There is ample evidence showing that the stress of caring for a relative with Alzheimer's Disease (AD) adversely affects caregivers. In the longitudinal study funded by the current grant, we found that caregivers had substantially higher rates of syndromal depressive disorders than controls. Caregivers also had poorer immune function on qualitative immunological assays, and more infectious disease episodes (primarily respiratory tract infections) than noncaregivers. Spousal caregivers' immune function has not returned to the level of well-matched control subjects across the four years of the study completed thus far; moreover, bereaved spousal caregivers to not differ significantly from """"""""continuous"""""""" caregivers on immune function or depression after bereavement. In fact, our data suggest that spousal caregivers continue to show immunological down-regulation as well as increased risk for syndromal depressive disorders for at least two years after bereavement. While ample evidence has accumulated demonstrating the adverse mental health consequences of caregiving, few studies have addressed how caregivers adapt after bereavement. The high caregiver-related incidence of syndromal depressive disorders both during and after caregiving is particularly troublesome in light of recent evidence that the long-term outcome of depressive episodes may be much less favorable than previously assumed, with many depressed individuals either failing to recover or frequently relapsing. In the depression literature, an increased relapse rate is associated with an older age of onset for depressive episodes, and impaired social relationships are characteristic of both currently depressed individuals and remitted depressives. Since caregivers have small networks and describe their relationships as less supportive than controls, and since immune function appears to be related to both depression and social support, there are significant reasons for concern about depression, immune function, and health both during caregiving and after bereavement.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
2R01MH042096-06
Application #
3567416
Study Section
Mental Disorders of Aging Review Committee (MDA)
Project Start
1987-04-01
Project End
1997-08-31
Budget Start
1992-09-01
Budget End
1993-08-31
Support Year
6
Fiscal Year
1992
Total Cost
Indirect Cost
Name
Ohio State University
Department
Type
DUNS #
098987217
City
Columbus
State
OH
Country
United States
Zip Code
43210
Padgett, David A; Glaser, Ronald (2003) How stress influences the immune response. Trends Immunol 24:444-8
Burleson, Mary H; Poehlmann, Kirsten M; Hawkley, Louise C et al. (2003) Neuroendocrine and cardiovascular reactivity to stress in mid-aged and older women: long-term temporal consistency of individual differences. Psychophysiology 40:358-69
Cacioppo, John T; Kiecolt-Glaser, Janice K; Malarkey, William B et al. (2002) Autonomic and glucocorticoid associations with the steady-state expression of latent Epstein-Barr virus. Horm Behav 42:32-41
Burleson, Mary H; Poehlmann, Kirsten M; Hawkley, Louise C et al. (2002) Stress-related immune changes in middle-aged and older women: 1-year consistency of individual differences. Health Psychol 21:321-31
Hadjiconstantinou, M; McGuire, L; Duchemin, A M et al. (2001) Changes in plasma nerve growth factor levels in older adults associated with chronic stress. J Neuroimmunol 116:102-6
Hawkley, L C; Burleson, M H; Poehlmann, K M et al. (2001) Cardiovascular and endocrine reactivity in older females: intertask consistency. Psychophysiology 38:863-72
Wu, H; Wang, J; Cacioppo, J T et al. (1999) Chronic stress associated with spousal caregiving of patients with Alzheimer's dementia is associated with downregulation of B-lymphocyte GH mRNA. J Gerontol A Biol Sci Med Sci 54:M212-5
Glaser, R; Kiecolt-Glaser, J K; Malarkey, W B et al. (1998) The influence of psychological stress on the immune response to vaccines. Ann N Y Acad Sci 840:649-55
Burleson, M H; Malarkey, W B; Cacioppo, J T et al. (1998) Postmenopausal hormone replacement: effects on autonomic, neuroendocrine, and immune reactivity to brief psychological stressors. Psychosom Med 60:17-25
Malarkey, W B; Burleson, M; Cacioppo, J T et al. (1997) Differential effects of estrogen and medroxyprogesterone on basal and stress-induced growth hormone release, IGF-1 levels, and cellular immunity in postmenopausal women. Endocrine 7:227-33

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