Is in‐home saliva collection of cortisol and DHEA‐S effective to measure stress in dementia care dyads?: A comparison between music‐based intervention group and comparison group

Abstract Background Despite the fact that music provides a wide array of benefits for dementia care dyads (persons with dementia and family caregivers), the increased attention to music for stress reduction in dementia care dyads has sparked questions about whether and how to effectively measure changes in stress throughout the interventions. The purpose of this study was to explore the feasibility of collecting salivary cortisol and dehydroepiandrosterone sulfate (DHEA‐S) as stress biomarkers to assess the short‐term effects of music among dementia care dyads living at home. Method Participants who were recruited from the memory evaluation center collected their saliva three times a day, five days a week, over the eight weeks of in‐home online music intervention. In this non‐randomized open study, we examined concentrations of endpoints morning cortisol and DHEA‐S, evening cortisol, and the ratio of cortisol to DHEA‐S. Mean values of logarithmically transformed endpoints during the last available week were compared between the intervention and comparison groups with adjustment for baseline mean values in linear regression models or non‐parametric Willett’s residual method. Result A total of 34 dyads (34 persons with dementia and 34 family caregivers; n = 24 dyads [intervention group], n = 10 dyads [comparison group]) were included. We did not find statistically significant differences between the intervention group and the comparison group in persons with dementia. Caregivers in the intervention group had lower concentrations of morning saliva cortisol (geometric mean: 3262 pg/ml) compared to the comparison group (geometric mean: 5271 pg/ml) ( p = 0.013). Conclusion The in‐home daily saliva collection of cortisol and DHEA‐S may be feasible to examine the short‐term effects of music on stress among dementia care dyads. The findings suggest that our in‐home music intervention may help reduce stress among family caregivers who provide care to persons with dementia. Considering the small sample with high intra‐individual variation of salivary biomarkers, a randomized controlled trial with a larger sample is needed in future research.