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护理与应激负荷可预测未来疾病与残疾:一项基于人群的研究。

Caregiving and allostatic load predict future illness and disability: A population-based study.

作者信息

Gallagher Stephen, Kate M Bennett

机构信息

Department of Psychology, Centre for Social Issues Research, Study of Anxiety, Stress and Health Laboratory, University of Limerick, Limerick, Ireland.

Health Research Institute, University of Limerick, Castletroy, Limerick, Ireland.

出版信息

Brain Behav Immun Health. 2021 Jul 7;16:100295. doi: 10.1016/j.bbih.2021.100295. eCollection 2021 Oct.

Abstract

BACKGROUND

Caring for sick or disabled relatives is a key model for understanding the effects of chronic stress on immunity/inflammation; biomarkers which are part of an index of allostatic load. Here, we examine whether caring and allostatic load are predictive of future illness/disability and if the association between caring and illness/disability is mediated by allostatic load.

METHOD

Using data from the Understanding Society Wave 2 (2011) and Wave 9 (2017-2019) datasets in the UK, a sample of 471 of caregivers and 2,151 non-caregivers (all initially healthy) were compared on allostatic load and future illness/disability.

RESULTS

Caregivers had higher allostatic risk scores, for total as well as immune and non-immune biomarkers, and were more likely (23.3% vs 17.4%) to have an illness/disability in the future compared to non-caregivers. Moreover, caregiving was responsible for a 33% future illness/disability risk. Further, allostatic load was also predictive of excess risk (OR ​= ​1.18, 95% CI ​= ​1.08 - 1.26;  ​< ​.001); higher allostatic load was associated with increased risk of illness/disability in the future. In an unadjusted mediation model, allostatic load mediated the association between caregiving and future illness/disability. However, after controlling for confounding, the mediation became non-significant.

CONCLUSIONS

These results confirm that caregiving and allostatic load are damaging for future health. Results are also discussed in relation to public health aspects of caregiving.

摘要

背景

照顾生病或残疾的亲属是理解慢性应激对免疫/炎症影响的关键模式;生物标志物是应激负荷指数的一部分。在此,我们研究照顾行为和应激负荷是否能预测未来的疾病/残疾,以及照顾行为与疾病/残疾之间的关联是否由应激负荷介导。

方法

利用英国“理解社会”项目第2波(2011年)和第9波(2017 - 2019年)数据集的数据,对471名照顾者和2151名非照顾者(均初始健康)的样本在应激负荷和未来疾病/残疾方面进行了比较。

结果

照顾者在总体以及免疫和非免疫生物标志物方面有更高的应激风险评分,与非照顾者相比,未来更有可能(23.3%对17.4%)出现疾病/残疾。此外,照顾行为导致未来疾病/残疾风险增加33%。此外,应激负荷也可预测额外风险(OR = 1.18,95%CI = 1.08 - 1.26;P <.001);更高的应激负荷与未来疾病/残疾风险增加相关。在未调整的中介模型中,应激负荷介导了照顾行为与未来疾病/残疾之间的关联。然而,在控制混杂因素后,中介效应变得不显著。

结论

这些结果证实照顾行为和应激负荷对未来健康有害。还从照顾行为的公共卫生方面对结果进行了讨论。

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