# Hair Cortisol as a Biomarker of Chronic Stress in Community-Dwelling Adults With Longstanding Multiple Sclerosis

## TL;DR

The study explores hair cortisol as a way to measure chronic stress in people with long-term multiple sclerosis, finding it feasible but with limited correlation to self-reported stress.

## Contribution

This study is the first to examine hair cortisol as a chronic stress biomarker in individuals with longstanding multiple sclerosis.

## Key findings

- Hair sample collection for cortisol analysis is feasible in community-dwelling individuals with longstanding MS.
- Younger participants and those with shorter MS duration were more likely to provide usable hair samples.
- Hair cortisol levels were significantly associated with employment status but not with self-reported stress measures.

## Abstract

Chronic stress may play a significant role in disease progression in individuals with multiple sclerosis (MS), but traditional methods of measuring stress through salivary and blood cortisol have limitations. Hair cortisol has emerged as a promising objective measure for chronic stress assessment, but its application in those with MS remains understudied.

To explore the feasibility of hair sample collection for cortisol analysis among community-dwelling individuals with longstanding MS (disease duration ≥20 years), including factors associated with participation and relationships between hair cortisol and self-reported measures, including perceived stress.

In this cross-sectional study, 75 participants completed surveys and provided usable hair samples for cortisol analysis. Factors associated with participation and correlations among study variables were examined.

The completion rate for hair sample collection was 59.6% (n = 90). Of the samples returned, 83.3% (n = 75) were used in the analysis. Younger survey participants and those with shorter MS duration were more likely to provide usable hair samples. Hair cortisol showed no significant linear relationships with self-reported variables. In a multiple regression model to predict hair cortisol, employment was significantly associated with increased hair cortisol levels.

Hair sample collection for cortisol analysis is feasible in community-dwelling individuals with longstanding MS. The lack of correlation between hair cortisol and perceived stress reflects the complexity of measuring chronic stress in MS, as in other populations. Future research may consider multi-method approaches to collect hair samples and explore relationships between hair cortisol, perceived stress, and health promotion variables.