Effects of Psychosocial Interventions and Caregiving Stress on Cardiovascular Biomarkers in Family Dementia Caregivers: The UCSD Pleasant Events Program (PEP) Randomized Controlled Trial

摘要: Background This study examined whether biological mechanisms linking dementia caregiving with an increased risk of coronary heart disease can be modified by psychosocial interventions and which caregivers might benefit the most from intervention. Methods Spousal were randomized to 12-week treatment either a behavioral activation intervention (ie, Pleasant Events Program [PEP]; n = 60), or active control Information Support (IS; 63) condition. Indicators stress assessed pretreatment circulating cardiovascular biomarkers measured pre- posttreatment. Results There no significant changes in biomarker levels posttreatment both condition across all caregivers. Regardless condition, exploratory regression analysis revealed that more likely show decreases C-reactive protein (CRP) D-dimer when their spouse had severe functional impairment; interleukin (IL)-6 CRP they greater distress due care recipient’s problem behaviors; tumor necrosis factor (TNF)-α higher negative affect; IL-6, CRP, TNF-α, personal mastery. Within PEP group, affect those positive reduction von Willebrand D-dimer, respectively. IS whose impairment decrease IL-6. Conclusions Unlike average caregiver, high burden/distress resources improve risk, although these observations need confirmation.