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Biomarkers may serve as objective measures in complicated grief (CG) potentially capturing responses to stress reduction treatment. This paper reports challenges in obtaining and assessing salivary cortisol and α-amylase (sAA) for a recent randomized clinical trial. Within-session changes in salivary cortisol and sAA for 54 older adults with CG who received Accelerated Resolution Therapy were compared with perceived stress measured by Subjective Units of Distress Scale. Bivariate correlations and multiple regressions examined changes in biomarkers. Protocols, study logs, and audit reports identified challenges. Challenges included obtaining unstimulated passive drool salivary samples and their analyses. Our sample of older females on multiple medications may have resulted in a perfect storm of moderating and intervening variables which affected the stress response. This paper contributes to the discussion on designing clinical trials for older adults which must account for physiologic changes, multimorbidity, and polypharmacy common in this population and makes recommendations moving forward. [ABSTRACT FROM AUTHOR]

BACKGROUND: The loss of a loved one, especially by a caregiver, can be stressful. Grief can affect one emotionally, mentally, behaviorally, spiritually, and physically and affects individuals differently. Complicated grief (CG), especially for a caregiver, can be intense, prolonged, and interfere with normal activities accompanied by destructive thoughts and behaviors. AIM : To synthesize the available research on persons experiencing CG and the effect on cortisol levels. METHODS : A literature search for articles published on CG and cortisol was performed using PubMed, Cochrane Library, PsychINFO, and Web of Science. Search terms included CG, cortisol, and their variants. No date limitations were applied. In accordance with PRISMA, articles were sorted and evaluated against specific inclusion and exclusion criteria. RESULTS : The search yielded 18 articles, of which 5 were included in the review. CONCLUSIONS : Cortisol levels and diurnal patterns are shown to be affected in individuals experiencing CG. With prolonged bereavement and dysregulated cortisol, physical and mental health outcomes may result warranting a need for effective stress reduction therapies for this population. [ABSTRACT FROM AUTHOR]

Objective: Cognitive deficits are common in patients with heart failure (HF), and can negatively affect self-care, predict rehospitalizations, and increase mortality rates 5-fold. Inflammation can produce vascular pathology, reducing cerebral blood flow to brain regions necessary for optimal cognitive function. The purpose of the investigation was to identify a pattern of peripheral blood inflammation-related biomarkers associated with cognitive impairment in patients with HF. Methods: Forty-five outpatients (median age = 67 years, SD = 9.9) were recruited from University of California, San Diego (UCSD) and Veterans Affairs San Diego Healthcare Systems (VASDHS), diagnosed with New York Heart Association Stages I–III HF. Participants were administered the Montreal Cognitive Assessment (MoCA) as a measure of global cognitive impairment, and blood was analyzed for plasma biomarkers, interferon-γ, tumor necrosis factor-α (TNFα), soluble intercellular adhesion molecule-1 (sICAM-1), soluble vascular cell adhesion molecule-1 (sVCAM-1), brain-derived neurotrophic factor (BDNF), interleukin-8 (IL-8), matrix metallopeptidase-9 (MMP-9), IL-6, C-reactive protein (CRP), and serum amyloid-A (SAA). Results: Almost half the patients scored below the threshold on the MoCA, indicating at least mild cognitive impairment. A factor analysis produced three biomarker factors: vascular inflammatory factor-1: TNFα, sICAM1, sVCAM1; neuroinflammatory factor-2: BDNF, MMP-9, IL-8; peripheral inflammatory factor-3: IL-6, CRP, SAA. Only vascular inflammatory factor-1 was significantly associated with cognitive function (MoCA) (ΔR2 = 0.214, beta = –0.468, p = 0.008). Conclusions: In this cohort with HF, vascular inflammation appears related to poorer cognitive function. This could indicate targets for treatment to reduce cognitive deficits in HF. However, this is a preliminary study, and further research is needed. [ABSTRACT FROM AUTHOR]

Objective: To evaluate relationships between hair cortisol levels and perceived stress in mothers who deliver preterm and term. We hypothesized that the rate of change in cortisol levels would be greater in the preterm delivery group. Methods: This preliminary study compared hair cortisol levels and Perceived Stress Scale (PSS) scores in predominately Caucasian mothers who delivered preterm (n = 22) and term (n = 30). We collected PSS and hair samples of ≥10 cm in length from mothers after delivery. Hair was segmented into three sections, and cortisol was measured using enzyme-linked immunosorbent assay. Results: The mean gestational age was 31.45 (SD = 4.2) weeks for preterm deliveries and 39.45 (SD = 1.1) for term. Cortisol differed significantly in the third trimester between mothers delivering term and preterm (t = 2.16, df = 48, p = .04) and trended toward significance in the second trimester (t = 1.88, df = 48, p = .06). PSS differed significantly between the two groups (t = −2.96, df = 50, p = .05). Our data did not provide support for our hypothesis. Conclusion: There appeared to be a blunted, flattened pattern of change in cortisol levels across gestation in the women who delivered preterm, suggesting diminished hypothalamic–pituitary–adrenal axis responsiveness in mechanisms that promote preterm labor. Future studies are needed to further evaluate best strategies for measuring the mechanisms of allostatic load during pregnancy along with the psychoneuroendocrine and immune triggers and placental responses that lead to premature birth. [ABSTRACT FROM AUTHOR]

Background: Toxoplasma gondii is an intracellular protozoan parasite with zoonotic potential that causes acute and chronic diseases, which has been associated with schizophrenia, depression, bipolar disorder, and suicidal behavior. Military personnel may be at increased risk for exposure to the parasite when deployed to countries with high prevalence rates.Methods: Women Veterans were recruited to participate in the study at an event to recognize women Veterans and later through e-mails. Blood samples were collected from 70 women Veterans (mean age: 47 years) and analyzed for T. gondii IgG titer. Participants completed a demographic instrument, Center for Epidemiologic Studies Depression scale, Profile of Mood States (POMS), and Post-Traumatic Stress Disorder Checklist-Military.Results: The infectivity rate was lower than the rate in the United States (11.4% [8 out of 70 were seropositive], but 6 of the 8 [75%] had been deployed outside the United States. Pearson correlations and t tests showed significant relationships between T. gondii seropositivity and Center for Epidemiologic Studies Depression score), POMS-depression, POMS-confusion, and POMS-anger subscale scores, and total mood disturbance score.Conclusions: This study is the first to describe biobehavioral relationships between chronic T. gondii infection, depression, and dysphoric moods in a military veteran population. [ABSTRACT FROM AUTHOR]