Receiving caregiver support and its association with hair hormones in people living with Alzheimer’s disease: The role of caregivers’ perspective taking

Receiving support in later life is often experienced as stressful, but for people living with Alzheimer’s disease (PLWD) support is an unavoidable necessity for daily functioning. The current study examined the association between receiving support in this unique context and PLWD’s hair cortisol, dehydroepiandrosterone (DHEA), and DHEA-to-cortisol ratio, which serve as non-invasive, objective physiological measures that may reflect longer-term HPA-axis activity related to stress. Further, we explored whether caregivers’ perspective taking—their ability to understand PLWD’s thoughts and feelings, moderated associations between support receipt and hair hormones. Participants included 58 couples managing mild-to-moderate Alzheimer’s disease ( M age = 77.60 for PLWD; M age = 75.48 for caregivers). PLWD self-reported the frequency of emotional and practical support received from their spousal caregivers. Hair samples were collected from the posterior vertex to assess cortisol and DHEA concentrations and were assayed using enzyme immunoassay (EIA) method. Caregivers reported their own perspective taking and both spouses’ demographic characteristics. Multiple regressions showed that receiving more frequent emotional support and less frequent practical support from spousal caregivers were associated with higher hair cortisol concentrations in PLWD. Yet, these associations were only evident if caregivers had greater perspective taking. In addition, caregiver perspective taking exacerbated the negative association between receiving emotional support and the DHEA-to-cortisol ratio. By using hair hormones, this study offers preliminary insights into PLWD’s stress-related physiological processes in the context of intensive caregiving. Findings refine our understanding of the benefits and costs of caregiver perspective taking and inform caregiver interventions. • Receiving support from caregivers affects hair hormones in PLWD • Links between caregiver support and PLWD hair hormones vary by the type of support • Caregivers’ perspective taking shapes how PLWD reacts to caregiver support