| Problem behavior of dementia patients predicts low-grade hypercoagulability in spousal caregivers. | |
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MedLine Citation:
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PMID: 20484338 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Low-grade hypercoagulability might be one pathway to explain how the chronic stress of dementia caregiving increases cardiovascular disease risk, but the specific aspects of caregiver stress that elicit hypercoagulability are elusive. We hypothesized that dementia patients' problem behaviors and negative reactions of caregivers to these behaviors would relate to hypercoagulability in caregivers. METHODS: One hundred and eight participants (mean age 74 +/- 8 years, 70% women) providing in-home care for their spouse with Alzheimer's disease were examined. Caregivers were interviewed about the number of 24 predefined patient problem behaviors in the previous week (range 0-24) and how upset or bothered they felt in response to these behaviors (total score 0-96). Von Willebrand factor, plasminogen activator inhibitor-1, and D-dimer were determined in plasma and standardized z-scores of their concentrations summed into a procoagulant index. RESULTS: Greater number of problem behaviors (Delta R(2) = 0.046, p = .014) and negative reactions of caregivers to these behaviors (Delta R(2) = 0.044, p = .017) were associated with greater procoagulant index after controlling for sociodemographic factors, major cardiovascular risk factors, health habits, and health problems. However, the number of and reaction to problem behaviors did not significantly predict procoagulant activity independent from each other. Post hoc analysis revealed a positive association between the number of problem behaviors and D-dimer (p = .010, Delta R(2) = 0.053), even when controlling for negative reactions (p = .033, Delta R(2) = 0.036). Caregiver reaction to problem behaviors was not significantly associated with any procoagulant factor individually. CONCLUSION: Alzheimer patients' problem behavior and their negative appraisal by the caregiver may contribute to the chronic low-grade hypercoagulable state in dementia caregivers. |
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Authors:
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Roland von Känel; Brent T Mausbach; Joel E Dimsdale; Paul J Mills; Thomas L Patterson; Sonia Ancoli-Israel; Michael G Ziegler; Susan K Roepke; Matthew Allison; Igor Grant |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural Date: 2010-05-19 |
Journal Detail:
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Title: The journals of gerontology. Series A, Biological sciences and medical sciences Volume: 65 ISSN: 1758-535X ISO Abbreviation: J. Gerontol. A Biol. Sci. Med. Sci. Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-08-13 Completed Date: 2010-09-14 Revised Date: 2011-09-13 |
Medline Journal Info:
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Nlm Unique ID: 9502837 Medline TA: J Gerontol A Biol Sci Med Sci Country: United States |
Other Details:
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Languages: eng Pagination: 1004-11 Citation Subset: AIM; IM |
Affiliation:
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Department of General Internal Medicine, Division of Psychosomatic Medicine, Inselspital, Bern University Hospital, CH-3010 Bern, Switzerland. roland.vonkaenel@insel.ch |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Biological Markers / blood Caregivers / psychology* Dementia / psychology* Female Fibrin Fibrinogen Degradation Products / analysis Humans Male Multivariate Analysis Plasminogen Activator Inhibitor 1 / blood Spouses* Stress, Psychological Thrombophilia / blood* von Willebrand Factor / analysis |
| Grant Support | |
ID/Acronym/Agency:
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AG 03090/AG/NIA NIH HHS; AG 15301/AG/NIA NIH HHS; AG08415/AG/NIA NIH HHS; R01 AG008415-20/AG/NIA NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers; 0/Fibrin Fibrinogen Degradation Products; 0/Plasminogen Activator Inhibitor 1; 0/fibrin fragment D; 0/von Willebrand Factor |
| Comments/Corrections | |
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