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Physiological and functional consequences of caregiving for relatives with dementia
Open accessAbstract
BACKGROUND: Chronic stress negatively affects health and well-being. A growing population of informal dementia caregivers experience chronic stress associated with extraordinary demands of caring for a relative with dementia. This review summarizes physiological and functional changes due to chronic dementia caregiver stress. METHODS: A literature search for papers assessing effects of dementia caregiving was conducted focusing on publications evaluating differences between caregivers and non-caregivers in objective measures of health and cognition. RESULTS: The review identified 37 studies describing data from 4,145 participants including 749 dementia caregivers and 3,396 non-caregiver peers. Objective outcome measures affected in dementia caregivers included markers of dyscoagulation, inflammation, and cell aging as well as measures of immune function, sleep, and cognition. Though diverse in designs, samples, and study quality, the majority of the studies indicated increased vulnerability of dementia caregivers to detrimental changes in health and cognition. Demographic and personality characteristics moderating or mediating effects of chronic stress in caregivers were also reviewed. CONCLUSIONS: There is accumulating evidence that chronic dementia caregiver stress increases their vulnerability to disease and diminishes their ability to provide optimal care. Clinicians and society need to appreciate the extent of deleterious effects of chronic stress on dementia caregiver health.
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“Evidence suggests that the stress of providing dementia care increases caregivers' susceptibility to disease and health complications.505”
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“Evidence suggests that the stress of providing dementia care increases caregivers’ susceptibility to disease and health complications. 551”
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“Specifically, family caregivers of PWD were found to have higher risks of atherosclerosis [34–37], poorer physical health conditions [4,10,38], cognitive impairments [6–9], and poorer psychological health including stress [39], depression, and anxiety [13,40–42].”
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“…to disease, irregular levels of stress hormones/increased allostatic load, and higher morbidity (Aneshensel et al., 1995; Cuijpers, 2005; Fonareva & Oken, 2014; Hinrichsen & Zweig, 1994; Mausbach et al., 2013; Perkins et al., 2013; Pinquart & Sörensen, 2006; Schulz & Beach, 1999; von…”
“IT TOOK THE STRESS OUT OF GETTING HELP”: THE STAR-CTELEMEDICINE MIXED METHODS PILOT
Lindauer, A., Croff, R., Mincks, K., Mattek, N., Shofner, S. J., Bouranis, N., & Teri, L. L. (2018) · Care weekly · doi:10.14283/cw.2018.10 · Cited by 22
Miller, L. M., Utz, R., Supiano, K. P., Lund, D. A., & Caserta, M. S. (2020) · Social Science & Medicine · doi:10.1016/j.socscimed.2020.113455 · Cited by 22
Shin, J. H., & Kim, J. H. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph192316252 · Cited by 23
“More specifically, the family caregivers of patients with various dementia disorders were more likely to have an increased risk of cardiovascular diseases [74–76], poor physical health status [13,16,24], poor psychological health status including strain, depression, and anxiety [25,77–79], sleep disturbances and poor…”
BackgroundSacco, L., Leineweber, C., & Platts, L. G. (2017) · SLEEP · doi:10.1093/sleep/zsx198 · Cited by 21
Dean, G. E., Weiss, C., Morris, J. L., & Chasens, E. R. (2017) · Nursing Clinics of North America · doi:10.1016/j.cnur.2017.04.009 · Cited by 22
Ribeiro, F. E. D. M., Moreno-Cámara, S., da-Silva-Domingues, H., Moral, P. Á. P., & Casado, R. D. P. (2024) · Healthcare · doi:10.3390/healthcare12151494 · Cited by 34
Preliminary Evidence for Effectiveness of Resourcefulness Training in Women Dementia Caregivers.
Zauszniewski, J. A., Lekhak, N., Burant, C. J., Variath, M., & Morris, D. L. (2016) · PubMed · Cited by 20
Moretta, P., Masotta, O., Crispino, E., Castronovo, G., Ruvolo, S., Montalbano, C., Loreto, V., Trojano, L., & Estraneo, A. (2017) · Brain Injury · doi:10.1080/02699052.2017.1290278 · Cited by 20
“Even if we did not measure cortisol levels in our participants, their stressful condition was clearly demonstrated by indirect indexes of psychological distress, such as depressive symptoms, anxiety, psychophysiological distress and perceived burden, to an extent comparable to that described in caregivers of demented…”
ResultLa dependencia: efectos en la salud familiar
Fernández, M. E. E., Gil‐Lacruz, A. I., Gil‐Lacruz, M., & López, A. V. (2017) · Atención Primaria · doi:10.1016/j.aprim.2016.12.007 · Cited by 22
Thomas, N., Lindauer, A., & Kaye, J. A. (2019) · Dementia and Geriatric Cognitive Disorders · doi:10.1159/000497805 · Cited by 20
Time use by family caregivers of elderly with dementia: an integrative review
Carvalho, E. B., & Neri, A. L. (2018) · Revista Brasileira de Enfermagem · doi:10.1590/0034-7167-2017-0268 · Cited by 19
Wennberg, A. M. V., Anderson, L. R., Cagnin, A., Chen-Edinboro, L. P., & Pini, L. (2023) · Frontiers in Public Health · doi:10.3389/fpubh.2023.1130099 · Cited by 20
“Decades of evidence have shown that the stress and burden of caregiving is associated with poorer physical and mental health outcomes in caregivers (6).”
BackgroundDementia Caregiver Insights on Use of Assistive Technologies
Mikula, C. M., Perry, C., Boone, A. E., Benge, J. F., Scullin, M. K., & Kiselica, A. M. (2022) · Work Aging and Retirement · doi:10.1093/workar/waac027 · Cited by 18
Testing Tele‐Savvy: Protocol for a randomized controlled trial
Kovaleva, M. A., Bilsborough, E., Griffiths, P. C., Nocera, J. R., Higgins, M. K., Epps, F. R., Kilgore, K. M., Lindauer, A., Morhardt, D., Shah, R. C., et al. (2018) · Research in Nursing & Health · doi:10.1002/nur.21859 · Cited by 18
“Many caregivers experience poor physical and psychological health (Coffman, Resnick, & Lathan, 2017; Fonareva & Oken, 2014; Pinquart & Sörensen, 2007); compromised immune response (Bennett, Fagundes, & Kiecolt-Glaser, 2012); and strained employment and financial hardships (Alzheimer's Association,…”
BackgroundElderly Who Care for Elderly: DoubleVulnerability and Quality of Life
Flesch, L. D., Batistoni, S. S. T., Neri, A. L., & Cachioni, M. (2020) · Paidéia (Ribeirão Preto) · doi:10.1590/1982-4327e3003 · Cited by 18
Rural Caregivers: Identification of Informational Needs Through Telemedicine Questions
Bardach, S. H., Gibson, A., Parsons, K., Stauffer, A., & Jicha, G. A. (2020) · The Journal of Rural Health · doi:10.1111/jrh.12431 · Cited by 19
Moholt, J.-M., Friborg, O., Skaalvik, M. W., & Henriksen, N. O. (2018) · SAGE Open Medicine · doi:10.1177/2050312118792812 · Cited by 17
Pozet, A., Lejeune, C., Bonnet, M., Dabakuyo‐Yonli, T. S., Dion, M., Fagnoni, P., Gaimard, M., Imbert, G., Nerich, V., Foubert, A., et al. (2016) · Trials · doi:10.1186/s13063-016-1622-8 · Cited by 17
Leszko, M., & Allen, D. J. (2023) · The Journals of Gerontology Series B · doi:10.1093/geronb/gbad086 · Cited by 15
Moholt, J.-M., Friborg, O., Henriksen, N. O., Hamran, T., & Blix, B. H. (2020) · Ageing and Society · doi:10.1017/s0144686x2000015x · Cited by 15
“, 2016) and increase the risk of physical ailments (Fonareva and Oken, 2014).”
BackgroundLucero, R. J., Yoon, S., Suero-Tejeda, N. M., Arcia, A., Iribarren, S., Mittelman, M. S., Luchsinger, J. A., & Henry, S. B. (2022) · JAMIA Open · doi:10.1093/jamiaopen/ooab114 · Cited by 14
Lucero, R. J., Jaime-Lara, R. B., Cortés, Y. I., Kearney, J. A., Granja, M. R., Suero-Tejeda, N. M., Henry, S. B., & Luchsinger, J. A. (2018) · Hispanic Health Care International · doi:10.1177/1540415318819220 · Cited by 13
“The experience of these emotional challenges can make IDCs vulnerable to physical health complications (Fonareva & Oken, 2014).”
BackgroundKlein, O. A., Boekholt, M., Afrin, D., Dornquast, C., Dreier, A., Keller, A., Michalowsky, B., Zwingmann, I., Teipel, S. J., Thyrian, J. R., et al. (2021) · Trials · doi:10.1186/s13063-021-05290-w · Cited by 15
“Family caregivers of people with dementia are likely to suffer from a range of health problems, such as depression, anxiety and physical illnesses [8, 9], as well as other negative conditions, such as social isolation, financial strain and poor quality of life [8, 10].”
BackgroundDuRant, S. E., de Bruijn, R., Tran, M. N., & Romero, L. M. (2016) · General and Comparative Endocrinology · doi:10.1016/j.ygcen.2016.03.009 · Cited by 13
Melo, G., Marôco, J. P., Basto, M. L., & de Mendonça, A. (2016) · Geriatric Nursing · doi:10.1016/j.gerinurse.2016.08.001 · Cited by 13
The role of caregiving in cognitive function and change: The REGARDS study.
Elayoubi, J., Nelson, M. E., Mu, C., Haley, W. E., Wadley, V. G., Clay, O. J., Crowe, M. G., Cushman, M., Grant, J. S., Roth, D. L., et al. (2023) · Psychology and Aging · doi:10.1037/pag0000766 · Cited by 12
Williamson, H. J., Begay, A. B., Dunn, D. J., Bacon, R. J., Remiker, M. W., Garcia, Y. E., McCarthy, M. J., & Baldwin, J. A. (2022) · The Qualitative Report · doi:10.46743/2160-3715/2022.5193 · Cited by 12
Hedman, R., Norberg, A., & Hellström, I. (2017) · Dementia · doi:10.1177/1471301217706268 · Cited by 12
Clarke, R., Farina, N., Chen, H. L., & Rusted, J. M. (2020) · Journal of Applied Gerontology · doi:10.1177/0733464820917861 · Cited by 12
“In addition, Lamont et al. (2019) reported that, controlling for age, sex, and number of hours of caregiving, self-efficacy, optimism, and self-esteem were independently associated with capability of carers of PwD to “live well.””
BackgroundInfluentialFekete, M., Szabó, Á., Stephens, C. V., & Alpass, F. (2017) · Dementia · doi:10.1177/1471301217725897 · Cited by 12
Klein, A. Z., Magge, A., O’Connor, K., & Gonzalez‐Hernandez, G. (2022) · JMIR Aging · doi:10.2196/39547 · Cited by 11
“For instance, compared with noncaregivers, they are more vulnerable to disease due to chronic stress [5] and have lower durations and quality of sleep [6].”
BackgroundEpisodic memory and executive functioning in informal dementia caregivers
Jütten, L. H., Mark, R. E., & Sitskoorn, M. M. (2019) · Aging & Mental Health · doi:10.1080/13607863.2019.1617242 · Cited by 11
Metadata
- Authors
- Fonareva, I., & Oken, B. S.
- Affiliations
- Oregon Health & Science University (US)
- Corresponding author
- Oken, Barry S.
- ORCID
- Oken, Barry S.
- Venue
- International Psychogeriatrics
- Publisher
- Elsevier BV
- Published
- 2014-05
- Volume
- 26
- Issue
- 5
- Pages
- 725-747
- ISSN
- 1041-6102 (ISSN-L)
- PMC
- PMC3975665
- OpenAlex
- W2125058262
- Cited by
- 249
- References
- 50
- Citations by year
- 2026: 21 · 2025: 19 · 2024: 17 · 2023: 19 · 2022: 21 · 2021: 36 · 2020: 31 · 2019: 21 · 2018: 23 · 2017: 19 · 2016: 13 · 2015: 5 · 2014: 2
- FWCI
- 1.79
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- International Psychogeriatrics (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- National Institute on Aging (P30AG008017)
- National Institute on Drug Abuse (T32DA007262)
- National Center for Complementary and Integrative Health (F31AT006647, T32AT002688, K24AT005121)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Nursing › Research and Theory › Nursing care and research
- Social Sciences › Psychology › Clinical Psychology › Family Caregiving in Mental Illness
- Keywords
- dementia caregiving, informal caregivers, chronic stress, caregiver health, inflammation, cellular aging, immune function, sleep, cognition, personality moderators, caregiver burden
- MeSH terms
- Aged, Dementia, Female, General Adaptation Syndrome, Humans, Male, Stress, Physiological, Stress, Psychological, Time, Caregivers, Outcome Assessment, Health Care
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