Author + information
- Received July 29, 2009
- Revision received November 18, 2009
- Accepted November 19, 2009
- Published online June 8, 2010.
- Brent T. Mausbach, PhD*,* (, )
- Susan K. Roepke, MS*,
- Michael G. Ziegler, MD†,
- Milos Milic, MD, PhD†,
- Roland von Känel, MD*,§,
- Joel E. Dimsdale, MD*,
- Paul J. Mills, PhD*,
- Thomas L. Patterson, PhD*,
- Matthew A. Allison, MD‡,
- Sonia Ancoli-Israel, PhD* and
- Igor Grant, MD*
- ↵*Reprint requests and correspondence:
Dr. Brent T. Mausbach, Department of Psychiatry (0680), University of California San Diego, 9500 Gilman Drive, La Jolla, California 92093-0680
Objectives We examined the relationship between chronic caregiving stress and endothelial function.
Background Evidence suggests that caregiving stress is associated with pathophysiologic processes related to atherosclerosis. Endothelial dysfunction is a possible underlying mechanism explaining the relationship between caregiving stress and cardiovascular morbidity. We investigated the relationship between chronic caregiving stress and endothelial dysfunction assessed by reactive hyperemia–induced flow-mediated dilation (FMD).
Methods Seventy-eight elderly individuals participated in the study. Fifty-five were providing in-home care to a spouse with Alzheimer's disease, and 23 were married and living with a healthy, nondemented spouse. Analysis of covariance was used to examine the relationships between advancing dementia severity (Clinical Dementia Rating scores) and FMD and nitroglycerin-induced vasodilation of the brachial artery. Multiple linear regression was used to examine the relationship between years of caregiving and FMD.
Results Clinical Dementia Rating scale scores were significantly related to FMD (p = 0.033), with participants caring for a spouse with moderate to severe dementia showing significantly worse FMD than those caring for a spouse with mild dementia (p = 0.028) and noncaregivers (p = 0.032). Within the caregiver sample, the number of years of caregiving was significantly related to FMD (r = −0.465, p < 0.001).
Conclusions These results suggest that the chronic stress of caregiving is associated with impaired endothelial function, which may be a potential mechanistic link to the observed increased risk of cardiovascular disease in elderly caregivers.
This study was supported by the National Institutes of Health/National Institute on Agingthrough award AG 15301(to Dr. Grant). Additional support was provided through award AG 03090(to Dr. Mausbach). Dr. Dimsdale receives research grant support from Sepracor Pharmaceuticalsfor work unrelated to that discussed in this paper. Dr. Ancoli-Israel serves as a consultant and is on the Scientific Advisory Board for Ferring Pharmaceuticals Inc., GlaxoSmithKline, Orphagen Pharmaceuticals, Pfizer, Respironics, Sanofi-Aventis, Sepracor, Inc., and Schering-Plough for work unrelated to this paper; she also has received grants/contracts from Sepracor, Inc.and Litebook, Inc.for work unrelated to this paper.
- Received July 29, 2009.
- Revision received November 18, 2009.
- Accepted November 19, 2009.
- American College of Cardiology Foundation