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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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“Several review papers have reported the same, finding caregivers to be more compromised than non-caregivers across a wide spectrum of cognitive domains (Fonareva & Oken, 2014; Romero-Martínez et al., 2020).”
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Jeong, H. Y., Park, S. Y., Kim, J. L., Kim, S. Y., & Jeon, S. Y. (2025) · Journal of Alzheimer s Disease Reports · doi:10.1177/25424823251322499 · Cited by 1
The Dementia Care Partner Hub: An innovative approach to addressing unmet social and health needs
Gelmon, S. B., Reed, J., & Dawson, W. D. (2025) · Alzheimer s & Dementia Behavior & Socioeconomics of Aging · doi:10.1002/bsa3.70010 · Cited by 1
Life satisfaction of carers of people with dementia of the Alzheimer type.
Sołtys, A. (2025) · Psychiatria Polska · doi:10.12740/pp/188810 · Cited by 2
Inflammation impacts the relationship between gait speed and cognitive function in caregivers
Morgan, E., Savettiere, A., Lam, J. C., Gomez, R. G., Schulte, T., & Fairchild, J. K. (2025) · Applied Neuropsychology Adult · doi:10.1080/23279095.2025.2507846 · Cited by 1
Carlozzi, N. E., Freeman, J. L., GRAVES, C. M., Leggett, A. N., Miner, J. A., & Capellari, E. C. (2025) · BMJ Open · doi:10.1136/bmjopen-2025-100051 · Cited by 1
Osei-Owusu, H., Ofori‐Dua, K., Forkuor, J. B., & Kontor, A. O. (2026) · Journal of Gerontological Social Work · doi:10.1080/01634372.2025.2611759 · Cited by 1
Yu, R., Yu, M., Tong, C., Ho, F., Hui, A., Lui, E., & Woo, J. (2026) · The Journal of Frailty & Aging · doi:10.1016/j.tjfa.2025.100126 · Cited by 1
“These dual burdens increase the likelihood of neglecting personal health needs, as competing demands divert attention from preventive care [4].”
Psychological Flexibility in Dementia Caregiving: The Adaptive Support Model
Green, G., Batura, J., Kelley, H. H., Bradford, K. P., & Fauth, E. B. (2026) · Journal of Family Theory & Review · doi:10.1111/jftr.70054 · Cited by 1
Bharti, J. (2026) · Amrita Journal of Medicine · doi:10.4103/amjm.amjm_73_25 · Cited by 1
Carlozzi, N. E., Lombard, W. L., Fansher, M., Freeman, J. L., Capellari, E. C., GRAVES, C. M., Miner, J. A., Hampstead, B. M., Lai, J., & Leggett, A. N. (2026) · Frontiers in Dementia · doi:10.3389/frdem.2026.1824829 · Cited by 1
Neuropsychiatric symptoms of dementia and caregiver burden: a systematic review and meta-regression
Moura, C. B., Maria, A. C. L., Calazans, L. L., Sena, L., Leite, M. G. H. S. J., González, F. R., de Castro, M. N. F. L., & da Costa, R. Q. M. (2026) · Dementia & Neuropsychologia · doi:10.1590/1980-5764-dn-2025-0369 · Cited by 1
“Caregivers may struggle to comfort the patient, and the inability to alleviate the patient’s distress can lead to feelings of helplessness or frustration 29 .”
Busted, L. M., Nielsen, D. S., & Birkelund, R. (2019) · Open Journal of Nursing · doi:10.4236/ojn.2019.911085 · Cited by 1
“The review also asserted that it might be useful to start viewing dementia caregiving as a health hazard [9].”
BackgroundAntheunissen, T., Bakker, A. J. E. M., & Collet, J. (2020) · Tijdschrift voor Gerontologie en Geriatrie · doi:10.36613/tgg.1875-6832/2020.02.08 · Cited by 1
Dialogue résident-famille-institution : clé du consentement à l’entrée en Ehpad
Angel, O., Bonardi, C., Drouot, C., & Corveleyn, X. (2020) · Gérontologie et société · doi:10.3917/gs1.163.0235 · Cited by 1
“Sometimes Life Throws You a Curve Ball”
O’Neil, H. A., & Fletcher, P. C. (2021) · Clinical Nurse Specialist · doi:10.1097/nur.0000000000000635 · Cited by 1
What Matters Most? Intersectional Correlates of Caregiver Burdens
Hicks, N. M., Sellers, S. L., Zhang, J., Sun, N., & Harris, K. (2022) · Journal of Applied Gerontology · doi:10.1177/07334648221100227 · Cited by 3
“Email: Nytasia.Hicks@VA.gov Caregiver burden has been described as a multifaceted, complex health hazard, especially when caring for aging populations (Fonareva & Oken, 2014).”
BackgroundCavalli, A., Lelli, D., Pedone, C., Boccardi, V., Mecocci, P., & Incalzi, R. A. (2022) · Journal of Alzheimer s Disease · doi:10.3233/jad-215732 · Cited by 1
“There is growing evidence that stress increases the vulnerability of chronic dementia caregiver to disease and diminishes their ability to provide optimal care[49].”
The intricate connection between depression and dementia as a major challenge for clinicians
Ronchetto, F., & Ronchetto, M. (2022) · Journal of Gerontology and Geriatrics · doi:10.36150/2499-6564-n518 · Cited by 1
Hutmacher, F. (2023) · cultura & psyché · doi:10.1007/s43638-023-00073-3 · Cited by 1
Teresi, J. A., Ocepek‐Welikson, K., Eimicke, J. P., Ramirez, M. M., Liu, S., Silver, S. A., & Luchsinger, J. A. (2024) · Alzheimer Disease & Associated Disorders · doi:10.1097/wad.0000000000000625 · Cited by 1
“6,7 Latino/a family caregivers have been found to experience more adverse effects than their counterparts of other races and ethnic groups.”
BackgroundBankole, A., Ji, W., Barbour, T. B., Lozano, A. J., & Hanlon, A. L. (2024) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2024.105055 · Cited by 1
Granier, K. L., & Ingram, R. (2024) · Clinical Gerontologist · doi:10.1080/07317115.2024.2418834 · Cited by 1
“…(Freedman et al., 2022; Janson et al., 2022; Karg et al., 2018) and are at increased risk of adverse outcomes including physical (Dassel & Carr, 2016; Fonareva & Oken, 2014), emotional (Abreu et al., 2018; Colvin & Bullock, 2016; Ma et al., 2018), and social (J. Lee et al., 2022) strains.”
Does caregiver stress get under the skin? Associations with care recipient inflammation
Tsuker, S., Liu, Y., Bangerter, L. R., Baker, E., Lee, H., & Leggett, A. N. (2025) · The Gerontologist · doi:10.1093/geront/gnaf175 · Cited by 1
Decreasing Stress Through Education for Caregivers of Community-Dwelling Individuals with Dementia
Conant, J. (2019) · MOspace Institutional Repository (University of Missouri) · Cited by 1
Erfaringer med deltakelse på kommunale pårørendeskoler
Larsen, L. S., Moholt, J.-M., Hamran, T., Henriksen, N. O., & Blix, B. H. (2020) · Tidsskrift for omsorgsforskning · doi:10.18261/issn.2387-5984-2020-01-03 · Cited by 1
Kesseler, T. A., & Rayman, L. (2020) · Journal of Nursing Education and Practice · doi:10.5430/jnep.v11n3p17 · Cited by 1
“[11] Physical and mental/emotional health are neglected as caregivers make the needs of their family member a priority.[12]”
BackgroundSocialpædagogik og digital kommunikation for ægtefæller til mennesker med demens
Andersen, R. N., Skjødt, U., & Aagerup, L. C. (2021) · Forskning i Pædagogers Profession og Uddannelse · doi:10.7146/fppu.v5i1.125707 · Cited by 1
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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