The Relationship Among Depression and Caregiver Burden with Salivary Cortisol Awakening Levels in Female Caregivers of Stroke Survivors

Saban KL. The Relationship Among Depression and Caregiver Burden with Salivary Cortisol Awakening Levels in Female Caregivers of Stroke Survivors. Paper presented at: Midwest Nursing Research Society Annual Conference; 2011 Mar 26; Columbus, OH.

Family caregivers of stroke survivors experience high levels of chronic stress, placing them at risk for developing depression. Chronic stress has also been associated with altered diurnal cortisol patterns that may promote the development of inflammatory-related disease. In a crosssectional study we investigated the impact of caregiver burden and depression on the salivary cortisol awakening levels of caregivers of stroke survivors. A national sample of 45 females (mean age = 51.5) caring for a significant other who suffered a stroke within the past 3-12 months were enrolled. Subjects collected salivary cortisol samples upon awakening and completed the Caregiver Reaction Assessment (CRA) and Center for Epidemiologic Depression Studies, as measures of caregiver burden and depressive symptoms. The findings revealed that awakening cortisol levels were inversely associated with depression (r = -.457, p = .002), as well as inversely associated with the perceived caregiver burden subscales: lack of family support (r = -.320, p = .037), financial burden (r = -.441, p = .003), and impact on schedule (r = -.511, p < .001). Depression, caregiver burden, age, race, and employment status significantly predicted awakening cortisol levels (p = .000) and explained 53% of its variance (adjusted r2 = .529). However, only the caregiver burden subscale of impact on schedule (p = .000) and race (p = .039) remained significant variables in the regression model. Results indicate that greater caregiver burden and depression are associated with decreased cortisol awakening levels. These findings may have implications for future health risks of family caregivers.