Resumen de Cardiometabolic Effects in Caregivers of Nursing Home Placement and Death of Their Spouse with Alzheimer's Disease
Roland von Känel, Brent T. Mausbach, Joel E. Dimsdale, Paul J. Mills, Thomas Patterson, Sonia Ancoli Israel, Michael G. Ziegler, Susan K. Roepke, Elizabeth A. Chattillion, Matthew Allison, Igor Grant
Objectives: To test the hypothesis that cardiometabolic risk is attenuated when caregivers are relieved of caregiving stress when the caregiving recipient transitions out of the home.
Design: Longitudinal.
Setting: Participants� homes.
Participants: One hundred nineteen spousal caregivers of a patient with Alzheimer's disease (AD) and 55 noncaregiving controls (mean age of entire sample 75 ± 8, 68% women).
Measurements: Participants underwent up to three yearly assessments of metabolic syndrome (MetS) factors related to adiposity, dyslipidemia, hypertension, and hyperglycemia. Changes in the total number of MetS factors (range: 0�5) 3 months after caregiver transitions were evaluated using random regression models with fixed and time-variant effects for sociodemographic and health-related covariates.
Results: Caregivers had a greater number of MetS factors over time than noncaregivers (1.78 ± 0.13 vs 1.36 ± 0.18, P = .008), which, after the death of the spouse, dropped by 0.46 ± 0.16 (P = .003) being no longer different from those of noncaregivers; this effect was most prominently related to decreases in triglycerides (-22.2 ± 11.0 mg/dL, P = .03), systolic blood pressure (-6.2 ± 2.6 mmHg, P = .02), and diastolic blood pressure (-3.4 ± 1.5 mmHg, P = .03). Placement of the spouse decreased the number of MetS factors only in caregivers with lower levels of depressive symptoms (-0.48 ± 0.18, P = .01) and sleeping difficulties (-0.42 ± 0.18, P = .02) but not in caregivers with higher levels in these measures at postplacement.
Conclusion: High cardiometabolic risk in caregivers decreased to the level of that of noncaregivers within 3 months of death of the spouse with AD, although placement, a transition in the course of dementia caregiving, did not benefit cardiovascular health in highly distressed caregivers.
