Daily Stressors and Inflammation Among Family Dementia Caregivers.

摘要

Acute laboratory stressors elicit elevations in circulating inflammatory biomarkers. Chronic stressors, such as family dementia caregiving, promote a state of chronic low-grade inflammation. The recurrent daily stressors associated with chronic stress may lead to repeated and sustained activation the inflammatory system. The goals of the present study were to evaluate whether greater exposure and reactivity to daily stressors fueled increased inflammation among family dementia caregivers, compared to noncaregiving controls. This cross-sectional study included 78 family dementia caregivers and 105 noncaregiving controls. A semi-structured interview, the Daily Inventory of Stressful Events, assessed the occurrence of daily stressors in the past 24 hours; self-report questionnaires evaluated mood, health, and health behaviors; a blood sample provided data on two inflammatory markers, C-reactive protein (CRP) and interleukin-6 (IL-6). Results showed that caregivers were more likely to experience multiple stressors in the past 24 hours than noncaregiving controls. The occurrence of multiple daily stressors was associated with greater CRP, and exposure to multiple daily stressors mediated the relationship between parental caregiving and increased CRP. Statin use moderated the relationship between daily stressors and IL-6 production; daily stressors were related to IL-6, but only among participants not using statins. Furthermore, among participants not using statins, the chronic stress of caregiving amplified IL-6, but not CRP, responses to daily stressors. The associations between daily stressors and inflammation remained significant even after adjusting for differences in health and health behaviors. These results indicate that the cumulative effect of daily stressors promotes sustained elevations in inflammation. Greater exposure to daily stressors among family dementia caregivers may promote the chronic low-grade inflammation and the enhanced health risk observed in this chronically-stressed population.