Is Salivary Chromogranin A a Valid Psychological Stress Biomarker During Sensory Stimulation in People with Advanced Dementia?

Abstract

Salivary chromogranin A (sCgA) is gaining attention as a biomarker of psychological stress. The objective of this work was to determine whether individualized music intervention and multisensory stimulation environment (MSSE) in a Snoezelen room produce changes in sCgA in severely demented older patients, and to assess the possible existence of differences in sCgA levels between the two types of interventions. Older adults with severe dementia (n = 22) were randomly assigned to two intervention groups. They participated in MSSE or individualized music interventions in 30-min weekly sessions for 16 weeks. Levels of sCgA were evaluated before and after a session, or 30-min interval, at four different time points: before starting the trial, in the middle and end of the intervention period, and two months later. Comparison of sCgA values obtained after each session with those obtained before (or at the same hour in before trial and follow-up samplings) showed no significant differences either in the individualized music or in the MSSE group at any sampling time. Comparison between the two types of interventions, both before and after each session, in the four sampling times, did not produce any significant difference either. Furthermore, no significant correlation was obtained between agitation, anxiety, cognitive function, and dementia severity with sCgA levels. In conclusion, despite beneficial effects of both individualized music and MSSE interventions being previously reported on neuropsychiatric outcomes for older patients with dementia, sCgA seems to not be a good indicator of these benefits.

Impact of individualised music listening intervention on persons with dementia: A systematic review of randomised controlled trials

“…Further data extraction of 141 full‐text articles excluded 135 papers based on the inclusion criteria. Although six papers met the inclusion criteria, three papers were from the same research project as confirmed by the study author . Thus, a total of four studies were included in this review as shown in Figure .…”

“…Music was played through a compact disc (CD) player or a computer in the participant's room, in a private/quiet room or a familiar area. Trained professionals and a research assistant delivered the intervention. In one study, it was stated only that the participants passively listened to their preferred music, while in another study, the music therapist prepared the music playlist but the participants listened to the music without interaction with the therapist .…”

“…Other outcome measures include the Cornell Brown Scale for Quality of Life in Dementia to evaluate quality of life and the Faces Scale to assess emotion . The physiological outcomes were evaluated using the heart rate, oxygen saturation, autonomic nerve index and salivary chromogranin A …”

“…All studies were at high risk of bias based on not blinding participants or personnel, due to the nature of the intervention. For the blinding of outcome assessment, the ratings were mixed: two studies were at low risk, one was at high risk, and one was unclear . Three studies were at low risk for incomplete data, while one study was rated unclear due to the lack of description as to how the authors managed missing data .…”

“…For the blinding of outcome assessment, the ratings were mixed: two studies were at low risk, one was at high risk, and one was unclear . Three studies were at low risk for incomplete data, while one study was rated unclear due to the lack of description as to how the authors managed missing data . All of the included studies were rated unclear for the selective outcome reporting as there was no published protocol paper for reference on further details about the study outcomes.…”