Publication Abstract Display
Type: Published Manuscript
Title: Carotid plaque in Alzheimer caregivers and the role of sympatho-adrenal arousal.
Authors: Roepke SK
Year: 2011
Publication: Psychosomatic Medicine
Volume: 73 Issue: Pages: 206-213
Abstract:Objective: Providing care for a spouse diagnosed 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. We hypothesized that Alzheimer caregivers would have increased prevalence of carotid artery plaque compared to non-caregiving controls and that prolonged sympatho-adrenal arousal to acute stress would relate to this difference. Methods: Participants were 111 spousal caregivers (74±8 years of age, 69% women) to patients with Alzheimer’s disease and 51 non-caregiving controls (75±6 years of age, 69% women). In-home assessment of carotid artery plaque via B-mode ultrasonography was conducted. Plasma catecholamine response to an acute speech stressor task was also measured. Results: Logistic regression indicated that caregiving status (i.e., caregiver vs. non-caregiver) was significantly associated with a 2.2 times greater odds for the presence of plaque independent of other risk factors of atherosclerosis (95% CI=1.01-4.73, p=.048). Decreased recovery to basal levels of epinephrine after a psychological stress task was significantly associated with the presence of plaque in caregivers, but not in non-caregivers. Norepinephrine recovery post-stressor was not associated with plaque in either group. Conclusions: Caregivers had a higher prevalence of carotid plaque compared to non-caregivers. Poorer epinephrine recovery after acute stress was associated with the presence of plaque in caregivers but not in non-caregivers. A prolonged sympatho-adrenal response to acute stress might enhance the development of atherosclerosis in chronically stressed Alzheimer caregivers. Key Words: caregiving, stress, Alzheimer’s disease, carotid artery plaque; atherosclerosis; catecholamines. Abbreviations: BMI=body mass index; CDC=Centers for Disease Control; CESD=Center for Epidemiologic Studies Depression Scale; CHD=coronary heart disease; IMT=intima-media thickness; MAP=mean arterial pressure; RAPA=Rapid Assessment of Physical Activity; UCSD=University of California, San Diego.

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