Informal caregivers consistently report higher rates of stress than non-caregivers, and there is evidence that chronic stress has adverse effects on physical health and cognitive functioning. However, no study has evaluated the biological processes between caregiving-related stress and health decline. Recent theories of stress-induced metabolic syndrome and health decline suggest a plausible mechanism: chronic stress disrupts several interrelated homeostatic systems (neuroendocrine, HPA axis, and immune systems), which lead to metabolic syndrome and subsequent health decline. The proposed study will evaluate these associations over a 3-year period in 400 elderly caregivers and non-caregivers from the Boston, MA metropolitan area. Caregivers will be recruited from the Boston University Alzheimer's Disease Core Center Registry (n=200). Non-caregivers will be recruited from the Harvard Cooperative Program on Aging Registry (n=200). Data will be collected during 4 annual interviews at the BU General Clinical Research Center. Biological measures will be obtained from 24-hour urine (catecholamines and cortisol), serum (DHEAS, IL-6, glucose, triglycerides and HDL cholesterol);blood pressure and anthropomorphic measures will be taken. Data on stressors, the caregiving situation (measures from Pearlin's Caregiver Stress model), and potential confounders and effect modifiers will be collected through interviewer-administered questionnaires at each interview. Functional status will be based on walking speed, chair stands and self-reported ADLs. Cognitive status will be based on multiple domains (e.g., executive functioning, working memory). Hypotheses will address: 1) the sequential pathway from stress, to physiological changes, metabolic syndrome, and functional and cognitive decline;2) comparisons of these outcomes in non-caregivers and non-caregivers;and 3) the mechanisms by which modifiers, such as social support and caregiving characteristics, affect this pathway. Mixed effects models will be used to analyze the longitudinal process between caregiver stress and functional and cognitive changes. Latent growth curve modeling will be used to examine the effects of time-varying covariates (i.e., caregiver transitions) on intra-individual change across the four measurement points. Results will provide insight into biological pathways underlying health decline in aged caregivers, and have implications for interventions to reduce adverse effects of chronic stress.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Research Project (R01)
Project #
5R01AG028144-04
Application #
7835531
Study Section
Special Emphasis Panel (ZRG1-HOP-W (03))
Program Officer
Nielsen, Lisbeth
Project Start
2007-08-15
Project End
2012-05-31
Budget Start
2010-06-01
Budget End
2011-05-31
Support Year
4
Fiscal Year
2010
Total Cost
$644,239
Indirect Cost
Name
Boston University
Department
Public Health & Prev Medicine
Type
Schools of Public Health
DUNS #
604483045
City
Boston
State
MA
Country
United States
Zip Code
02118
Fredman, Lisa (2017) Interconnections Between My Research and Experience as a Caregiver: Impacts on Empirical and Personal Perspectives. Gerontologist 57:40-45
Lyons, Jennifer G; Ensrud, Kristine E; Schousboe, John T et al. (2016) Slow Gait Speed and Risk of Long-Term Nursing Home Residence in Older Women, Adjusting for Competing Risk of Mortality: Results from the Study of Osteoporotic Fractures. J Am Geriatr Soc 64:2522-2527
Lyons, Jennifer G; Heeren, Tim; Stuver, Sherri O et al. (2015) Assessing the agreement between 3-meter and 6-meter walk tests in 136 community-dwelling older adults. J Aging Health 27:594-605
Fredman, Lisa; Lyons, Jennifer G; Cauley, Jane A et al. (2015) The Relationship Between Caregiving and Mortality After Accounting for Time-Varying Caregiver Status and Addressing the Healthy Caregiver Hypothesis. J Gerontol A Biol Sci Med Sci 70:1163-8
Gardiner, Paula; Sadikova, Ekaterina; Filippelli, Amanda C et al. (2015) Stress Management and Relaxation Techniques use among underserved inpatients in an inner city hospital. Complement Ther Med 23:405-12
Lyons, Jennifer G; Cauley, Jane A; Fredman, Lisa (2015) The Effect of Transitions in Caregiving Status and Intensity on Perceived Stress Among 992 Female Caregivers and Noncaregivers. J Gerontol A Biol Sci Med Sci 70:1018-23
Zeki Al Hazzouri, Adina; Vittinghoff, Eric; Byers, Amy et al. (2014) Long-term cumulative depressive symptom burden and risk of cognitive decline and dementia among very old women. J Gerontol A Biol Sci Med Sci 69:595-601
Fredman, Lisa; Gordon, Sheryl A; Heeren, Timothy et al. (2014) Positive affect is associated with fewer sleep problems in older caregivers but not noncaregivers. Gerontologist 54:559-69
Givens, Jane L; Mezzacappa, Catherine; Heeren, Timothy et al. (2014) Depressive symptoms among dementia caregivers: role of mediating factors. Am J Geriatr Psychiatry 22:481-8
Gordon, Sheryl A; Fredman, Lisa; Orwig, Denise L et al. (2013) Comparison of methods to measure height in older adults. J Am Geriatr Soc 61:2244-6

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