Mausbach Brent T, Aschbacher Kirstin, Mills Paul J, Roepke Susan K, von Känel Roland, Patterson Thomas L, Dimsdale Joel E, Ziegler Michael G, Ancoli-Israel Sonia, Grant Igor
Department of Psychiatry, University of California at San Diego, La Jolla, CA, USA.
Psychiatry Res. 2008 Sep 30;160(3):247-55. doi: 10.1016/j.psychres.2007.09.006. Epub 2008 Aug 16.
Caring for a spouse with Alzheimer's disease (AD) is associated with overall health decline and impaired cardiovascular functioning. This morbidity may be related to the effects of caregiving stress and impaired coping on beta(2)-adrenergic receptors, which mediate hemodynamic and vascular responses and are important for peripheral blood mononuclear cell (PBMC) trafficking and cytokine production. This study investigated the longitudinal relationship between stress, personal mastery, and beta(2)-adrenergic receptor sensitivity assessed in vitro on PBMC. Over a 5-year study, 115 spousal AD caregivers completed annual assessments of caregiving stress, mastery, and PBMC beta(2)-adrenergic receptor sensitivity, as assessed by in vitro isoproterenol stimulation. Heightened caregiving stress was associated with significantly decreased receptor sensitivity, whereas greater sense of personal mastery was associated with significantly increased receptor sensitivity. These results suggest that increased stress may be associated with a desensitization of beta(2)-receptors, which may contribute to the development of illness among caregivers. However, increased mastery is associated with increased receptor sensitivity, and may therefore serve as a resource factor for improved health in this population.
照顾患有阿尔茨海默病(AD)的配偶与整体健康状况下降和心血管功能受损有关。这种发病率可能与照顾压力的影响以及应对能力受损对β₂-肾上腺素能受体的作用有关,β₂-肾上腺素能受体介导血液动力学和血管反应,对外周血单核细胞(PBMC)的运输和细胞因子产生很重要。本研究调查了压力、个人掌控感与体外评估的PBMC上β₂-肾上腺素能受体敏感性之间的纵向关系。在一项为期5年的研究中,115名配偶为AD患者的照顾者完成了对照顾压力、掌控感和PBMCβ₂-肾上腺素能受体敏感性的年度评估,后者通过体外异丙肾上腺素刺激进行评估。照顾压力增加与受体敏感性显著降低相关,而更强的个人掌控感与受体敏感性显著增加相关。这些结果表明,压力增加可能与β₂-受体脱敏有关,这可能导致照顾者患病。然而,掌控感增强与受体敏感性增加相关,因此可能是该人群健康改善的一个资源因素。