Brice Kelly N, Paoletti-Hatcher Jensine, Wu-Chung E Lydia, Lai Vincent D, Argueta Daniel L, Chen Michelle A, Mahant Itee, Denny Bryan T, Green Charles, Medina Luis D, Schulz Paul, Stinson Jennifer, Henry Samantha K, Heijnen Cobi, Fagundes Christopher P
Department of Psychological Sciences, Rice University, USA; Institute of Health Resilience and Innovation, Rice University, USA.
Department of Psychology, Portland State University, USA.
Psychoneuroendocrinology. 2025 Sep;179:107523. doi: 10.1016/j.psyneuen.2025.107523. Epub 2025 Jun 18.
Dementia spousal caregivers are at a disproportionate risk for adverse mental and physical health outcomes. Loneliness is associated with depressive symptoms and proinflammatory cytokine production among caregivers. Additionally, childhood trauma, anticipatory grief, and poor sleep quality are all associated with enhanced stress reactivity. This study used a cross-sectional design to investigate whether loneliness is associated with proinflammatory cytokine production and depressive symptoms in caregivers, and whether these relationships are strongest among caregivers who report high levels of childhood trauma, high amounts of anticipatory grief, or poor sleep quality. A sample of 111 dementia spousal caregivers provided blood samples and completed self-report measures of loneliness, childhood trauma, anticipatory grief, depression, and subjective sleep quality. We measured the ex vivo immune cell proinflammatory cytokine response to whole-blood LPS stimulation. Caregivers who reported greater loneliness exhibited elevated LPS-stimulated proinflammatory cytokine production and more depressive symptoms. The relationship between loneliness and proinflammatory cytokine production was stronger at higher levels of childhood trauma and higher levels of anticipatory grief. The association between loneliness and depressive symptoms was stronger at higher levels of childhood trauma and higher levels of anticipatory grief. These results suggest that loneliness could have more robust effects on adverse health outcomes for caregivers who have experienced more childhood trauma and anticipatory grief. This research contributes to the existing literature investigating the mechanisms that underlie individual differences in health outcomes among dementia spousal caregivers.
患有痴呆症患者的配偶照顾者出现不良身心健康结果的风险极高。孤独感与照顾者的抑郁症状及促炎细胞因子的产生有关。此外，童年创伤、预期性悲伤和睡眠质量差均与应激反应增强有关。本研究采用横断面设计，以调查孤独感是否与照顾者的促炎细胞因子产生及抑郁症状相关，以及在报告童年创伤程度高、预期性悲伤程度高或睡眠质量差的照顾者中，这些关系是否最为显著。111名患有痴呆症患者的配偶照顾者提供了血样，并完成了关于孤独感、童年创伤、预期性悲伤、抑郁和主观睡眠质量的自我报告测量。我们测量了全血脂多糖刺激下离体免疫细胞的促炎细胞因子反应。报告孤独感更强的照顾者表现出脂多糖刺激的促炎细胞因子产生增加，抑郁症状也更多。在童年创伤程度较高和预期性悲伤程度较高的情况下，孤独感与促炎细胞因子产生之间的关系更强。在童年创伤程度较高和预期性悲伤程度较高的情况下，孤独感与抑郁症状之间的关联更强。这些结果表明，孤独感可能对经历过更多童年创伤和预期性悲伤的照顾者的不良健康结果产生更显著的影响。本研究为现有文献做出了贡献，这些文献探讨了痴呆症配偶照顾者健康结果个体差异背后 的机制。
