This Alzheimer Caregiver Study has been exploring the physiological and psychological mechanisms that may be associated with increased health risk in groups of elderly spousal caregivers (CG). Results indicate that CG experience increased sympathoadrenalmedullary (SAM) arousal, which may be related to sleep disturbance, and associated with physiological changes previously linked to risk of cardiovascular (CV) disease, such as increase in circulating catecholamines, rise in the procoagulant factor D dimer, and the proinflammatory marker IL-6. Older CG show greatest changes. In the renewal we wish to develop a more complete mechanistic understanding of the stress to CV risk translation. The general hypotheses are that specific elements of the caregiving situation, such as problem behaviors of the care recipient and lack of respite induce affective arousal and sleep problems which favor a state of increased SAM arousal. Chronic SAM excitation favors the release of inflammatory markers such as IL-6, and a shift toward procoagulation. These physiological changes, if chronic, may lead to CV vulnerability, including hypertension and vascular endothelial injury. The buffering effects of coping that emphasize mastery will also be explored. A novel focus of this renewal application is our proposal to link the major markers of psychobiological stress related to caregiving (i.e., affective arousal, sleep disturbance, and biomarkers such as catecholamines, hemostatis variables, inflammatory markers) to indicators of CV injury including degree of endothelial injury, early signs of larger vessel pathology and baroreflex desensitization. The study design involves repeated observation of 120 spousal caregivers of Alzheimer patients and a comparison group of 60 non-caregivers. Using our unique strategy of """"""""taking the laboratory to the home"""""""", participants will be assessed annually (with added assessments following placement or death of care recipient) with respect to their caregiving situation, psychological status, and several biological indicators (e.g. SAM arousal, sleep disturbance, pro-inflammatory and hemostasis molecules, baroreflex, measures of endothelial function, and large vessel disease). This study will provide a basis for a mechanistic understanding of the path from CG stress to CV morbidity in elderly CG, and opens the possibility of targeted interventions to reduce this risk.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Research Project (R01)
Project #
5R01AG015301-22
Application #
8118478
Study Section
Biobehavioral Mechanisms of Emotion, Stress and Health Study Section (MESH)
Program Officer
Nielsen, Lisbeth
Project Start
1997-09-30
Project End
2013-03-31
Budget Start
2011-09-01
Budget End
2013-03-31
Support Year
22
Fiscal Year
2011
Total Cost
$807,935
Indirect Cost
Name
University of California San Diego
Department
Psychiatry
Type
Schools of Medicine
DUNS #
804355790
City
La Jolla
State
CA
Country
United States
Zip Code
92093
Mausbach, Brent T; Romero-Moreno, Rosa; Bos, Taylor et al. (2017) Engagement in Pleasant Leisure Activities and Blood Pressure: A 5-Year Longitudinal Study in Alzheimer Caregivers. Psychosom Med 79:735-741
Wu, Kevin K; Bos, Taylor; Mausbach, Brent T et al. (2017) Long-term caregiving is associated with impaired cardiovagal baroreflex. J Psychosom Res 103:29-33
von Känel, Roland (2015) ACUTE MENTAL STRESS AND HEMOSTASIS: WHEN PHYSIOLOGY BECOMES VASCULAR HARM. Thromb Res 135:S52-S55
von Känel, Roland (2015) Acute mental stress and hemostasis: When physiology becomes vascular harm. Thromb Res 135 Suppl 1:S52-5
Mausbach, Brent T; Chattillion, Elizabeth A; Ho, Jennifer et al. (2014) Why does placement of persons with Alzheimer's disease into long-term care improve caregivers' well-being? Examination of psychological mediators. Psychol Aging 29:776-86
von Känel, Roland; Mausbach, Brent T; Mills, Paul J et al. (2014) Longitudinal relationship of low leisure satisfaction but not depressive symptoms with systemic low-grade inflammation in dementia caregivers. J Gerontol B Psychol Sci Soc Sci 69:397-407
von Känel, Roland; Mausbach, Brent T; Ancoli-Israel, Sonia et al. (2014) Positive affect and sleep in spousal Alzheimer caregivers: a longitudinal study. Behav Sleep Med 12:358-72
Ho, Jennifer S; Bordon, Jennifer; Wang, Vicki et al. (2014) Reduced activity restriction buffers the relations between chronic stress and sympathetic nervous system activation. J Gerontol B Psychol Sci Soc Sci 69:408-16
Mausbach, Brent T; Chattillion, Elizabeth A; Roepke, Susan K et al. (2013) A comparison of psychosocial outcomes in elderly Alzheimer caregivers and noncaregivers. Am J Geriatr Psychiatry 21:5-13
Moore, Raeanne C; Chattillion, Elizabeth A; Ceglowski, Jennifer et al. (2013) A randomized clinical trial of Behavioral Activation (BA) therapy for improving psychological and physical health in dementia caregivers: results of the Pleasant Events Program (PEP). Behav Res Ther 51:623-32

Showing the most recent 10 out of 73 publications