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Lincoln KD, Lloyd DA, Nguyen AW. Social Relationships and Salivary Telomere Length Among Middle-Aged and Older African American and White Adults. J Gerontol B Psychol Sci Soc Sci 2020; 74:1053-1061. [PMID: 28486613 DOI: 10.1093/geronb/gbx049] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 04/24/2017] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES A common mechanism underlying premature morbidity may be accelerated biological aging as reflected by salivary telomere length (STL). This study examined the extent to which social relationships, both positive and negative, can be protective or confer risk relative to biological aging. METHOD Data from the Health and Retirement Study and multiple regression were used to examine cross-sectional associations between STL, self-reported social support, and negative interaction (e.g., conflict, criticism) with family in a nationally representative sample of African American and non-Hispanic White middle-aged and older adults (N = 4,080). RESULTS Social support from family was associated with shorter STL. Negative interaction with family had no main effect on STL but interactions characterized by high social support and more frequent negative interactions were associated with longer STL. Negative interaction with family was negatively associated with STL for African Americans and Whites but the magnitude of the effect was greater for African Americans. DISCUSSION Study findings highlight the role of social relationships in physiological deterioration among middle-aged and older adults and identify a potential mechanism whereby race is linked to accelerated biological aging. Findings highlight the importance of considering positive and negative aspects of social relationships to understand the consequences of social connections for cellular aging in diverse populations.
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Affiliation(s)
- Karen D Lincoln
- University of Southern California, Suzanne Dworak-Peck School of Social Work, Los Angeles
| | - Donald A Lloyd
- University of Southern California, Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, Los Angeles
| | - Ann W Nguyen
- Case Western Reserve University, Jack, Joseph and Morton Mandel School of Applied Social Sciences, Cleveland, Ohio
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Allen AP, Curran EA, Duggan Á, Cryan JF, Chorcoráin AN, Dinan TG, Molloy DW, Kearney PM, Clarke G. A systematic review of the psychobiological burden of informal caregiving for patients with dementia: Focus on cognitive and biological markers of chronic stress. Neurosci Biobehav Rev 2016; 73:123-164. [PMID: 27986469 DOI: 10.1016/j.neubiorev.2016.12.006] [Citation(s) in RCA: 151] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 10/28/2016] [Accepted: 12/09/2016] [Indexed: 12/18/2022]
Abstract
As the physiological impact of chronic stress is difficult to study in humans, naturalistic stressors are invaluable sources of information in this area. This review systematically evaluates the research literature examining biomarkers of chronic stress, including neurocognition, in informal dementia caregivers. We identified 151 papers for inclusion in the final review, including papers examining differences between caregivers and controls as well as interventions aimed at counteracting the biological burden of chronic caregiving stress. Results indicate that cortisol was increased in caregivers in a majority of studies examining this biomarker. There was mixed evidence for differences in epinephrine, norepinephrine and other cardiovascular markers. There was a high level of heterogeneity in immune system measures. Caregivers performed more poorly on attention and executive functioning tests. There was mixed evidence for memory performance. Interventions to reduce stress improved cognition but had mixed effects on cortisol. Risk of bias was generally low to moderate. Given the rising need for family caregivers worldwide, the implications of these findings can no longer be neglected.
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Affiliation(s)
- Andrew P Allen
- APC Microbiome Institute, Biosciences Institute, University College Cork, Cork, Ireland; Department of Psychiatry & Neurobehavioural Science, University College Cork, Cork, Ireland
| | - Eileen A Curran
- The Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, Cork, Ireland; Department of Epidemiology & Public Health, University College Cork, Cork, Ireland
| | - Áine Duggan
- School of Medicine, University College Cork, Cork, Ireland
| | - John F Cryan
- APC Microbiome Institute, Biosciences Institute, University College Cork, Cork, Ireland; Department of Anatomy & Neuroscience, University College Cork, Cork, Ireland
| | - Aoife Ní Chorcoráin
- Centre for Gerontology & Rehabilitation, University College Cork, Cork, Ireland
| | - Timothy G Dinan
- APC Microbiome Institute, Biosciences Institute, University College Cork, Cork, Ireland; Department of Psychiatry & Neurobehavioural Science, University College Cork, Cork, Ireland
| | - D William Molloy
- Centre for Gerontology & Rehabilitation, University College Cork, Cork, Ireland
| | - Patricia M Kearney
- The Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, Cork, Ireland; Department of Epidemiology & Public Health, University College Cork, Cork, Ireland
| | - Gerard Clarke
- APC Microbiome Institute, Biosciences Institute, University College Cork, Cork, Ireland; Department of Psychiatry & Neurobehavioural Science, University College Cork, Cork, Ireland.
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Marshall S, Reidlinger DP, Young A, Isenring E. The nutrition and food-related roles, experiences and support needs of female family carers of malnourished older rehabilitation patients. J Hum Nutr Diet 2016; 30:16-26. [DOI: 10.1111/jhn.12397] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- S. Marshall
- Faculty of Health Sciences and Medicine; Bond Institute of Health and Sport, Bond University; Robina Qld Australia
| | - D. P. Reidlinger
- Faculty of Health Sciences and Medicine; Bond Institute of Health and Sport, Bond University; Robina Qld Australia
| | - A. Young
- Royal Brisbane and Women's Hospital; Herston Qld Australia
| | - E. Isenring
- Faculty of Health Sciences and Medicine; Bond Institute of Health and Sport, Bond University; Robina Qld Australia
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Nguyen AW, Chatters LM, Taylor RJ, Mouzon DM. Social Support from Family and Friends and Subjective Well-Being of Older African Americans. JOURNAL OF HAPPINESS STUDIES 2016; 17:959-979. [PMID: 27212890 PMCID: PMC4869534 DOI: 10.1007/s10902-015-9626-8] [Citation(s) in RCA: 104] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Affiliation(s)
- Ann W Nguyen
- School of Social Work, Department of Psychology, University of Michigan, 530 Church Street, Room 3269 East Hall, Ann Arbor, MI 48109
| | - Linda M Chatters
- School of Public Health, School of Social Work, University of Michigan, 1415 Washington Heights, Room 3818 SPH I, Ann Arbor, MI 48109
| | - Robert Joseph Taylor
- School of Social Work, University of Michigan, 1080 South University Avenue, Room 3778 SSWB, Ann Arbor, MI 48109
| | - Dawne M Mouzon
- Edward J. Bloustein School of Planning and Public Policy, Institute for Health, Health Care Policy, and Aging Research, Rutgers, The State University of New Jersey, 33 Livingston Avenue, New Brunswick, NJ 08901
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Extended family and friendship support networks are both protective and risk factors for major depressive disorder and depressive symptoms among African-Americans and black Caribbeans. J Nerv Ment Dis 2015; 203:132-40. [PMID: 25594791 PMCID: PMC4310769 DOI: 10.1097/nmd.0000000000000249] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This study explores relationships between lifetime and 12-month Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) major depressive disorder (MDD), depressive symptoms, and involvement with family and friends within a national sample of African-American and Black Caribbean adults (n = 5191). MDD was assessed using the DSM-IV World Mental Health Composite International Diagnostic Interview and depressive symptoms were assessed using the Center for Epidemiologic Studies-Depression subscale and the K6. Findings indicated that among both populations, close supportive ties with family members and friends are associated with lower rates of depression and MDD. For African-Americans, closeness to family members was important for both 12-month and lifetime MDD, and both family and friend closeness were important for depressive symptoms. For Caribbean Blacks, family closeness had more limited associations with outcomes and was directly associated with psychological distress only. Negative interactions with family (conflict, criticisms), however, were associated with higher MDD and depressive symptoms among both African-Americans and Black Caribbeans.
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Pickering CE, Moon A, Pieters HC, Mentes JC, Phillips LR. Relationship management strategies for daughters in conflicted relationships with their ageing mothers. J Adv Nurs 2014; 71:609-19. [DOI: 10.1111/jan.12547] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2014] [Indexed: 11/26/2022]
Affiliation(s)
| | - Ailee Moon
- University of California Los Angeles; California USA
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Taylor RJ, Forsythe-Brown I, Taylor HO, Chatters LM. Patterns of Emotional Social Support and Negative Interactions among African American and Black Caribbean Extended Families. JOURNAL OF AFRICAN AMERICAN STUDIES (NEW BRUNSWICK, N.J.) 2014; 18:147-163. [PMID: 25580101 PMCID: PMC4286156 DOI: 10.1007/s12111-013-9258-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Affiliation(s)
| | | | - Harry Owen Taylor
- George Warren Brown School of Social Work Washington University in St. Louis
| | - Linda M Chatters
- School of Social Work School of Public Health Institute for Social Research University of Michigan
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Mosher CE, Bakas T, Champion VL. Physical health, mental health, and life changes among family caregivers of patients with lung cancer. Oncol Nurs Forum 2013; 40:53-61. [PMID: 23269770 DOI: 10.1188/13.onf.53-61] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To describe physical health, mental health, and life changes among family caregivers of patients with lung cancer. DESIGN Cross-sectional quantitative study. SETTING A university outpatient oncology center, two Veterans Affairs outpatient clinics, and a private outpatient oncology practice in Indianapolis, IN. SAMPLE 91 family caregivers of patients with lung cancer. METHODS Data were collected using standardized instruments and analyzed using descriptive statistics and hierarchical multiple regression. MAIN RESEARCH VARIABLES Demographic and medical factors, physical health, mental health, and life changes from caregiving. FINDINGS Caregivers' physical health and mental health were below population norms, whereas social functioning did not differ from norms. More than 50% of caregivers reported negative emotional effects of caregiving, and more than 33% reported negative physical health effects of caregiving. About 40% of caregivers, however, reported positive changes in their relationships with the patients with lung cancer and other family members as a result of caregiving. Caregivers' mental health was more strongly associated with life changes than physical health. CONCLUSIONS Findings suggest that many family caregivers of patients with lung cancer experience negative physical and mental health effects of caregiving, whereas relations with family members improve for a substantial minority of caregivers. These positive and negative consequences of caregiving should be jointly considered when developing self-report measures and interventions for this population. IMPLICATIONS FOR NURSING Nurses can conduct brief screening assessments to identify caregivers with probable distress and can provide practical and psychosocial support, as well as referrals to support services. KNOWLEDGE TRANSLATION Findings suggest that interventions are needed to address the negative physical and emotional health consequences of caring for family members with lung cancer. Such interventions could build on the relational benefits of caregiving to improve the patient-caregiver relationship and expand caregivers' support system.
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Affiliation(s)
- Catherine E Mosher
- Department of Psychology, Indiana University-Purdue University, Indianapolis, IN, USA.
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Suicide, negative interaction and emotional support among black Americans. Soc Psychiatry Psychiatr Epidemiol 2012; 47:1947-58. [PMID: 22534818 DOI: 10.1007/s00127-012-0512-y] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2011] [Accepted: 04/09/2012] [Indexed: 10/28/2022]
Abstract
OBJECTIVES This study is the first to investigate the relationship between perceived emotional support and negative interaction with family members and suicide ideation and attempts among African American and Caribbean black adults. METHOD Cross-sectional epidemiologic data from the National Survey of American Life and multivariable logistic regression analyses were used to examine the association between perceived emotional support and negative interaction and suicide behaviors among 3,570 African Americans and 1,621 Caribbean blacks age 18 and older. RESULTS Multivariate analyses found that perceived emotional support was associated with lower odds of suicide ideation and attempts for African Americans and Caribbean blacks. Negative interaction with family was associated with greater odds of suicide ideation among African Americans and Caribbean blacks. Ethnicity moderated the impact of emotional support and negative interaction on suicide attempts; among Caribbean blacks, those who reported more frequent emotional support from their family had a significantly greater reduced risk for suicide attempts than African Americans. The effect of negative interaction on suicide attempts was also more pronounced for Caribbean blacks compared to African Americans. DISCUSSION Negative interaction was a risk factor for suicide ideation and emotional support was a protective factor for attempts and ideation. These associations were observed even after controlling for any mental disorder. The findings demonstrate the importance of social relationships as both risk and protective factors for suicide and ethnic differences in suicidal ideation and attempts among black Americans.
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Chattillion EA, Ceglowski J, Roepke SK, von Känel R, Losada A, Mills PJ, Romero-Moreno R, Grant I, Patterson TL, Mausbach BT. Pleasant events, activity restriction, and blood pressure in dementia caregivers. Health Psychol 2012; 32:793-801. [PMID: 22888824 DOI: 10.1037/a0029412] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE A combination of high engagement in pleasurable activities and low perceived activity restriction is potentially protective for a number of health and quality of life outcomes. This study tests the newly proposed Pleasant Events and Activity Restriction (PEAR) model to explain level of blood pressure (BP) in a sample of elderly dementia caregivers. METHODS This cross-sectional study included 66 caregivers, ≥55 years of age, providing in-home care to a relative with dementia. Planned comparisons were made to assess group differences in BP between caregivers reporting high engagement in pleasant events plus low perceived activity restriction (HPLR; n = 22) to those with low pleasure plus high restriction (LPHR; n = 23) or those with either high pleasure plus high restriction or low pleasure plus low restriction (HPHR/LPLR; n = 21). RESULTS After adjustments for age, sex, body mass index, use of antihypertensive medication, physical activity, and number of health problems, HPLR participants (86.78 mm|Hg) had significantly lower mean arterial pressure compared with LPHR participants (94.70 mm|Hg) (p = .01, Cohen's d = 0.89) and HPHR/LPLR participants (94.84 mm|Hg) (p = .023, d = 0.91). Similar results were found in post hoc comparisons of both systolic and diastolic BP. CONCLUSIONS This study extends support for the PEAR model to physical health outcomes. Differences in BP between the HPLR group and other groups were of large magnitude and thus clinically meaningful. The findings may inform intervention studies aimed at investigating whether increasing pleasant events and lowering perceived activity restriction may lower BP.
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Affiliation(s)
- Elizabeth A Chattillion
- Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, CA, USA
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Lincoln KD, Taylor RJ, Bullard KM, Chatters LM, Woodward AT, Himle JA, Jackson JS. Emotional support, negative interaction and DSM IV lifetime disorders among older African Americans: findings from the National Survey of American Life (NSAL). Int J Geriatr Psychiatry 2010; 25:612-21. [PMID: 20157904 PMCID: PMC2955427 DOI: 10.1002/gps.2383] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVES Both emotional support and negative interaction with family members have been linked to mental health. However, few studies have examined the associations between emotional support and negative interaction and psychiatric disorders in late life. This study investigated the relationship between emotional support and negative interaction on lifetime prevalence of mood and anxiety disorders among older African Americans. DESIGN The analyses utilized the National Survey of American Life. METHODS Logistic regression and negative binomial regression analyses were used to examine the effect of emotional support and negative interaction with family members on the prevalence of lifetime DSM-IV mood and anxiety disorders. PARTICIPANTS Data from 786 African Americans aged 55 years and older were used. MEASUREMENT The DSM-IV World Mental Health Composite International Diagnostic Interview (WMH-CIDI) was used to assess mental disorders. Three dependent variables were investigated: the prevalence of lifetime mood disorders, the prevalence of lifetime anxiety. RESULTS Multivariate analysis found that emotional support was not associated with any of the three dependent variables. Negative interaction was significantly and positively associated with the odds of having a lifetime mood disorder, a lifetime anxiety disorder and the number of lifetime mood and anxiety disorders. CONCLUSIONS This is the first study to investigate the relationships among emotional support, negative interaction with family members and psychiatric disorders among older African Americans. Negative interaction was a risk factor for mood and anxiety disorders among older African Americans, whereas emotional support was not significant.
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Affiliation(s)
- Karen D Lincoln
- School of Social Work, University of Southern California, Los Angeles, CA, USA.
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Lincoln KD, Takeuchi DT. Variation in the trajectories of depressive symptoms: results from the Americans' Changing Lives Study. BIODEMOGRAPHY AND SOCIAL BIOLOGY 2010; 56:24-41. [PMID: 20589986 PMCID: PMC2998763 DOI: 10.1080/19485561003709180] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
This study examines the association between race and depressive symptoms over a 16-year study period. The analysis is based on the responses of 3485 African-American and White respondents from four waves of the Americans' Changing Lives Panel Study. Growth mixture modeling was used to identify latent trajectory classes based on the reported levels of depressive symptoms over 16 years. Four latent trajectory classes were identified: two "high-risk" groups and two "low-risk" groups. Findings show the heterogeneity among and within racial groups in their trajectories of depressive symptoms and the distinct demographic and social relationship predictors for symptom trajectories.
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Affiliation(s)
- Karen D Lincoln
- School of Social Work, University of Southern California, Los Angeles, California 90089-0411, USA.
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Pruchno RA, Brill JE, Shands Y, Gordon JR, Genderson MW, Rose M, Cartwright F. Convenience Samples and Caregiving Research: How Generalizable Are the Findings? THE GERONTOLOGIST 2008; 48:820-7. [DOI: 10.1093/geront/48.6.820] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Kim Y, Given BA. Quality of life of family caregivers of cancer survivors: across the trajectory of the illness. Cancer 2008; 112:2556-68. [PMID: 18428199 DOI: 10.1002/cncr.23449] [Citation(s) in RCA: 303] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Cancer affects not only the quality of life (QOL) of individuals with the disease but also that of their family members and close friends. The impact on various aspects of the family caregivers' QOL is significant throughout the trajectory of the illness. The authors reviewed literature on the QOL of family caregivers at the acute and middle- to long-term survivorship phases as well as the bereavement phase. METHODS By using several databases, the authors searched the literature published in English from 1996 through July 2007. Keywords searched included cancer, carcinoma, family, family member, caregivers, and quality of life. Several criteria were used to guide the literature review: Articles had to be published in refereed journals and had to use rigorous methods, sample, and validated measures. RESULTS The findings suggested that the QOL of family caregivers of individuals with cancer varies along the illness trajectory. This highlights were importance of assessing the ongoing adjustment of the caregivers over time. However, there were few theory-driven studies, and significant gaps remain in the current understanding of the effects of family caregiving beyond the time of diagnosis and treatment. CONCLUSIONS Accumulating evidence has supported the concept that cancer affects not only the patients/survivors but also their family members. However, theoretically and methodologically rigorous research on various aspects of the family's QOL, including not only the psychological but also the physical, spiritual, and behavioral adjustment to cancer in the family, remains sparse. Family-based interventions across the trajectory of the illness also are needed.
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Affiliation(s)
- Youngmee Kim
- Behavioral Research Center, American Cancer Society, Atlanta, Georgia 30303-1002, USA.
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Spousal caregivers of patients with Alzheimer's disease show longitudinal increases in plasma level of tissue-type plasminogen activator antigen. Psychosom Med 2007; 69:816-22. [PMID: 17942832 DOI: 10.1097/psy.0b013e318157d461] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To determine if caregivers of spouses with Alzheimer's disease demonstrate greater increase in tissue plasminogen activator (t-PA) antigen relative to noncaregiving controls. Caring for a spouse with Alzheimer's disease has been associated with increased mortality and reduced time to developing cardiovascular disease (CVD), possibly due to impaired fibrinolysis resulting from chronic stress. METHODS Annual in-home assessments of plasma t-PA antigen were collected from 165 participants (112 caregivers and 53 noncaregivers) enrolled in the University of California, San Diego Alzheimer caregiver study. Participants were married, living with their spouses, at least 55 years of age, and free of serious medical conditions (e.g., cancer). Caregivers provided in-home care for their spouse with Alzheimer's disease at the time of enrollment. Exclusion criteria included taking anticoagulant medication or evidenced severe hypertension (>200/120 mm Hg). Mixed (random effects) regression was used to assess slopes for t-PA antigen over the study period at the same time controlling for medical and demographic characteristics associated with t-PA antigen. RESULTS Caregivers demonstrated significantly greater increases in t-PA antigen over the 5-year study period compared with noncaregiving controls (p = .02), even when controlling for body mass index, mean blood pressure, age, gender, and use of CVD medication. CONCLUSIONS The accelerated rate of developing a prothrombotic environment including elevated t-PA antigen may provide one mechanism by which caregiving is associated with greater morbidity and mortality and the development of CVD.
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Kim Y, Baker F, Spillers RL. Cancer caregivers' quality of life: effects of gender, relationship, and appraisal. J Pain Symptom Manage 2007; 34:294-304. [PMID: 17572056 DOI: 10.1016/j.jpainsymman.2006.11.012] [Citation(s) in RCA: 138] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2006] [Revised: 11/04/2006] [Accepted: 11/08/2006] [Indexed: 10/23/2022]
Abstract
The objective of this study was to examine caregivers' gender and relationship to the cancer survivor as plausible predictors of their appraisals of providing care, and to further examine the association of the caregivers' appraisal with their own quality of life. Of the 739 caregivers who participated in the American Cancer Society's Quality of Life Survey for Caregivers, 627 were either the spouse or the offspring of a cancer survivor. Of those, 448 who provided complete information on study variables were included in this study. Multivariate analyses revealed that male caregivers were more likely to appraise the caregiving experience as boosting their self-esteem (positive) than female caregivers, whereas adult daughters appraised the experience as stressful (negative), and sons appraised the experience as the least stressful. More importantly, caregivers' esteem and caregiving stress were strong predictors of the caregivers' quality of life. These effects were significant after controlling for potentially confounding variables. The findings suggest that cancer caregivers may benefit from programs designed to assist them in viewing their involvement in cancer care as meaningful and as a personal growth experience, as well as helping them to seek support to minimize their caregiving stress.
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Affiliation(s)
- Youngmee Kim
- Behavioral Research Center, American Cancer Society, Atlanta, Georgia 30303, USA.
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A Proposed Theoretical Framework Addressing the Effects of Informal Caregivers on Health-Related Outcomes of Elderly Recipients in Home Health Care. Asian Nurs Res (Korean Soc Nurs Sci) 2007; 1:23-34. [DOI: 10.1016/s1976-1317(08)60006-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Kim Y, Carver CS. Frequency and difficulty in caregiving among spouses of individuals with cancer: effects of adult attachment and gender. Psychooncology 2007; 16:714-23. [PMID: 17096451 DOI: 10.1002/pon.1110] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
How caregivers relate to care recipients can affect how well care is provided and how much burden is experienced in providing it. We conceptualized the relationship of spousal caregivers via adult attachment theory and examined how attachment qualities of caregivers related to level of caregiving involvement and difficulties in caregiving. Gender differences in the associations were also explored. From participants in the ACS Quality of Life Survey for Caregivers, 400 spousal caregivers provided valid data for the study variables. Findings indicated that frequency of various types of care was a joint function of attachment orientation and gender. In contrast, the difficulty that caregivers experienced in providing care related directly to attachment, without moderation by gender. Our findings suggest that ineffective caregivers of cancer patients, who can be identified by their attachment orientation and/or gender, may benefit from educational programs to improve their caregiving skills and to encourage them to utilize resources from other family members or community.
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Affiliation(s)
- Youngmee Kim
- Behavioral Research Center, American Cancer Society, 1599 Clifton Rd., NE, Atlanta, GA 30329-4251, USA.
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Kim Y, Loscalzo MJ, Wellisch DK, Spillers RL. Gender differences in caregiving stress among caregivers of cancer survivors. Psychooncology 2006; 15:1086-92. [PMID: 16634112 DOI: 10.1002/pon.1049] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Despite a growing body of research on male caregivers, limited information is available on male caregivers of cancer survivors. Furthermore, few studies have examined the unique contribution of caregiver esteem as well as care-recipient's functional status as potential mediators of the link between gender and caregiving stress. Thus, the present study examines how the caregiver's perception of providing care to a spouse with cancer differs by gender. The proposed mediators, caregiver's esteem and care-recipient's psychosocial and physical functioning, were tested simultaneously, utilizing structural equation modeling. Results revealed that both caregiver's esteem and care-recipient's psychosocial functioning were significant mediators, but in different directions. Specifically, husband caregivers reported higher caregiver's esteem, which resulted in reporting less stress from providing care to their wife with cancer. On the other hand, when husband caregivers provided care to their wife with poorer psychosocial functioning, they reported greater stress from caregiving. Husband caregivers will benefit from programs designed to educate them to effectively assist their wife's psychosocial adjustment to cancer by reducing their stress from providing care.
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Affiliation(s)
- Youngmee Kim
- Behavioral Research Center, American Cancer Society, Atlanta, GA 30329-4251, USA.
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