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Cited by 123Dementia and Cognitive Impairment ResearchNursing care and researchGeriatric Care and Nursing Homes

Health Consequences of Alzheimer’s Caregiving Transitions: Effects of Placement and Bereavement

Grant, Igor, Adler, Karen A., Patterson, Thomas L., Dimsdale, Joel E., Ziegler, Michael G., Irwin, Michael R.·2002·Psychosomatic Medicine
DOI 10.1097/00006842-200205000-00012
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Abstract

OBJECTIVE: To determine the extent to which the chronic stress of Alzheimer's disease caregiving may be alleviated by placement or death of the Alzheimer's disease patient, we prospectively compared groups of caregivers (CG) who continued to care for their Alzheimer's disease spouse at home, CG who placed their spouses, and CG whose spouses died with similarly aged noncaregiving comparison subjects (control subjects). METHODS: A sample of 119 CG who had been studied for at least 18 months at 6-month intervals was included in the present analyses (ie, had at least three assessments). Data were gathered on CG mood, blood pressure, and medical symptoms among 38 CG whose spouses were at home at all three visits (home-home-home [HHH]); 28 CG who placed their spouse at follow-up (home-placed-placed [HPP]); 27 CG whose spouses were placed and subsequently died at follow-up (home-placed-deceased [HPD]); and 26 CG whose spouses died at home (home-deceased-deceased [HDD]). Data were compared with 48 noncaregiving control subjects (NC group). RESULTS: CG in the HPP, HPD, and HDD groups showed improvement in depressive and physical symptoms compared with HHH and NCs. CG had significantly higher systolic blood pressure at rest than did NCs. Both placement and death of the Alzheimer's disease spouse were associated with higher systolic blood pressure in response to postural challenge in CG experiencing these transitions. CONCLUSIONS: Despite improvement seen in mood and medical symptoms among CG who place their spouses or experience the spouse's death, there may be longer term physiological alterations, possibly in sympathoadrenalmedullary arousal, that cause the cardiovascular system to continue to respond to acute stressors such as postural challenge more actively for a period of 6 to 12 months after such transitions.

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  • Compared with noncaregivers, caregivers are at greater risk for developing mild hypertension.

    “they are at greater risk for developing mild hypertension (6, 7)”

    From Chronic stress and age-related increases in the proinflammatory cytokine IL-6. (2003) · cites this paper as [7]

  • Other longitudinal studies have found that caregivers show some improvement in psychological functioning after bereavement, albeit without returning to normative levels.

    “Other longitudinal studies have found that caregivers show some improvement in psychological functioning after bereavement, albeit without returning to normative levels (7, 45, 46).”

    From Chronic stress and age-related increases in the proinflammatory cytokine IL-6. (2003) · cites this paper as [7]

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Authors
Grant, I., Adler, K. A., Patterson, T. L., Dimsdale, J. E., Ziegler, M. G., & Irwin, M. R.
Affiliations
San Diego State University (US)
ORCID
Venue
Psychosomatic Medicine
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2002-05
Volume
64
Issue
3
Pages
477-486
ISSN
0033-3174 (ISSN-L)
DOI
10.1097/00006842-200205000-00012
OpenAlex
W2054286202
Cited by
123
References
60
Citations by year
2025: 2 · 2023: 2 · 2022: 3 · 2021: 5 · 2020: 5 · 2019: 4 · 2018: 2 · 2017: 3 · 2016: 4 · 2015: 6 · 2014: 8 · 2013: 7 · 2012: 10
FWCI
3.85
Type
journal article
Language
en
Open access
closed
Locations
  • Psychosomatic Medicine (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Institute on Aging (AG05131, P50AG005131, AG 15301)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Health Sciences › Health Professions › Pharmacy › Nursing care and research
  • Health Sciences › Health Professions › General Health Professions › Geriatric Care and Nursing Homes
Keywords
Alzheimer's disease, caregiver stress, bereavement, death of a spouse, depressive symptoms, blood pressure, postural challenge, cardiovascular stress response, home care, caregiver health
MeSH terms
Affect, Aged, Aged, 80 and over, Arousal, Bereavement, Blood Pressure, Depression, Female, Health Status, Homes for the Aged, Humans, Institutionalization, Male, Nursing Homes, Psychophysiologic Disorders, Stress, Psychological, Geriatric Assessment, Caregivers, Spouses

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