Publication Abstract Display
Type: Published Abstract
Title: Fibrin turnover (plasma D-dimer) is higher in Alzheimer caregivers than in non-caregiving controls.
Authors: , Dimsdale JE, Adler KA, Patterson TL, Grant I
Year: 2003
Publication: Psychosomatic Medicine
Volume: 65 Issue: 1 Pages: A23
Abstract:The burden of providing care for a spouse with Alzheimer’s disease has been associated with increased risk for coronary artery events. We have recently proposed that D-dimer, a marker of fibrin turnover that is prospectively associated with atherothrombotic events, may constitute a marker of psychosocial distress. We hypothesized that dementia caregivers might show higher fibrin-turnover than non-caregiving controls. Subjects were 46 (29 female, 17 male) elderly (mean age±SD, 72±9years) spousal Alzheimer caregivers and 20 non-caregiving age- and gender-matched controls, who had been recruited to participate in a longitudinal study of biological and psychosocial adaptation to caregiving. At study entry, all participants had a blood sample drawn between 8:30 and 10:30 am following a 15-min rest period. Plasma D-dimer levels were measured by an enzymelinked immunosorbent assay. D-dimer was significantly higher in caregivers than in non-caregiving controls (688±575 vs. 406±175 ng/ml; p=.021). There were no significant differences in the proportion of cardiovascular diseases and risk factors (body mass index, hypertension status, smoking status, diabetes, and hypercholesterolemia) between groups, which might have accounted for that difference. Also, the same percentage of caregivers and non-caregivers took a non-steroidal anti-inflammatory drug or hormone replacement therapy with premarin (women only). The finding suggests that Alzheimer caregivers have increased fibrin turnover as compared to non-caregiving controls independent from demographic variables, established cardiovascular risk factors, and medications known to affect plasma D-dimer levels. Such increased clotting diathesis might contribute to increased cardiovascular risk and overall mortality with caregiving strain.

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