Caregivers are individuals who are responsible for the physical well-being of a family member. Caregivers in general are more likely to experience increased stress than noncaregivers. But for those who care for a loved one with Alzheimer’s, heart disease and depression are two main concerns. Previous research has shown that depression can put people at risk for cardiovascular disease (CVD), including caregivers, as measured by their sympathetic nervous system. Specifically, researchers can use a noninvasive technique called brachial artery flow-mediated dilation (FMD) to evaluate the lining of the heart. Studies that have used this method have shown that the bidirectional relationship between stress and depression in caregivers increases their risk for CVD. But few studies have looked at which factors specifically led to the depressive symptoms or elevated stress. Therefore, Brent T. Mausbach of the Department of Psychiatry at the University of California San Diego at La Jolla recently conducted a study that examined the levels of depression and stress in 116 elderly caregivers. Using the FMD technique, Mausbach evaluated the participants, all of whom cared for a spouse with Alzheimer’s, three times over one year. He also measured their negative and positive affect and recorded how much leisure activity they engaged in.
The study revealed that the caregivers who participated in leisure activities had lower levels of stress than those who did not. Mausbach also found that depression did not significantly affect FMD, suggesting that the pathway by which CVD risk is increased is through stress that is independent of depressive symptoms. Although more than one-third of the caregivers did exhibit clinical levels of depression, Mausbach believes it is the lack of leisure activity, perhaps resulting from the guilt associated with depression, that leads to negative affect and increased stress in the caregivers. Mausbach also noted that the link between depression and FMD was much weaker in his sample of non-CVD participants than has been found in general population individuals with CVD. These findings demonstrate that caregivers should be engaged in activities that increase their positive affect in order to protect themselves from the risk of depression, stress, and even CVD. Mausbach hopes these results will help clinicians design focused treatments for caregivers. He added, “In particular, therapies that emphasize engagement in enjoyable activities may be associated with better FMD over time.”
Mausbach, B. T., Chattillion, E., Roepke, S. K., Ziegler, M. G., Milic, M., von Känel, R., et al. (2012). A longitudinal analysis of the relations among stress, depressive symptoms, leisure satisfaction, and endothelial function in caregivers. Health Psychology. Advance online publication. doi: 10.1037/a0027783
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