A systematic review of the psychobiological burden of informal caregiving for patients with dementia: Focus on cognitive and biological markers of chronic stress

Neuroscience and Biobehavioral Reviews

Volumn 73, Issue , 2017, Pages 123-164

  Allen, Andrew P ^a,b   Curran, Eileen A ^b,c   Duggan, Áine ^d   Cryan, John F ^a,b   Chorcoráin, Aoife Ní ^d   Dinan, Timothy G ^a,b   Molloy, D William ^d   Kearney, Patricia M ^b,c   Clarke, Gerard ^a,b  

^a UNIVERSITY COLLEGE CORK   (Ireland)

^b UNIVERSITY COLLEGE CORK   (Ireland)

^c UNIVERSITY COLLEGE CORK   (Ireland)

^d UNIVERSITY COLLEGE CORK   (Ireland)

Author keywords

Attention; Biomarker; Cardiovascular; Caregiver; Cognition; Cortisol; Dementia; Epinephrine; Immune system; Memory; Norepinephrine; Stress

Indexed keywords

EPINEPHRINE; HYDROCORTISONE; INFLUENZA VACCINE; L SELECTIN; NEUROTROPIN; NORADRENALIN; PADGEM PROTEIN; BIOLOGICAL MARKER;

AFRICAN AMERICAN; AGE; ANTIBODY TITER; ASIAN; BEREAVEMENT; CAREGIVER BURDEN; CAUCASIAN; CHRONIC STRESS; COGNITION; COPING BEHAVIOR; DEMENTIA; DEPRESSION; DISEASE MARKER; ETHNICITY; EXECUTIVE FUNCTION; GENDER; HUMAN; HYPOPITUITARISM; HYPOTHALAMUS HYPOPHYSIS ADRENAL SYSTEM; IMMUNE SYSTEM; IRRITABLE COLON; MENTAL DISEASE; MENTAL PERFORMANCE; PACIFIC ISLANDER; PATIENT CARE; PERIPHERAL BLOOD MONONUCLEAR CELL; POSITRON EMISSION TOMOGRAPHY; PRIORITY JOURNAL; PSYCHOBIOLOGY; RESTING HEART RATE; REVIEW; SALIVA LEVEL; SEX DIFFERENCE; STRESS; SYSTEMATIC REVIEW; WORKING MEMORY; CAREGIVER; MENTAL STRESS;

BIOMARKERS; CAREGIVERS; COGNITION; DEMENTIA; HUMANS; STRESS, PSYCHOLOGICAL;

EID: 85007410717     PISSN: 01497634     EISSN: 18737528     Source Type: Journal    
DOI: 10.1016/j.neubiorev.2016.12.006     Document Type: Review

References (193)

1. Aboulafia-Brakha, T., Suchecki, D., Gouveia-Paulino, F., Nitrini, R., Ptak, R., Cognitive-behavioural group therapy improves a psychophysiological marker of stress in caregivers of patients with Alzheimer's disease. Aging Ment. Health 18 (2014), 801–808.
2. Adler, K.A., Mills, P.J., Dimsdale, J.E., Ziegler, M.G., Patterson, T.L., Sloan, R.P., Grant, I., Temporal stability of acute stress-induced changes in leukocyte subsets and cellular adhesion molecules in older adults. Brain Behav. Immun. 16 (2002), 262–274.
3. Allen, A.P., Hutch, W., Borre, Y., Kennedy, P.J., Temko, A., Boylan, G., Murphy, E., Cryan, J.F., Dinan, T.G., Clarke, G., Bifidobacterium longum 1714 as a translational psychobiotic: Modulation of stress, electrophysiology and neurocognition in healthy volunteers. Transl. Psychiatr., 6, 2016, e939.
4. Allen, A.P., Kennedy, P.J., Cryan, J.F., Dinan, T.G., Clarke, G., Biological and psychological markers of stress in humans: focus on the trier social stress test. Neurosci. Biobehav. Rev. 38 (2014), 94–124.
5. Aschbacher, K., Mills, P.J., von Känel, R., Hong, S., Mausbach, B.T., Roepke, S.K., Dimsdale, J.E., Patterson, T.L., Ziegler, M.G., Ancoli-Israel, S., Grant, I., Effects of depressive and anxious symptoms on norepinephrine and platelet P-selectin responses to acute psychological stress among elderly caregivers. Brain Behav. Immun. 22 (2008), 493–502.
6. Aschbacher, K., O'Donovan, A., Wolkowitz, O.M., Dhabhar, F.S., Su, Y., Epel, E., Good stress, bad stress and oxidative stress: insights from anticipatory cortisol reactivity. Psychoneuroendocrinology 38 (2013), 1698–1708.
7. Aschbacher, K., Patterson, T.L., von Känel, R., Dimsdale, J.E., Mills, P.J., Adler, K.A., Ancoli-Israel, S., Grant, I., Coping processes and hemostatic reactivity to acute stress in dementia caregivers. Psychosom. Med. 67 (2005), 964–971.
8. Aschbacher, K., Roepke, S.K., von Känel, R., Mills, P.J., Mausbach, B.T., Patterson, T.L., Dimsdale, J.E., Ziegler, M.G., Ancoli-Israel, S., Grant, I., Persistent versus transient depressive symptoms in relation to platelet hyperactivation: a longitudinal analysis of dementia caregivers. J. Affect. Disord. 116 (2009), 80–87.
9. Aschbacher, K., von Känel, R., Dimsdale, J.E., Patterson, T.L., Mills, P.J., Mausbach, B.T., Allison, M.A., Ancoli-Israel, S., Grant, I., Dementia severity of the care receiver predicts procoagulant response in Alzheimer caregivers. Am. J. Geriatr. Psychiatr. 14 (2006), 694–703.
10. Aschbacher, K., von Känel, R., Mills, P.J., Hong, S., Roepke, S.K., Mausbach, B.T., Patterson, T.L., Ziegler, M.G., Dimsdale, J.E., Ancoli-Israel, S., Grant, I., Combination of caregiving stress and hormone replacement therapy is associated with prolonged platelet activation to acute stress among postmenopausal women. Psychosom. Med. 69 (2007), 910–917.
11. Atienza, A.A., Henderson, P.C., Wilcox, S., King, A.C., Gender differences in cardiovascular response to dementia caregiving. Gerontology 41 (2001), 490–498.
12. Bauer, M.E., Vedhara, K., Perks, P., Wilcock, G.K., Lightman, S.L., Shanks, N., Chronic stress in caregivers of dementia patients is associated with reduced lymphocyte sensitivity to glucocorticoids. J. Neuroimmunol. 103 (2000), 84–92.
13. Bauer, M.J., Maddox, M.K., Kirk, L.N., Burns, T., Kuskowski, M.A., Progressive dementia: personal and relational impact on caregiving wives. Am. J. Alzheimers Dis. Other Demen. 16 (2001), 329–334.
14. Baumgarten, M., Hanley, J.A., Infante-Rivard, C., Battista, R.N., Becker, R., Gauthier, S., Health of family members caring for elderly persons with dementia: a longitudinal study. Ann. Intern. Med. 120 (1994), 126–132.
15. Beck, A.T., The evolution of the cognitive model of depression and its neurobiological correlates. Am. J. Psychiatr. 165 (2008), 969–977.
16. Bédard, M., Molloy, D.W., Pedlar, D., Lever, J.A., Stones, M.J., Associations between dysfunctional behaviors, gender, and burden in spousal caregivers of cognitively impaired older adults. Int. Psychogeriatr. 9 (1997), 277–290.
17. Black, D.S., Cole, S.W., Irwin, M.R., Breen, E., St Cyr, N.M., Nazarian, N., Khalsa, D.S., Lavretsky, H., Yogic meditation reverses NF-kappaB and IRF-related transcriptome dynamics in leukocytes of family dementia caregivers in a randomized controlled trial. Psychoneuroendocrinology 38 (2013), 348–355.
18. Black, W., Almeida, O.P., A systematic review of the association between the Behavioral and Psychological Symptoms of Dementia and burden of care. Int. Psychogeriatr. 16 (2004), 295–315.
19. Boerner, K., Schulz, R., Horowitz, A., Positive aspects of caregiving and adaptation to bereavement. Psychol. Aging 19 (2004), 668–675.
20. Bristow, M., Cook, R., Erzinclioglu, S., Hodges, J., Stress, distress and mucosal immunity in carers of a partner with fronto-temporal dementia. Aging Ment. Health 12 (2008), 595–604.
21. Brummet, B.H., Siegler, I.C., Rohe, W.M., Barefoot, J.C., Vitaliano, P.P., Surwit, R.S., Feinglos, M.N., Williams, R.B., Neighborhood characteristics moderate effects of caregiving on glucose functioning. Psychosom. Med. 67 (2005), 752–758.
22. Brummett, B.H., Austin, S.B., Welsh-Bohmer, K.A., Williams, R.B., Siegler, I.C., Long-term impact of caregiving and metabolic syndrome with perceived decline in cognitive function 8 years later: a pilot study suggesting important avenues for future research. Open J. Med. Psychol. 2 (2013), 23–28.
23. Brummett, B.H., Boyle, S.H., Siegler, I.C., Kuhn, C.M., Surwit, R.S., Garrett, M.E., Collins, A., Ashley-Koch, A., Williams, R.B., HPA axis function in male caregivers: effect of the monoamine oxidase-A gene promoter (MAOA-uVNTR). Biol. Psychol. 79 (2008), 250–255.
24. Brummett, B.H., Krystal, A.D., Ashley-Koch, A., Kuhn, C.M., Züchner, S., Siegler, I.C., Barefoot, J.C., Ballard, E.L., Gwyther, L.P., Williams, R.B., Sleep quality varies as a function of 5-HTTLPR genotype and stress. Psychosom. Med. 69 (2007), 621–624.
25. Burns, E.A., Wagstaff, D.A., Hirschman, R., Fleming, R., Goodwin, J.S., Greenberg, J.J., Affective and behavioral stress outcomes in Alzheimer's caregivers. J. Appl. Biobehav. Res. 7 (2002), 65–74.
26. Cacioppo, J.T., Burleson, M.H., Poehlmann, K.M., Malarkey, W.B., Kiecolt-Glaser, J.K., Berntson, G.G., Uchino, B.N., Glaser, R., Autonomic and neuroendocrine responses to mild psychological stressors: effects of chronic stress on older women. Ann. Behav. Med. 22 (2000), 140–148.
27. Cacioppo, J.T., Poehlmann, K.M., Burleson, M.H., Kiecolt-Glaser, J.K., Malarkey, W.B., Berntson, G.G., Glaser, R., Cellular immune responses to acute stress in female caregivers of dementia patients and matched controls. Health Psychol. 17 (1998), 182–189.
28. Carpenter, L.L., Tyrka, A.R., Ross, N.S., Khoury, L., Anderson, G.M., Price, L.H., Effect of childhood emotional abuse and age on cortisol responsivity in adulthood. Biol. Psychiatr. 66 (2009), 69–75.
29. Castle, S., Wilkins, S., Heck, E., Tanzy, K., Fahey, J., Depression in caregivers of demented patients is associated with altered immunity: impaired proliferative capacity, increased CD8+, and a decline in lymphocytes with surface signal transduction molecules (CD38 + ) and a cytotoxicity marker (CD56+ CD8 +). Clin. Exp. Immunol. 101 (1995), 487–493.
30. Caswell, L.W., Vitaliano, P.P., Croyle, K.L., Scanlan, J.M., Zhang, J., Daruwala, A., Negative associations of chronic stress and cognitive performance in older adult spouse caregivers. Exp. Aging Res. 29 (2003), 303–318.
31. Chattillion, E.A., Ceglowski, J., Roepke, S.K., von Känel, R., Losada, A., Mills, P.J., Romero-Moreno, R., Grant, I., Patterson, T.L., Mausbach, B.T., Pleasant events, activity restriction, and blood pressure in dementia caregivers. Health Psychol. 32 (2013), 793–801.
32. Chattillion, E.A., Mausbach, B.T., Roepke, S.K., von Känel, R., Mills, P.J., Dimsdale, J.E., Allison, M., Ziegler, M.G., Patterson, T.L., Ancoli-Israel, S., Grant, I., Leisure activities, caregiving demands and catecholamine levels in dementia caregivers. Psychol. Health 27 (2012), 1134–1149.
33. Choi, K., Vickers, K., Tassone, A., Trait emotional intelligence, anxiety sensitivity, and experiential avoidance in stress reactivity and their improvement through psychological methods. Eur. J. Psychol. 10 (2014), 376–404.
34. Chrousus, G.P., Gold, P.W., A health body in a healthy mind-and vice versa-the damaging power of uncontrollable stress. J. Clin. Endocr. Metab. 83 (1998), 1842–1845.
35. Clark, M.S., Bond, M.J., Hecker, J.R., Environmental stress, psychological stress and allostatic load. Psychol. Health Med. 12 (2007), 18–30.
36. Clipp, E.C., George, L.K., Dementia and cancer- a comparison of spouse caregivers. Gerontology 33 (1993), 534–541.
37. Correa, M.S., Vedovelli, K., Giacobbo, B.L., de Souza, C.E., Ferrari, P., de Lima, A. I.I., Walz, J.C., Kapczinski, F., Bromberg, E., Psychophysiological correlates of cognitive deficits in family caregivers of patients with Alzheimer Disease. Neuroscience 286 (2015), 371–382.
38. Da Roza Davis, J.M., Cowen, P.J., Biochemical stress of caring. Psychol. Med. 31 (2001), 1475–1478.
39. Damjanovic, A.K., Yang, Y., Glaser, R., Kiecolt-Glaser, J.K., Nguyen, H., Laskowski, B., Zou, Y., Beversdorf, D.Q., Weng, N.P., Accelerated telomere erosion is associated with a declining immune function of caregivers of Alzheimer's disease patients. J. Immunol. 179 (2007), 4249–4254.
40. Dantzer, R., O'Connor, J.C., Freund, G.G., Johnson, R.W., Kelley, K.W., From inflammation to sickness and depression: when the immune system subjugates the brain. Nat. Rev. Neurosci. 9 (2008), 46–56.
41. Danucalov, M.A.D., Kozasa, E.H., Ribas, K.T., Galduróz, J.C.F., Garcia, M.C., Verreschi, I.T.N., Oliveira, K.C., Romani De Oliveira, L., Leite, J.R., A yoga and compassion meditation program reduces stress in familial caregivers of Alzheimer's disease patients. Evid. Complement. Altern. Med., 2013 Article ID 513149.
42. Davis, L.L., Weaver, M., Zamrini, E., Stevens, A., Kang, D., Parker, C.R. Jr., Biopsychological markers of distress in informal caregivers. Biol. Res. Nurs. 6 (2004), 90–99.
43. de Vugt, M.E., Jolles, J., van Osch, L., Stevens, F., Aalten, P., Lousberg, R., Verhey, F.R., Cognitive functioning in spousal caregivers of dementia patients: findings from the prospective MAASBED study. Age Ageing 35 (2006), 160–166.
44. de Vugt, M.E., Nicolson, N.A., Aalten, P., Lousberg, R., Jolle, J., Verhey, F.R., Behavioral problems in dementia patients and salivary cortisol patterns in caregivers. J. Neuropsychiatry Clin. Neurosci. 17 (2005), 201–207.
45. Dettenborn, L., Tietze, A., Bruckner, F., Kirschbaum, C., Higher cortisol content in hair among long-term unemployed individuals compared to controls. Psychoneuroendocrinology 35 (2010), 1404–1409.
46. Dhabhar, F.S., Miller, A.H., McEwen, B.S., Spencer, R.L., Effects of stress on immune cell distribution. Dynamics and hormonal mechanisms. J. Immunol. 154 (1995), 5511–5527.
47. Dickerson, S.S., Kemeny, M.E., Acute stressors and cortisol responses: a theoretical integration and synthesis of laboratory research. Psychol. Bull., 130, 2004, 355.
48. Dinan, T.G., Novel approaches to the treatment of depression by modulating the hypothalamic–pituitary–adrenal axis. Hum. Psychopharmacol. Clin. Exp. 16 (2001), 89–93.
49. Dinan, T.G., Cryan, J.F., Regulation of the stress response by the gut microbiota: implications for psychoneuroendocrinology. Psychoneuroendocrinology 37 (2012), 1369–1378.
50. Epel, E.S., Lin, J., Dhabhar, F.S., Wolkowitz, O.M., Puterman, E., Karan, L., Blackburn, E.H., Dynamics of telomerase activity in response to acute psychological stress. Brain Behav. Immun. 24 (2010), 531–539.
51. Esterling, B.A., Kiecolt-Glaser, J.K., Bodnar, J.C., Glaser, R., Chronic stress, social support, and persistent alterations in the natural killer cell response to cytokines in older adults. Health Psychol. 13 (1994), 291–298.
52. Esterling, B.A., Kiecolt-Glaser, J.K., Glaser, R., Psychosocial modulation of cytokine-induced natural killer cell activity in older adults. Psychosom. Med. 58 (1996), 264–272.
53. Fonareva, I., Amen, A.M., Zajdel, D.P., Ellingson, R.M., Oken, B.S., Assessing sleep architecture in dementia caregivers at home using an ambulatory polysomnographic system. J. Geriatr. Psychiatr. Neurol. 24 (2011), 50–59.
54. Gallagher-Thompson, D., Shurgot, G.R., Rider, K., Gray, H.L., McKibbin, C.L., Kraemer, H.C., Sephton, S.E., Thompson, L.W., Ethnicity, stress, and cortisol function in hispanic and non-hispanic white women: a preliminary study of family dementia caregivers and noncaregivers. Am. J. Geriatr. Psychiatr. 14 (2006), 334–342.
55. Gallagher, S., Sumner, R.C., Muldoon, O.T., Creaven, A., Hannigan, A., Unemployment is associated with lower cortisol awakening and blunted dehydroepiandrosterone responses. Psychoneuroendocrinology 69 (2016), 41–49.
56. Garand, L., Buckwalter, K.C., Lubaroff, D.M., Tripp-Reimer, T., Frantz, R.A., Ansley, T.N., A pilot study of immune and mood outcomes of a community-based intervention for dementia caregivers: the PLST intervention. Arch. Psychiatr. Nurs. 16 (2002), 156–167.
57. Glaser, R., Kiecolt-Glaser, J.K., Chronic stress modulates the virus-specific immune response to latent herpes simplex virus type 1. Ann. Behav. Med. 19 (1997), 78–82.
58. Glaser, R., Kiecolt-Glaser, J.K., Malarkey, W.B., Sheridan, J.F., The influence of psychological stress on the immune response to vaccines. Ann. N.Y. Acad. Sci. 840 (1998), 649–655.
59. Glaser, R., MacCallum, R.C., Laskowski, B.F., Malarkey, W.B., Sheridan, J.F., Kiecolt-Glaser, J.K., Evidence for a shift in the Th-1 to Th-2 cytokine response associated with chronic stress and aging. J. Gerontol. Ser. A Biol. Sci. Med. Sci. 56 (2001), M477–482.
60. Glaser, R., Sheridan, J., Malarkey, W.B., MacCallum, R.C., Kiecolt-Glaser, J.K., Chronic stress modulates the immune response to a pneumococcal pneumonia vaccine. Psychosom. Med. 62 (2000), 804–807.
61. Godbout, J.P., Glaser, R., Stress-induced immune dysregulation: implications for wound healing, infectious disease and cancer. J. Neuroimmune Pharmacol. 1 (2006), 421–427.
62. Goldsmith, D.R., Rapaport, M.H., Miller, B.J., A meta-analysis of blood cytokine network alterations in psychiatric patients: comparisons between schizophrenia, bipolar disorder and depression. Mol. Psychiatry 21 (2016), 1696–1709.
63. Gouin, J.P., Glaser, R., Malarkey, W.B., Beversdorf, D., Kiecolt-Glaser, J., Chronic stress, daily stressors, and circulating inflammatory markers. Health Psychol. 31 (2012), 264–268.
64. Graham, J.E., Robles, T.F., Kiecolt-Glaser, J.K., Malarkey, W.B., Bissell, M.G., Glaser, R., Hostility and pain are related to inflammation in older adults. Brain Behav. Immun. 20 (2006), 389–400.
65. Grant, I., McKibbin, C.L., Taylor, M.J., Mills, P., Dimsdale, J., Ziegler, M., Patterson, T.L., In-home respite intervention reduces plasma epinephrine in stressed Alzheimer caregivers. Am. J. Geriatr. Psychiatry 11 (2003), 62–72.
66. Hadjiconstantinou, M., McGuire, L., Duchemin, A.M., Laskowski, B., Kiecolt-Glaser, J., Glaser, R., Changes in plasma nerve growth factor levels in older adults associated with chronic stress. J. Neuroimmunol. 116 (2001), 102–106.
67. Harmell, A.L., Mausbach, B.T., Roepke, S.K., Moore, R.C., von Känel, R., Patterson, T.L., Dimsdale, J.E., Mills, P.J., Ziegler, M.G., Allison, M.A., Ancoli-Israel, S., Grant, I., The relationship between self-efficacy and resting blood pressure in spousal Alzheimer's caregivers. Br. J. Health Psychol. 16 (2011), 317–328.
68. Ho, J.S., Bordon, J., Wang, V., Ceglowski, J., Kim, D.H., Chattillion, E.A., Patterson, T.L., Grant, I., Ziegler, M.G., Mills, P.J., Mausbach, B.T., Reduced activity restriction buffers the relations between chronic stress and sympathetic nervous system activation. J. Gerontol. Ser. B Psychol. Sci. Soc. Sci. 69 (2014), 408–416.
69. Holland, J.M., Thompson, L.W., Cucciare, M.A., Tsuda, A., Okamura, H., Spiegel, D., Rasgon, N.L., Gallagher-Thompson, D., Cortisol outcomes among caucasian and latina/hispanic women caring for a family member with dementia: a preliminary examination of psychosocial predictors and effects of a psychoeducational intervention. Stress Health 27 (2011), 334–346.
70. Holland, J.M., Thompson, L.W., Tzuang, M., Gallagher-Thompson, D., Psychosocial factors among Chinese American women dementia caregivers and their association with salivary cortisol: results of an exploratory study. Ageing Int. 35 (2010), 109–127.
71. Innes, K.E., Selfe, T.K., Brown, C.J., Rose, K.M., Thompson-Heisterman, A., The effects of meditation on perceived stress and related indices of psychological status and sympathetic activation in persons with Alzheimer's disease and their caregivers: a pilot study. Evid. Complement. Altern. Med., 2012 Article ID 927509.
72. Irwin, M., Brown, M., Patterson, T., Hauger, R., Mascovich, A., Grant, I., Neuropeptide Y and natural killer cell activity: findings in depression and Alzheimer caregiver stress. FASEB J. 5 (1991), 3100–3107.
73. Irwin, M., Hauger, R., Patterson, T.L., Semple, S., Ziegler, M., Grant, I., Alzheimer caregiver stress: basal natural killer cell activity, pituitary-adrenal cortical function, and sympathetic tone. Ann. Behav. Med. 19 (1997), 83–90.
74. Irwin, S.A., Mausbach, B.T., Koo, D., Fairman, N., Roepke-Buehler, S.K., Chattillion, E.A., Dimsdale, J.E., Patterson, T.L., Ancoli-Israel, S., Mills, P.J., von Känel, R., Ziegler, M.G., Grant, I., Association between hospice care and psychological outcomes in Alzheimer's spousal caregivers. J. Palliat. Med. 16 (2013), 1450–1454.
75. Jeckel, C.M., Lopes, R.P., Berleze, M.C., Luz, C., Feix, L., Argimon, I.I., Stein, L.M., Bauer, M.E., Neuroendocrine and immunological correlates of chronic stress in ‘strictly healthy' populations. Neuroimmunomodulation 17 (2010), 9–18.
76. Jeffery, I.B., O'Toole, P.W., Öhman, L., Claesson, M.J., Deane, J., Quigley, E.M.M., Simrén, M., An irritable bowel syndrome subtype defined by species-specific alterations in faecal microbiota. Gut 61 (2012), 997–1006.
77. Kennedy, P.J., Allen, A.P., O'Neill, A., Quigley, E.M.M., Cryan, J.F., Dinan, T.G., Clarke, G., Acute tryptophan depletion reduces kynurenine levels: implications for treatment of impaired visuospatial memory performance in irritable bowel syndrome. Psychopharmacology 232 (2015), 1357–1371.
78. Kennedy, P.J., Clarke, G., O‘Neill, A., Groeger, J.A., Quigley, E.M.M., Shanahan, F., Cryan, J.F., Dinan, T.G., Cognitive performance in irritable bowel syndrome: evidence of a stress-related impairment in visuospatial memory. Psychol. Med. 44 (2014), 1553–1566.
79. Kiecolt-Glaser, J.K., Dura, J.R., Speicher, C.E., Trask, O.J., Glaser, R., Spousal caregivers of dementia victims: longitudinal changes in immunity and health. Psychosom. Med. 53 (1991), 345–362.
80. Kiecolt-Glaser, J.K., Glaser, R., Gravenstein, S., Malarkey, W.B., Sheridan, J., Chronic stress alters the immune response to influenza virus vaccine in older adults. Proc. Natl. Acad. Sci. U. S. A. 93 (1996), 3043–3047.
81. Kiecolt-Glaser, J.K., Gouin, J.P., Weng, N.P., Malarkey, W.B., Beversdorf, D.Q., Glaser, R., Childhood adversity heightens the impact of later-life caregiving stress on telomere length and inflammation. Psychosom. Med. 73 (2011), 16–22.
82. Kiecolt-Glaser, J.K., Marucha, P.T., Malarkey, W.B., Mercado, A.M., Glaser, R., Slowing of wound-healing by psychological stress. Lancet 346 (1995), 1194–1196.
83. Kiecolt-Glaser, J.K., Preacher, K.J., MacCallum, R.C., Atkinson, C., Malarkey, W.B., Glaser, R., Chronic stress and age-related increases in the proinflammatory cytokine IL-6. Proc. Natl. Acad. Sci. U. S. A. 100 (2003), 9090–9095.
84. Kim, H., The effect of a support program for family caregivers of dementia on stress hormones. Commun. Computer Inf. Sci., 2011, 278–285.
85. Kim, J.H., Knight, B.G., Longmire, C.V.F., The role of familism in stress and coping processes among African American and Whitedementia caregivers: effects on mental and physical health. Health Psychol. 26 (2007), 564–576.
86. Kim, Y., Schulz, R., Family caregivers' strains: comparative analysis of cancer caregiving with dementia, diabetes, and frail elderly caregiving. J. Aging Health 20 (2008), 483–503.
87. King, A.C., Atienza, A., Castro, C., Collins, R., Physiological and affective responses to family caregiving in the natural setting in wives versus daughters. Int. J. Behav. Med. 9 (2002), 176–194.
88. King, A.C., Baumann, K., O'Sullivan, P., Wilcox, S., Castro, C., Effects of moderate-intensity exercise on physiological, behavioral, and emotional responses to family caregiving: a randomized controlled trial. J. Gerontol. Ser. A Biol. Sci. Med. Sci. 57 (2002), M26–36.
89. Klein, L.C., Kim, K., Almeida, D.M., Femia, E.E., Rovine, M.J., Zarit, S.H., Anticipating an easier day: effects of adult day services on daily cortisol and stress. Gerontology 56 (2014), 303–312.
90. Knight, B.G., Longmire, C.V.F., Dave, J., Kim, J.H., David, S., Mental health and physical health of family caregivers for persons with dementia: a comparison of African American and white caregivers. Aging Ment. Health 11 (2007), 538–546.
91. Knight, B.G., McCallum, T.J., Heart rate reactivity and depression in African-American and white dementia caregivers: reporting bias or positive coping?. Aging Ment. Health 2 (1998), 212–221.
92. Kring, S.I., Brummett, B.H., Barefoot, J., Garrett, M.E., Ashley-Koch, A.E., Boyle, S.H., Siegler, I.C., Sorensen, T.I., Williams, R.B., Impact of psychological stress on the associations between apolipoprotein E variants and metabolic traits: findings in an American sample of caregivers and controls. Psychosom. Med. 72 (2010), 427–433.
93. Lavretsky, H., Epel, E.S., Siddarth, P., Nazarian, N., St Cyr, N., Khalsa, D.S., Lin, J., Blackburn, E., Irwin, M.R., A pilot study of yogic meditation for family dementia caregivers with depressive symptoms: effects on mental health, cognition, and telomerase activity. Int. J. Geriatr. Psychiatry 28 (2013), 57–65.
94. Leach, M.J., Francis, A., Ziaian, T., Transcendental Meditation for the improvement of health and wellbeing in community-dwelling dementia caregivers [TRANSCENDENT]: a randomised wait-list controlled trial. BMC Complement. Altern. Med., 15, 2015, 145.
95. Leggett, A.N., Zarit, S.H., Kim, K., Almeida, D.M., Klein, L.C., Depressive mood, anger, and daily cortisol of caregivers on high- and low-stress days. J. Gerontol. Ser. B Psychol. Sci. Soc. Sci. 70 (2014), 820–829.
96. Li, J., Cowden, L.G., King, J.D., Briles, D.A., Schroeder, H.W. Jr., Stevens, A.B., Perry, R.T., Chen, Z., Simmons, M.S., Wiener, H.W., Tiwari, H.K., Harrell, L.E., Go, R.C.P., Effects of chronic stress and interleukin-10 gene polymorphisms on antibody response to tetanus vaccine in family caregivers of patients with Alzheimer's disease. Psychosom. Med. 69 (2007), 551–559.
97. Lovell, B., Wetherell, M.A., The cost of caregiving: endocrine and immune implications in elderly and non elderly caregivers. Neurosci. Biobehav. Rev. 35 (2011), 1342–1352.
98. Lupien, S.J., McEwen, B.S., Gunnar, M.R., Heim, C., Effects of stress throughout the lifespan on the brain, behaviour and cognition. Nat. Rev. Neurosci. 10 (2009), 434–445.
99. Lutgendorf, S.K., Garand, L., Buckwalter, K.C., Reimer, T.T., Hong, S.Y., Lubaroff, D.M., Life stress, mood disturbance, and elevated interleukin-6 in healthy older women. J. Gerontol. A: Biol. Sci. Med. Sci. 54 (1999), M434–M439.
100. McAllister-Williams, R.H., Anderson, I.M., Finkelmeyer, A., Gallagher, P., Grunze, H.C., Antidepressant augmentation with metyrapone for treatment-resistant depression (the ADD study): a double-blind, randomised, placebo-controlled trial. Lancet Psychiatry 3 (2016), 117–127.
101. MacMahon, S., Peto, R., Collins, R., Godwin, J., MacMahon, S., Cutler, J., Sorlie, P., Abbott, R., Collins, R., Neaton, J., Abbott, R., Dyer, A., Stamler, J., Blood pressure, stroke, and coronary heart disease: part 1, prolonged differences in blood pressure: prospective observational studies corrected for the regression dilution bias. Lancet 335 (1990), 765–774.
102. Mackenzie, C.S., Wiprzycka, U.J., Khatri, N., Cheng, J., Clinically significant effects of group cognitive behavioral therapy on spouse caregivers’ mental health and cognitive functioning: a pilot study. J. Gerontol. Soc. Work. 56 (2013), 675–692.
103. Mahoney, R., Regan, C., Katona, C., Livingston, G., Anxiety and depression in family caregivers of people with Alzheimer disease: the LASER-AD study. Am. J. Geriatr. Psychiatry 13 (2005), 795–801.
104. Malarkey, W.B., Wu, H., Cacioppo, J.T., Malarkey, K.L., Poehlmann, K.M., Glaser, R., Kiecolt-Glaser, J.K., Chronic stress down-regulates growth hormone gene expression in peripheral blood mononuclear cells of older adults. Endocrine 5 (1996), 33–39.
105. Mausbach, B.T., Ancoli-Israel, S., von Känel, R., Patterson, T.L., Aschbacher, K., Mills, P.J., Ziegler, M.G., Dimsdale, J.E., Calleran, S., Grant, I., Sleep disturbance, norepinephrine, and D-dimer are all related in elderly caregivers of people with Alzheimer disease. Sleep 29 (2006), 1347–1352.
106. Mausbach, B.T., Aschbacher, K., Mills, P.J., Roepke, S.K., von Känel, R., Patterson, T.L., Dimsdale, J.E., Ziegler, M.G., Ancoli-Israel, S., Grant, I., A 5-year longitudinal study of the relationships between stress, coping, and immune cell beta(2)-adrenergic receptor sensitivity. Psychiatry Res. 160 (2008), 247–255.
107. Mausbach, B.T., Aschbacher, K., Patterson, T.L., von Känel, R., Dimsdale, J.E., Mills, P.J., Ancoli-Israel, S., Grant, I., Effects of placement and bereavement on psychological well-being and cardiovascular risk in Alzheimer's caregivers: a longitudinal analysis. J. Psychosom. Res. 62 (2007), 439–445.
108. Mausbach, B.T., Chattillion, E., Roepke, S.K., Ziegler, M.G., Milic, M., von Känel, R., Dimsdale, J.E., Mills, P.J., Patterson, T.L., Allison, M.A., Ancoli-Israel, S., Grant, I., A longitudinal analysis of the relations among stress, depressive symptoms, leisure satisfaction, and endothelial function in caregivers. Health Psychol. 31 (2012), 433–440.
109. Mausbach, B.T., Dimsdale, J.E., Ziegler, M.G., Mills, P.J., Ancoli-Israel, S., Patterson, T.L., Grant, I., Depressive symptoms predict norepinephrine response to a psychological stressor task in Alzheimer's caregivers. Psychosom. Med. 67 (2005), 638–642.
110. Mausbach, B.T., Mills, P.J., Patterson, T.L., Aschbacher, K., Dimsdale, J.E., Ancoli-Israel, S., von Känel, R., Grant, I., Stress-related reduction in personal mastery is associated with reduced immune cell beta2-adrenergic receptor sensitivity. Int. Psychogeriatr. 19 (2007), 935–946.
111. Mausbach, B.T., Roepke, S.K., Ziegler, M.G., Milic, M., von Känel, R., Dimsdale, J.E., Mills, P.J., Patterson, T.L., Allison, M.A., Ancoli-Israel, S., Grant, I., Association between chronic caregiving stress and impaired endothelial function in the elderly. J. Am. Coll. Cardiol. 55 (2010), 2599–2606.
112. Mausbach, B.T., von Känel, R., Aschbacher, K., Roepke, S.K., Dimsdale, J.E., Ziegler, M.G., Mills, P.J., Patterson, T.L., Ancoli-Israel, S., Grant, I., Spousal caregivers of patients with Alzheimer's disease show longitudinal increases in plasma level of tissue-type plasminogen activator antigen. Psychosom. Med. 69 (2007), 816–822.
113. McCallum, T.J., Sorocco, K.H., Fritsch, T., Mental health and diurnal salivary cortisol patterns among African American and European American female dementia family caregivers. Am. J. Geriatr. Psychiatry 14 (2006), 684–693.
114. McDonald, S.D., Murphy, K., Beyene, J., Ohlsson, A., Perinatal outcomes of singleton pregnancies achieved by in vitro fertilization: a systematic review and meta-analysis. J. Obstet. Gynaecol. Can. 27 (2005), 449–459.
115. Merritt, M.M., McCallum, T.J., Too much of a good thing?: Positive religious coping predicts worse diurnal salivary cortisol patterns for overwhelmed African American female dementia family caregivers. Am. J. Geriatr. Psychiatry 21 (2013), 46–56.
116. Merritt, M.M., McCallum, T.J., Fritsch, T., How much striving is too much?: John Henryism active coping predicts worse daily cortisol responses for African American but not white female dementia family caregivers. Am. J. Geriatr. Psychiatry 19 (2011), 451–460.
117. Mills, P.J., Adler, K.A., Dimsdale, J.E., Perez, C.J., Ziegler, M.G., Ancoli-Israel, S., Patterson, T.L., Grant, I., Vulnerable caregivers of Alzheimer disease patients have a deficit in beta 2-adrenergic receptor sensitivity and density. Am. J. Geriatr. Psychiatry 12 (2004), 281–286.
118. Mills, P.J., Ancoli-Israel, S., von Känel, R., Mausbach, B.T., Aschbacher, K., Patterson, T.L., Ziegler, M.G., Dimsdale, J.E., Grant, I., Effects of gender and dementia severity on Alzheimer's disease caregivers' sleep and biomarkers of coagulation and inflammation. Brain Behav. Immun. 23 (2009), 605–610.
119. Mills, P.J., Yu, H., Ziegler, M.G., Patterson, T., Grant, I., Vulnerable caregivers of patients with Alzheimer's Disease have a deficit in circulating CD62L- T lymphocytes. Psychosom. Med. 61 (1999), 168–174.
120. Mills, P.J., Ziegler, M.G., Patterson, T., Dimsdale, J.E., Hauger, R., Irwin, M., Grant, I., Plasma catecholamine and lymphocyte beta 2-adrenergic receptor alterations in elderly Alzheimer caregivers under stress. Psychosom. Med. 59 (1997), 251–256.
121. Moore, R.C., Chattillion, E.A., Ceglowski, J., Ho, J., von Känel, R., Mills, P.J., Ziegler, M.G., Patterson, T.L., Grant, I., Mausbach, B.T., A randomized clinical trial of Behavioral Activation (BA) therapy for improving psychological and physical health in dementia caregivers: results of the Pleasant Events Program (PEP). Behav. Res. Ther. 51 (2013), 623–632.
122. Neri, M., Bonati, P.A., Pinelli, M., Borella, P., Tolve, I., Nigro, N., Biological, psychological and clinical markers of caregiver's stress in impaired elderly with dementia and age-related disease. Arch. Gerontol. Geriatr. 44:Suppl. 1 (2007), 289–294.
123. Ockenfels, M.C., Porter, L., Smyth, J., Kirschbaum, C., Hellhammer, D.H., Stone, A.A., Effect of chronic stress associated with unemployment on salivary cortisol Overall cortisol levels, diurnal rhythm, and acute stress reactivity. Psychosom. Med. 57 (1995), 460–467.
124. Oken, B.S., Fonareva, I., Haas, M., Wahbeh, H., Lane, J.B., Zajdel, D., Amen, A., Pilot controlled trial of mindfulness meditation and education for dementia caregivers. J. Altern. Complement. Med. 16 (2010), 1031–1038.
125. Oken, B.S., Fonareva, I., Wahbeh, H., Stress-related cognitive dysfunction in dementia caregivers. J. Geriatr. Psychiatr. Neurol. 24 (2011), 191–198.
126. Otte, C., Gold, S.M., Penninx, B.W., Pariante, C.M., Etkin, A., Fava, M., Schatzberg, A.F., Major depressive disorder. Nat. Rev. Dis. Prim., 2, 2016, 16065.
127. Palma, K.A.X.A., Balardin, J.B., Vedana, G., De Lima Argimon, I.I., Luz, C., Schröder, N., Quevedo, J., Bromberg, E., Emotional memory deficit and its psychophysiological correlate in family caregivers of patients with dementia. Alzheimer Dis. Assoc. Dis. 25 (2011), 262–268.
128. Pariante, C.M., Lightman, S.L., The HPA axis in major depression: classical theories and new developments. Trends Neurosci. 31 (2008), 464–468.
129. Pearlin, L.I., Mullan, J.T., Semple, S.J., Skaff, M.M., Caregiving and the stress process: an overview of concepts and their measures. Gerontology 30 (1990), 583–594.
130. Penza, M.K., Heim, C., Nemeroff, B.C., Neurobiological effects of childhood abuse: implications for the pathophysiology of depression and anxiety. Arch. Women's Ment. Health 6 (2003), 15–22.
131. Pomykala, K.L., Silverman, D.H., Geist, C.L., Voege, P., Siddarth, P., Nazarian, N., St Cyr, N.M., Khalsa, D.S., Lavretsky, H., A pilot study of the effects of meditation on regional brain metabolism in distressed dementia caregivers. Aging Health 8 (2012), 509–516.
132. Prenderville, J.A., Kennedy, P.J., Dinan, T.G., Cryan, J.F., Adding fuel to the fire: the impact of stress on the ageing brain. Trends Neurosci. 38 (2015), 13–25.
133. Prince, M., Wimo, A., Guerchet, M., Ali, G., Wu, Y.T., Prina, M., World Alzheimer Report 2015. The Global Impact of Dementia. An Analysis of Prevalence, Incidence, Cost and Trends., 2015, Alzheimer's Disease International, London.
134. Redwine, L., Mills, P.J., Sada, M., Dimsdale, J., Patterson, T., Grant, I., Differential immune cell chemotaxis responses to acute psychological stress in Alzheimer caregivers compared to non-caregiver controls. Psychosom. Med. 66 (2004), 770–775.
135. Reese, D.R., Gross, A.M., Smalley, D.L., Messer, S.C., Caregivers of Alzheimer's disease and stroke patients: immunological and psychological considerations. Gerontology 34 (1994), 534–540.
136. Remes-Troche, J.M., Torres-Aguilera, M., Montes-Martínez, V., Jiménez-García, V.A., Roesch-Dietlen, F., Prevalence of irritable bowel syndrome in caregivers of patients with chronic diseases. Neurogastroenterol. Motil. 27 (2015), 824–831.
137. Roepke, S.K., Allison, M., von Känel, R., Mausbach, B.T., Chattillion, E.A., Harmell, A.L., Patterson, T.L., Dimsdale, J.E., Mills, P.J., Ziegler, M.G., Ancoli-Israel, S., Grant, I., Relationship between chronic stress and carotid intima-media thickness (IMT) in elderly Alzheimer's disease caregivers. Stress 15 (2012), 121–129.
138. Roepke, S.K., Chattillion, E.A., von Känel, R., Allison, M., Ziegler, M.G., Dimsdale, J.E., Mills, P.J., Patterson, T.L., Ancoli-Israel, S., Calleran, S., Harmell, A.L., Grant, I., Carotid plaque in Alzheimer caregivers and the role of sympathoadrenal arousal. Psychosom. Med. 73 (2011), 206–213.
139. Roepke, S.K., Mausbach, B.T., Aschbacher, K., Ziegler, M.G., Dimsdale, J.E., Mills, P.J., von Känel, R., Ancoli-Israel, S., Patterson, T.L., Grant, I., Personal mastery is associated with reduced sympathetic arousal in stressed Alzheimer caregivers. Am. J. Geriatr. Psychiatry 16 (2008), 310–317.
140. Roepke, S.K., Mausbach, B.T., Patterson, T.L., von Känel, R., Ancoli-Israel, S., Harmell, A.L., Dimsdale, J.E., Aschbacher, K., Mills, P.J., Ziegler, M.G., Allison, M., Grant, I., Effects of Alzheimer caregiving on allostatic load. J. Health Psychol. 16 (2011), 58–69.
141. Sakurai, S., Onishi, J., Hirai, M., Impaired autonomic nervous system activity during sleep in family caregivers of ambulatory dementia patients in Japan. Biol. Res. Nurs. 17 (2015), 21–28.
142. Sarabia-Cobo, C.M., Heart coherence: a new tool in the management of stress on professionals and family caregivers of patients with dementia. Appl. Psychophysiol. Biofeedback 40 (2015), 75–83.
143. Scanlan, J.M., Vitaliano, P.P., Ochs, H., Savage, M.V., Borson, S., CD4 and CD8 counts are associated with interactions of gender and psychosocial stress. Psychosom. Med. 60 (1998), 644–653.
144. Scanlan, J.M., Vitaliano, P.P., Zhang, J.P., Savage, M., Ochs, H.D., Lymphocyte proliferation is associated with gender, caregiving, and psychosocial variables in older adults. J. Behav. Med. 24 (2001), 537–559.
145. Schwartz, J., Allison, M.A., Ancoli-Israel, S., Hovell, M.F., Patterson, R.E., Natarajan, L., Marshall, S.J., Grant, I., Sleep, type 2 diabetes, dyslipidemia, and hypertension in elderly Alzheimer's caregivers. Arch. Gerontol. Geriatr. 57 (2013), 70–77.
146. Scott, L.V., Dinan, T.G., Urinary free cortisol in chronic fatigue syndrome, major depression and in healthy volunteers. J. Affect. Disord. 47 (1998), 49–54.
147. Segerstrom, S.C., Schipper, L.J., Greenberg, R.N., Caregiving, repetitive thought, and immune response to vaccination in older adults. Brain. Behav. Immun. 22 (2008), 744–752.
148. Shaw, W.S., Patterson, T.L., Semple, S.J., Dimsdale, J.E., Ziegler, M.G., Grant, I., Emotional expressiveness, hostility and blood pressure in a longitudinal cohort of Alzheimer caregivers. J. Psychosom. Res. 54 (2003), 293–302.
149. Shaw, W.S., Patterson, T.L., Ziegler, M.G., Dimsdale, J.E., Semple, S.J., Grant, I., Accelerated risk of hypertensive blood pressure recordings among Alzheimer caregivers. J. Psychosom. Res. 46 (1999), 215–227.
150. Stalder, T., Tietze, A., Steudte, S., Alexander, N., Dettenborn, L., Kirschbaum, C., Elevated hair cortisol levels in chronically stressed dementia caregivers. Psychoneuroendocrinology 47 (2014), 26–30.
151. Tarlow, B.J., Wisniewski, S.R., Belle, S.H., Rubert, M., Ory, M.G., Gallagher-Thompson, D., Positive aspects of caregiving: contributions of the REACH project to the development of new measures for Alzheimer's caregiving. Res. Aging 26 (2004), 429–453.
152. Tarrier, N., Barrowclough, C., Ward, J., Donaldson, C., Burns, A., Gregga, L., Expressed emotion and attributions in the carers of patients with Alzheimer's disease: the effect on carer burden. J. Abnorm. Psychol. 111 (2002), 340–349.
153. Thompson, R.L., Lewis, S.L., Murphy, M.R., Hale, J.M., Blackwell, P.H., Acton, G.J., Clough, D.H., Patrick, G.J., Bonner, P.N., Are there sex differences in emotional and biological responses in spousal caregivers of patients with Alzheimer's disease?. Biol. Res. Nurs. 5 (2004), 319–330.
154. Todd, S., Barr, S., Roberts, M., Passmore, A.P., Survival in dementia and predictors of mortality: a review. Int. J. Geriatr. Psychiatry 28 (2013), 1109–1124.
155. Tomiyama, A.J., O'Donovan, A., Lin, J., Puterman, E., Lazaro, A., Chan, J., Dhabhar, F.S., Wolkowitz, O., Kirschbaum, C., Blackburn, E., Epel, E., Does cellular aging relate to patterns of allostasis? An examination of basal and stress reactive HPA axis activity and telomere length. Physiol. Behav. 106 (2012), 40–45.
156. Uchino, B.N., Kiecolt-Glaser, J.K., Cacioppo, J.T., Age-related changes in cardiovascular response as a function of a chronic stressor and social support. J. Personal. Soc. Psychol. 63 (1992), 839–846.
157. Uchino, B.N., Kiecolt-Glaser, J.K., Cacioppo, J.T., Construals of preillness relationship quality predict cardiovascular response in family caregivers of Alzheimer's disease victims. Psychol. Aging 9 (1994), 113–120.
158. Vedhara, K., Bennett, P.D., Clark, S., Lightman, S.L., Shaw, S., Perks, P., Hunt, M.A., Philip, J.M.D., Tallon, D., Murphy, P.J., Jones, R.W., Wilcock, G.K., Shanks, N.M., Enhancement of antibody responses to influenza vaccination in the elderly following a cognitive-behavioural stress management intervention. Psychother. Psychosom. 72 (2003), 245–252.
159. Vedhara, K., Cox, N.K.M., Wilcock, G.K., Perks, P., Hunt, M., Anderson, S., Lightman, S.L., Shanks, N.M., Chronic stress in elderly carers of dementia patients and antibody response to influenza vaccination. Lancet 353 (1999), 627–631.
160. Vitaliano, P., Echeverria, D., Shelkey, M., Zhang, J., Scanlan, J., A cognitive psychophysiological model to predict functional decline in chronically stressed older adults. J. Clin. Psychol. Med. Settings 14 (2007), 177–190.
161. Vitaliano, P.P., Echeverria, D., Yi, J., Phillips, P.E., Young, H., Siegler, I.C., Psychophysiological mediators of caregiver stress and differential cognitive decline. Psychol. Aging 20 (2005), 402–411.
162. Vitaliano, P.P., Russo, J., Niaura, R., Plasma lipids and their relationships with psychosocial factors in older adults. J. Gerontol. Ser. B: Psychol. Sci. Soc. Sci. 50 (1995), P18–P24.
163. Vitaliano, P.P., Russo, J., Scanlan, J.M., Greeno, C.G., Weight changes in caregivers of Alzheimer's care recipients: psychobehavioral predictors. Psychol. Aging 11 (1996), 155–163.
164. Vitaliano, P.P., Scanlan, J.M., Krenz, C., Fujimoto, W., Insulin and glucose: relationships with hassles, anger, and hostility in nondiabetic older adults. Psychosom. Med. 58 (1996), 489–499.
165. Vitaliano, P.P., Scanlan, J.M., Krenz, C., Schwartz, R.S., Marcovina, S.M., Psychological distress, caregiving, and metabolic variables. J. Gerontol. Ser. B Psychol. Sci. Soc. Sci. 51 (1996), 290–299.
166. Vitaliano, P.P., Scanlan, J.M., Ochs, H.D., Syrjala, K., Siegler, I.C., Snyder, E.A., Psychosocial stress moderates the relationship of cancer history with natural killer cell activity. Ann. Behav. Med. 20 (1998), 199–208.
167. Vitaliano, P.P., Scanlan, J.M., Siegler, I.C., McCormick, W.C., Knopp, R.H., Coronary heart disease moderates the relationship of chronic stress with the metabolic syndrome. Health Psychol. 17 (1998), 520–529.
168. Vitaliano, P.P., Scanlan, J.M., Zhang, J., Savage, M.V., Brummett, B., Barefoot, J., Siegler, I.C., Are the salutogenic effects of social supports modified by income? A test of an added value hypothesis. Health Psychol. 20 (2001), 155–165.
169. Vitaliano, P.P., Scanlan, J.M., Zhang, J., Savage, M.V., Hirsch, I.B., Siegler, I.C., A path model of chronic stress, the metabolic syndrome, and coronary heart disease. Psychosom. Med. 64 (2002), 418–435.
170. Vitaliano, P.P., Zhang, J., Young, H.M., Caswell, L.W., Scanlan, J.M., Echeverria, D., Depressed mood mediates decline in cognitive processing speed in caregivers. Gerontology 49 (2009), 12–22.
171. Von Känel, R., Ancoli-Israel, S., Dimsdale, J.E., Mills, P.J., Mausbach, B.T., Ziegler, M.G., Patterson, T.L., Grant, I., Sleep and biomarkers of atherosclerosis in elderly Alzheimer caregivers and controls. Gerontology 56 (2010), 41–50.
172. Von Känel, R., Dimsdale, J.E., Fibrin D-dimer: a marker of psychosocial distress and its implications for research in stress-related coronary artery disease. Clin. Cardiol. 26 (2003), 164–168.
173. Von Känel, R., Dimsdale, J.E., Adler, K.A., Patterson, T.L., Mills, P.J., Grant, I., Exaggerated plasma fibrin formation (D-Dimer) in elderly Alzheimer caregivers as compared to noncaregiving controls. Gerontology 51 (2005), 7–13.
174. Von Känel, R., Dimsdale, J.E., Ancoli-Israel, S., Mills, P.J., Patterson, T.L., McKibbin, C.L., Archuleta, C., Grant, I., Poor sleep is associated with higher plasma proinflammatory cytokine interleukin-6 and procoagulant marker fibrin D-dimer in older caregivers of people with Alzheimer's disease. J. Am. Geriatr. Soc. 54 (2006), 431–437.
175. Von Känel, R., Dimsdale, J.E., Ziegler, M.G., Mills, P.J., Patterson, T.L., Lee, S.K., Grant, I., Effect of acute psychological stress on the hypercoagulable state in subjects (spousal caregivers of patients with Alzheimeräs Disease) with coronary or cerebrovascular disease and/or systemic hypertension. Am. J. Cardiol. 87 (2001), 1405–1408.
176. Von Känel, R., Dimsdale, J.E., Mills, P.J., Ancoli-Israel, S., Patterson, T.L., Mausbach, B.T., Grant, I., Effect of Alzheimer caregiving stress and age on frailty markers interleukin-6, C-reactive protein, and D-dimer. J. Gerontol. Ser. A Biol. Sci. Med. Sci. 61 (2006), 963–969.
177. Von Känel, R., Dimsdale, J.E., Patterson, T.L., Grant, I., Association of negative life event stress with coagulation activity in elderly Alzheimer caregivers. Psychosom. Med. 65 (2003), 145–150.
178. Von Känel, R., Mausbach, B.T., Ancoli-Israel, S., Dimsdale, J.E., Mills, P.J., Patterson, T.L., Ziegler, M.G., Roepke, S.K., Chattillion, E.A., Allison, M., Grant, I., Sleep in spousal Alzheimer caregivers: a longitudinal study with a focus on the effects of major patient transitions on sleep. Sleep 35 (2012), 247–255.
179. Von Känel, R., Mausbach, B.T., Dimsdale, J.E., Mills, P.J., Patterson, T.L., Ancoli-Israel, S., Ziegler, M.G., Roepke, S.K., Allison, M., Grant, I., Problem behavior of dementia patients predicts low-grade hypercoagulability in spousal caregivers. J. Gerontol. Ser. A, Biol. Sci. Med. Sci. 65A (2010), 1004–1011.
180. 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., Cardiometabolic effects in caregivers of nursing home placement and death of their spouse with Alzheimer's disease. J. Am. Geriatr. Soc. 59 (2011), 2037–2044.
181. 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., Effect of chronic dementia caregiving and major transitions in the caregiving situation on kidney function: a longitudinal study. Psychosom. Med. 74 (2012), 214–220.
182. Von Känel, R., Mausbach, B.T., Dimsdale, J.E., Mills, P.J., Patterson, T.L., Ancoli-Israel, S., Ziegler, M.G., Roepke, S.K., Harmell, A.L., Allison, M., Grant, I., Regular physical activity moderates cardiometabolic risk in Alzheimer's caregivers. Med. Sci. Sports Exerc. 43 (2011), 181–189.
183. Von Känel, R., Mausbach, B.T., Mills, P.J., Dimsdale, J.E., Patterson, T.L., Ancoli-Israel, S., Ziegler, M.G., Allison, M., Chattillion, E.A., Grant, I., Longitudinal relationship of low leisure satisfaction but not depressive symptoms with systemic low-grade inflammation in dementia caregivers. J. Gerontol. Ser. B Psychol. Sci. Soc. Sci. 69 (2014), 397–407.
184. Von Känel, R., Mills, P.J., Mausbach, B.T., Dimsdale, J.E., Patterson, T.L., Ziegler, M.G., Ancoli-Israel, S., Allison, M., Chattillion, E.A., Grant, I., Effect of Alzheimer caregiving on circulating levels of C-reactive protein and other biomarkers relevant to cardiovascular disease risk: a longitudinal study. Gerontology 58 (2012), 354–365.
185. Wahbeh, H., Kishiyama, S.S., Zajdel, D., Oken, B.S., Salivary cortisol awakening response in mild Alzheimer disease, caregivers, and noncaregivers. Alzheimer Dis. Assoc. Disord. 22 (2008), 181–183.
186. Wechsler, D., Wechsler Adult Intelligence Scale. 1981, Psychological Corporation, New York.
187. Wilcox, S., Bopp, M., Wilson, D.K., Fulk, L.J., Hand, G.A., Race differences in cardiovascular and cortisol responses to an interpersonal challenge in women who are family caregivers. Ethn. Dis. 15 (2005), 17–24.
188. Wilkins, S.S., Castle, S., Heck, E., Tanzy, K., Fahey, J., Immune function, mood, and perceived burden among caregivers participating in a psychoeducational intervention. Psychiatry Serv. 50 (1999), 747–749.
189. Williams, V.P., Bishop-Fitzpatrick, L., Lane, J.D., Gwyther, L.P., Ballard, E.L., Vendittelli, A.P., Hutchins, T.C., Williams, R.B., Video-based coping skills to reduce health risk and improve psychological and physical well-being in Alzheimer's disease family caregivers. Psychosom. Med. 72 (2010), 897–904.
190. Wu, H., Wang, J., Cacioppo, J.T., Glaser, R., Kiecolt-Glaser, J.K., Malarkey, W.B., Chronic stress associated with spousal caregiving of patients with Alzheimer's dementia is associated with downregulation of B-lymphocyte GH mRNA. J. Gerontol. Ser. A Biol. Sci. Med. Sci. 54 (1999), M212–215.
191. Zarit, S.H., Whetzel, C.A., Kim, K., Femia, E.E., Almeida, D.M., Rovine, M.J., Klein, L.C., Daily stressors and adult day service use by family caregivers: effects on depressive symptoms, positive mood, and dehydroepiandrosterone-sulfate. Am. J. Geriatr. Psychiatr. 22 (2014), 1592–1602.
192. Zhang, J., Vitaliano, P.P., Lin, H., Relations of caregiving stress and health depend on the health indicators used and gender. Int. J. Behav. Med. 13 (2006), 173–181.
193. Zhang, J., Vitaliano, P.P., Lutgendorf, S.K., Scanlan, J.M., Savage, M.V., Sense of coherence buffers relationships of chronic stress with fasting glucose levels. J. Behav. Med. 24 (2001), 33–55.