Key result
Transitioning to family caregiving was associated with greater worsening of perceived stress and depressive symptoms, but these psychological factors showed few significant associations with changes in inflammatory biomarkers over 9.3 years.
Why the study?
Few longitudinal studies have rigorously examined whether changes in perceived stress and depressive symptoms are associated with increased inflammation within family caregivers and non-caregivers.
Does transitioning to a family caregiving role and experiencing associated changes in perceived stress and depressive symptoms increase inflammation in older adults?
Cohort (n=480)
Yes
Does transitioning to a family caregiving role and experiencing associated changes in perceived stress and depressive symptoms increase inflammation in older adults?
Despite significant increases in perceived stress and depressive symptoms, transitioning to a caregiving role was not broadly associated with increased inflammatory biomarkers over a 9.3-year period.
Weak caregiver stress-depression-inflammation links appear confounded by demographics; leaves open causal pathways for targeted trials.
OBJECTIVES: Higher inflammation has been linked to poor physical and mental health outcomes, and mortality, but few studies have rigorously examined whether changes in perceived stress and depressive symptoms are associated with increased inflammation within family caregivers and non-caregivers in a longitudinal design. DESIGN: Longitudinal Study. SETTING: REasons for Geographic And Racial Differences in Stroke cohort study. PARTICIPANTS: Participants included 239 individuals who were not caregivers at baseline but transitioned to providing substantial and sustained caregiving over time. They were initially matched to 241 non-caregiver comparisons on age, sex, race, education, marital status, self-rated health, and history of cardiovascular disease. Blood was drawn at baseline and approximately 9.3 years at follow-up for both groups. MEASUREMENTS: Perceived Stress Scale, Center for Epidemiological Studies-Depression, inflammatory biomarkers, including high-sensitivity C-reactive protein, D dimer, tumor necrosis factor alpha receptor 1, interleukin (IL)-2, IL-6, and IL-10 taken at baseline and follow-up. RESULTS: Although at follow-up, caregivers showed significantly greater worsening in perceived stress and depressive symptoms compared to non-caregivers, there were few significant associations between depressive symptoms or perceived stress on inflammation for either group. Inflammation, however, was associated with multiple demographic and health variables, including age, race, obesity, and use of medications for hypertension and diabetes for caregivers and non-caregivers. CONCLUSIONS: These findings illustrate the complexity of studying the associations between stress, depressive symptoms, and inflammation in older adults, where these associations may depend on demographic, disease, and medication effects. Future studies should examine whether resilience factors may prevent increased inflammation in older caregivers.
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Elayoubi et al. (2022) conducted a cohort in Family caregiving (n=480). Transition to family caregiving vs. Matched non-caregivers was evaluated on Change in inflammatory biomarkers (CRP, D dimer, TNFR1, IL-2, IL-6, IL-10) associated with perceived stress and depressive symptoms. Transitioning to family caregiving was associated with greater worsening of perceived stress and depressive symptoms, but these psychological factors showed few significant associations with changes in inflammatory biomarkers over 9.3 years.
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