Long-term caregiving is associated with impaired cardiovagal baroreflex

• Published in: Journal of psychosomatic research Vol. 103; pp. 29 - 33
• Main Authors: Wu, Kevin K., Bos, Taylor, Mausbach, Brent T., Milic, Milos, Ziegler, Michael G., von Känel, Roland, Allison, Matthew A., Dimsdale, Joel E., Mills, Paul J., Ancoli-Israel, Sonia, Patterson, Thomas L., Grant, Igor
• Format: Journal Article
• Language: English
• Published: England Elsevier Inc 01.12.2017; Elsevier Science Ltd
• Subjects: Accumulation; Aged; Alzheimer's; Baroreceptor reflex; Baroreceptors; Baroreflex - physiology; Blood pressure; Cardiovascular disease; Cardiovascular diseases; Cardiovascular Diseases - etiology; Cardiovascular Diseases - pathology; Caregiver burden; Caregivers; Caregivers - psychology; Caregiving; Dementia; Dementia disorders; Demography; Female; Geriatrics; Heart disease; Home health care; Humans; Life stress; Male; Older people; Reflexes; Risk factors; Short term; Stress; Stress, Psychological - psychology; Cardiovascular disease; Baroreceptor reflex; Life stress; Heart disease; Alzheimer's
• ISSN: 0022-3999; 1879-1360
• DOI: 10.1016/j.jpsychores.2017.10.001

Caregiving stress is associated with increased risk of cardiovascular disease (CVD). Inability to adequately regulate blood pressure is a possible underlying mechanism explaining this risk. We examined the relationship between length of caregiving and cardiovagal baroreflex sensitivity (cBRS) to better understand the link between caregiving and CVD risk. A total of 146 elderly individuals (≥55years) participated in this study, of whom 96 were providing in-home care to a spouse with dementia and 50 were healthy controls married to a non-demented spouse (i.e., non-caregivers). Among the caregivers, 56 were short-term caregivers (caring<4years) and 40 were long-term caregivers (caring≥4years). A multiple linear regression model, with contrast codes comparing short and long-term caregivers with non-caregivers was used to understand relationships between chronic caregiving and cBRS. After controlling for relevant demographic and health characteristics, mean±SE log transformed cBRS for non-caregivers was 0.971±0.029. Relative to non-caregivers, the long-term caregivers had significantly impaired cBRS (0.860±0.033; p=0.013). However, mean cBRS for short-term caregivers did not significant differ from non-caregivers (0.911±0.028; p=0.144). These results suggest that long-term caregiving stress is associated with an impaired cBRS. Accumulation of stress from years of caregiving could result in worse cBRS function, which could be a mechanistic explanation for the correlation between caregiving stress and the increased risk of CVD. •Impaired cBRS function may have a role in poor CV outcomes of stressed caregivers.•We compared cBRS of long-term caregivers, short-term caregivers, and controls.•Long-term caregivers have a significantly blunted cBRS compared to controls.•cBRS of short-term caregivers did not differ significantly from controls.•Chronic caregiver stress may impair cBRS in a cumulative manner over time.