Problem behavior of dementia patients predicts low-grade hypercoagulability in spousal caregivers

Low-grade hypercoagulability might be one pathway to explain how the chronic stress of dementia caregiving increases cardiovascular disease risk, but the specific aspects of caregiver stress that elicit hypercoagulability are elusive. We hypothesized that dementia patients' problem behaviors and negative reactions of caregivers to these behaviors would relate to hypercoagulability in caregivers.

Sleep and biomarkers of atherosclerosis in elderly Alzheimer caregivers and controls

Perturbed sleep might contribute to cardiovascular disease by accelerating atherosclerosis. Sleep is poor in Alzheimer caregivers who are also a group at increased cardiovascular risk.

The relationship between self-efficacy and resting blood pressure in spousal Alzheimer's caregivers

Objective. To examine whether high levels of self-efficacy for problem-focused coping were significantly related to several resting BP measures in spousal Alzheimer's disease caregivers. Design. Cross-sectional. Methods. Participants included 100 older caregivers (mean age = 73.8 ± 8.14 years) providing in home care for a spouse with Alzheimer's disease. All participants completed a 13-item short form of the Coping Self-Efficacy Scale and underwent an in-home assessment where a visiting nurse took the average of three serial BP readings. Multiple regression was used to examine the relationship between self-efficacy and mean arterial pressure (MAP), systolic BP (SBP), diastolic BP (DBP), and pulse pressure (PP) after controlling for age, gender, smoking history, body mass index, the care recipient's clinical dementia rating, diabetes, alcohol use, and the use of antihypertensive medications. Results. Overall, high levels of self-efficacy for problem-focused coping were associated with lower MAP, SBP, and PP. Self-efficacy for problem-focused coping was marginally associated with resting DBP, but not significant. In addition, we conducted secondary analyses of the other two self-efficacy scales to explore the relationship between each dimension and MAP. We found that there were no significant relationships found between MAP and self-efficacy for stopping unpleasant thoughts/emotions or self-efficacy for getting social support. Conclusions. The present study adds to the current body of literature by illustrating the possibility that higher self-efficacy can have physiological advantages, perhaps by buffering chronic stress's impact on resting BP. Another contribution of the current study is its attempt to understand the role of each individual component of self-efficacy. These findings invite future research to investigate whether caregivers might experience cardiovascular benefits from interventions aimed at enhancing self-efficacy.

Regular physical activity moderates cardiometabolic risk in Alzheimer's caregivers

Dementia caregivers have an increased risk of cardiovascular disease, and it is possible that metabolic disturbances contribute to this risk. Regular physical exercise reduces cardiometabolic risk, but caregivers may have less opportunity to engage in such activity. We hypothesized that regular physical activity would moderate cardiometabolic risk in dementia caregivers.

Carotid plaque in Alzheimer caregivers and the role of sympathoadrenal arousal

To test the hypothesis that those who provide care for a spouse diagnosed with Alzheimer's disease would have increased prevalence of carotid artery plaque compared with noncaregiving controls and that prolonged sympathoadrenal arousal to acute stress would relate to this difference. Providing care for a spouse with Alzheimer's disease has been associated with an increased risk of coronary heart disease, potentially due to the impact of caregiving stress on the atherosclerotic disease process.

Leisure activities, caregiving demands and catecholamine levels in dementia caregivers

This study examined whether satisfaction from leisure activities moderates the relationship between caregiving demands (i.e., hours per day spent caring for a spouse with dementia) and resting levels of the catecholamines norepinephrine (NE) and epinephrine (EPI). Spousal caregivers (n = 107; mean age = 73.95 ± 8.12 years) were assessed in home for plasma levels of NE and EPI, amount of care provided, and leisure satisfaction. Regression was used to determine whether leisure satisfaction moderated the relationship between hours providing care per day and catecholamine levels. A significant interaction was found between hours caregiving and leisure satisfaction for NE, but not for EPI. Post hoc regressions were conducted for both NE and EPI. At low leisure satisfaction, time spent caring for a spouse was positively associated with plasma NE (β = 0.41; p = 0.005) and EPI (β = 0.44; p = 0.003). In contrast, at high levels of satisfaction, time caregiving was not significantly associated with plasma NE (β = -0.08; p = 0.57) or EPI (β = 0.23; p = 0.12). These findings suggest that leisure satisfaction may protect caregivers from increases in catecholamines, which have been implicated in cardiovascular risk. Further support for these findings may impact psychological treatments for distressed caregivers.