感知压力、抑郁症状与照料和炎症之间的关联：一项纵向研究。
Associations of perceived stress, depressive symptoms, and caregiving with inflammation: a longitudinal study.
作者信息
Elayoubi Joanne, Haley William E, Roth David L, Cushman Mary, Sheehan Orla C, Howard Virginia J, Hladek Melissa deCardi, Hueluer Gizem
机构信息
School of Aging Studies, University of South Florida, Tampa, FL, USA.
Center on Aging and Health, Division of Geriatric Medicine and Gerontology, Johns Hopkins University, Baltimore, MD, USA.
出版信息
Int Psychogeriatr. 2023 Feb;35(2):95-105. doi: 10.1017/S1041610222000370. Epub 2022 May 11.
OBJECTIVES
Higher inflammation has been linked to poor physical and mental health outcomes, and mortality, but few studies have rigorously examined whether changes in perceived stress and depressive symptoms are associated with increased inflammation within family caregivers and non-caregivers in a longitudinal design.
DESIGN
Longitudinal Study.
SETTING
REasons for Geographic And Racial Differences in Stroke cohort study.
PARTICIPANTS
Participants included 239 individuals who were not caregivers at baseline but transitioned to providing substantial and sustained caregiving over time. They were initially matched to 241 non-caregiver comparisons on age, sex, race, education, marital status, self-rated health, and history of cardiovascular disease. Blood was drawn at baseline and approximately 9.3 years at follow-up for both groups.
MEASUREMENTS
Perceived Stress Scale, Center for Epidemiological Studies-Depression, inflammatory biomarkers, including high-sensitivity C-reactive protein, D dimer, tumor necrosis factor alpha receptor 1, interleukin (IL)-2, IL-6, and IL-10 taken at baseline and follow-up.
RESULTS
Although at follow-up, caregivers showed significantly greater worsening in perceived stress and depressive symptoms compared to non-caregivers, there were few significant associations between depressive symptoms or perceived stress on inflammation for either group. Inflammation, however, was associated with multiple demographic and health variables, including age, race, obesity, and use of medications for hypertension and diabetes for caregivers and non-caregivers.
CONCLUSIONS
These findings illustrate the complexity of studying the associations between stress, depressive symptoms, and inflammation in older adults, where these associations may depend on demographic, disease, and medication effects. Future studies should examine whether resilience factors may prevent increased inflammation in older caregivers.
目的
较高的炎症水平与身心健康状况不佳及死亡率相关，但很少有研究在纵向设计中严格检验感知压力和抑郁症状的变化是否与家庭照料者和非照料者体内炎症增加有关。
设计
纵向研究。
背景
中风队列研究中地理和种族差异的原因。
参与者
参与者包括239名在基线时不是照料者但随着时间推移转变为提供大量持续照料的个体。他们最初在年龄、性别、种族、教育程度、婚姻状况、自我评定健康状况和心血管疾病史方面与241名非照料者对照匹配。两组在基线时和随访约9.3年后均采集了血液样本。
测量指标
感知压力量表、流行病学研究中心抑郁量表、炎症生物标志物，包括在基线和随访时采集的高敏C反应蛋白、D二聚体、肿瘤坏死因子α受体1、白细胞介素（IL）-2、IL-6和IL-10。
结果
尽管在随访时，与非照料者相比，照料者在感知压力和抑郁症状方面的恶化程度明显更大，但两组中抑郁症状或感知压力与炎症之间几乎没有显著关联。然而，炎症与多个人口统计学和健康变量相关，包括年龄、种族、肥胖以及照料者和非照料者使用的高血压和糖尿病药物。
结论
这些发现说明了研究老年人压力、抑郁症状和炎症之间关联的复杂性，其中这些关联可能取决于人口统计学、疾病和药物影响。未来的研究应检验复原力因素是否可以预防老年照料者体内炎症增加。
Zotero 插件