hypocortisol patterns, reflective of chronic stress experienced by caregivers, are associated with negative mood.