Effect of Chronic Dementia Caregiving and Major Transitions in the Caregiving Situation on Kidney Function: A Longitudinal Study
Open accessAbstract
OBJECTIVE: To estimate the glomerular filtration rate (GFR) in relation to the chronic stress of dementia caregiving and major transitions in the caregiving situation. METHODS: We longitudinally assessed 119 people serving as caregivers for their spouses with Alzheimer's disease and 58 noncaregiving controls for a period of up to 3 years (mean of 2.8 assessments per participant). At baseline, the mean (standard deviation [SD]) age of all participants was 74.5 (7.5) years. Random regression models with fixed and time-variant effects for psychosocial factors, risk factors of chronic kidney disease, and caregiving transitions were used to evaluate changes over time in estimated GFR. RESULTS: The change in GFR did not differ between caregivers and controls during follow-up (p = .77). Further analyses revealed that GFR declined disproportionately after placement of the spouse in a nursing home at 3 months after placement (-4.9 [2.2] mL/min per 1.73 m(2); p = .03). Post hoc analyses showed that this effect was stronger in caregivers with hypertension compared with those without hypertension (-5.7 [3.1] versus -2.4 [3.4] mL/min per 1.73 m(2)), as well as in caregivers with diastolic blood pressure (BP) levels at 1 SD above the mean than in those with diastolic BP levels at 1 SD below the mean (-8.3 [2.9] versus -1.4 [2.7] mL/min per 1.73 m(2)). CONCLUSIONS: Kidney function did not differ between caregivers and controls over time. However, GFR had impaired at 3 months after a major caregiving transition. Because the effect of placement of the spouse with Alzheimer's disease on the decline in GFR was moderated by BP, it might be confined to caregivers who experience increased sympathetic activation after placement.
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Chronic caregiving stress may be associated with increased incidence of hypertension and physiological changes that could increase risk of chronic conditions.
“The chronic stress of caregiving may be associated with an increased incidence of hypertension and a number of physiological changes that could increase the risk of developing chronic conditions, including high levels of stress hormones, impaired immune function, slow wound healing and coronary heart disease.[515][516][517][518][519][520][521][522]”
From 2023 Alzheimer's disease facts and figures (2023) · cites this paper as [515]
The Introduction reports earlier hypertension in Alzheimer’s caregivers, immune dysregulation, and increased coronary heart disease risk; the Discussion also describes greater sympathoadrenal arousal. Our copy does not substantiate the sentence’s specific claims of high stress-hormone levels or slow wound healing. The indexed passages provide section labels but no page numbers. (LLM, conf=0.86)
Experimental — accuracy not yet measuredThe chronic stress of caregiving may be associated with an increased incidence of hypertension and a number of physiological changes that could increase the risk of developing chronic conditions, including high levels of stress hormones, impaired immune function, slow wound healing and coronary heart disease.
“The chronic stress of caregiving may be associated with an increased incidence of hypertension and a number of physiological changes that could increase the risk of developing chronic conditions, including high levels of stress hormones, impaired immune function, slow wound healing and coronary heart disease. 563 , 564 , 565 , 566 , 567 , 568 , 569 , 570”
From 2024 Alzheimer's disease facts and figures (2024) · cites this paper as [563]
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Self-citation
- Authors
- von Känel, R., Mausbach, B. T., Dimsdale, J. E., Mills, P. J., Patterson, T. L., Ancoli-Israel, S., Ziegler, M. G., Roepke, S. K., Chattillion, E. A., Allison, M., & Grant, I.
- Affiliations
- University of Bern (CH)
- Venue
- Psychosomatic Medicine
- Published
- 2012-02
- Volume
- 74
- Issue
- 2
- Pages
- 214-220
- ISSN
- 0033-3174 (ISSN-L)
- PMC
- PMC3384744
- OpenAlex
- W2007187565
- Cited by
- 49
- References
- 51
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 1 · 2023: 1 · 2021: 19 · 2019: 2 · 2018: 3 · 2017: 5 · 2016: 3 · 2015: 3 · 2014: 6 · 2013: 2
- FWCI
- 2.50
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Psychosomatic Medicine (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Aging (R01AG015301, R01AG008415, AG 15301, AG03090, AG 08415, RF1AG015301, R01AG031090)
- National Institute of Mental Health (R25MH080916)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Health Professions › Pharmacy › Nursing care and research
- Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
- Keywords
- dementia caregiving, Alzheimer's disease, glomerular filtration rate, renal function, chronic stress, nursing home admission, hypertension, blood pressure, chronic kidney disease, caregiver burden, sympathetic activation
- MeSH terms
- Aged, Aged, 80 and over, Bereavement, Blood Pressure, Dementia, Female, Glomerular Filtration Rate, Health Status, Humans, Hypertension, Kidney Diseases, Life Change Events, Longitudinal Studies, Male, Middle Aged, Nursing Homes, Regression Analysis, Risk Factors, Stress, Psychological, Time Factors, Linear Models, Case-Control Studies, Caregivers, Spouses
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