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The Chronic Stress of Caregiving Accelerates the Natural Aging of the Immune System

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Immunosenescence

Abstract

Caregiving for a spouse with dementia is highly distressing. On average, spouses serving as dementia caregivers spend more than 10 h per day providing care for over 5 years. During this time, they experience a type of “living bereavement” as they watch their partners slowly lose their personality and intellect.

Given this burden, spouses serving as dementia caregivers are at heightened risk for depression with a 46 % prevalence rate, anxiety with a 25 % prevalence rate, and poor sleep quality. In addition, having lower social support increases the burden perceived by caregivers. These negative effects are particularly detrimental for spousal dementia caregivers because they are typically older adults who are also experiencing a natural decline in immunocompetence. In turn, they are at increased risk for a number of different illnesses as well as earlier mortality.

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References

  • Aggarwal BB, Shishodia S, Sandur SK, Pandey MK, Sethi G (2006) Inflammation and cancer: How hot is the link? Biochem Pharmacol 72:1605–1621

    Article  PubMed  CAS  Google Scholar 

  • Allen SM (1994) Gender differences in spousal caregiving and unment need for care. J Gerontol Soc Sci 49:S187–S195

    CAS  Google Scholar 

  • Aschbacher K, Mills PJ, von Kanel R, Hong S, Mausbach BT, Roepke SK et al (2008) Effects of depressive and anxious symptoms on norepinephrine and platelet P-selectin responses to acute psychological stress among elderly caregivers. Brain Behav Immun 22:493–502

    Article  PubMed  CAS  Google Scholar 

  • Aviv A (2004) Telomeres and human aging: Facts and fibs. Sci Aging Knowledge Environ 51:pe43

    Google Scholar 

  • Baldwin AS (1996) The NF-kappa B and I kappa B proteins: New discoveries and insights. Ann Rev Immunol 14:649–683

    Article  CAS  Google Scholar 

  • Barnes PJ (1998) Anti-inflammatory actions of glucocorticoids: molecular mechanisms. Clin Sci 94:557–572

    PubMed  CAS  Google Scholar 

  • Barnes PJ, Karin M (1997) Nuclear factor-kappaB: a pivotal transcription factor in chronic inflammatory diseases. New Engl J Med 336:1066–1071

    Article  PubMed  CAS  Google Scholar 

  • Bauer ME, Vedhara K, Perks P, Wilcock GK, Lightman SL, Shanks N (2000) Chronic stress in caregivers of dementia patients is associated with reduced lymphocyte sensitivity to glucocorticoids. J Neuroimmunol 103:84–92

    Article  PubMed  CAS  Google Scholar 

  • Bierhaus A, Wolf J, Andrassy M, Rohleder N, Humpert PM, Petrov D et al (2003) A mechanism converting psychosocial stress into mononuclear cell activation. Proc Natl Acad Sci USA 100:1920–1925

    Article  PubMed  CAS  Google Scholar 

  • Black PH, Garbutt LD (2002) Stress, inflammation and cardiovascular disease. J Psychosom Res 52:1–23

    Article  PubMed  Google Scholar 

  • Blackburn EH (2001) Switching and signaling at the telomere. Cell 106:661–673

    Article  PubMed  CAS  Google Scholar 

  • Bloomberg GR, Chen E (2005) The relationship of psychologic stress with childhood asthma. Immunol Allergy Clin 25:83–105

    Google Scholar 

  • Brattsand R, Linden M (1996) Cytokine modulation by glucocorticoids: mechanisms and actions in cellular studies. Aliment Pharm Therap 10:81–90

    CAS  Google Scholar 

  • Brown SL, Smith DM, Schulz R, Kabeto MU, Ubel PA, Poulin M et al (2009) Caregiving behavior is associated with decreased mortality risk. Psychol Sci 20:488–494

    Article  PubMed  Google Scholar 

  • Brummett B, Babyak M, Siegler I, Vitaliano P, Ballard E, Gwyther L et al (2006) Associations among perceptions of social support, negative affect, and quality of sleep in caregivers and noncaregivers. Health Psychol 25:220–225

    Article  PubMed  Google Scholar 

  • Bruunsgaard H, Pedersen BK (2003) Age-related inflammatory cytokines and disease. Immunol Allergy Clin 23:15–39

    Google Scholar 

  • Cannon J (1995) Cytokines in aging and muscle homeostasis. J Gerontol: Series A, Biol Sci Med Sci 50:120–123

    Google Scholar 

  • Christian LM, Graham JE, Padgett DA, Glaser R, Kiecolt-Glaser JK (2006) Stress and wound healing. Neuroimmunomodulation 13:337–346

    Article  PubMed  CAS  Google Scholar 

  • Clipp EC, George LK (1990) Caregiver needs and patterns of social support. J Gerontol 45:102–222

    Article  Google Scholar 

  • Clyburn L, Stones M, Hadjistavropoulos T, Tuokko H (2000) Predicting caregiver burden and depression in Alzheimer’s disease. J Gerontol Series B: Psychol Sci Soc Sci 55:S2

    Article  Google Scholar 

  • Cohen S, Herbert TB (1996) Health psychology: psychological factors and physical disease from the perspective of human psychoneuroimmunology. Ann Rev Psychol 47:113–142

    Article  CAS  Google Scholar 

  • Cooper C, Balamurali TBS, Livingston G (2007) A systematic review of the prevalence and covariates of anxiety in caregivers of people with dementia. Intl Psychogeriatrics 19:175–195

    Article  Google Scholar 

  • Croen KD (1991) Latency of the human herpesviruses. Ann Rev Med 42:61–67

    Article  PubMed  CAS  Google Scholar 

  • Damjanovic AK, Yang Y, Glaser R, Kiecolt-Glaser JK, Nguyen H, Laskowski B et al (2007) Accelerated telomere erosion is associated with a declining immune function of caregivers of Alzheimer’s disease patients. J Immunol 179:4249–4254

    PubMed  CAS  Google Scholar 

  • De Martinis M, Franceschi C, Monti D, Ginaldi L (2006) Inflammation markers predicting frailty and mortality in the elderly. Exper Molec Pathol 80:219–227

    Article  Google Scholar 

  • Donelan K, Hill CA, Hoffman C, Scoles K, Feldman PH, Levine C et al (2002) Challenged to care: Informal caregivers in a changing health system. Health Affairs 21:222–231

    Article  PubMed  Google Scholar 

  • Elenkov IJ, Chrousos GP (2002) Stress hormones, proinflammatory and anti-inflammatory cytokines, and autoimmunity. Ann NY Acad Sci 966:290–303

    Article  PubMed  CAS  Google Scholar 

  • Epel ES, Blackburn EH, Lin J, Dhabhar FS, Adler NE, Morrow JD et al (2004) Accelerated telomere shortening in response to life stress. Proc Natl Acad Sci USA 101:17312–17315

    Article  PubMed  CAS  Google Scholar 

  • Epel ES, Lin J, Dhabhar FS, Wolkowitz OM, Puterman E, Karan L et al (2010) Dynamics of telomerase activity in response to acute psychological stress. Brain Behav Immun 24:531–539

    Article  PubMed  CAS  Google Scholar 

  • Ershler W, Keller E (2000) Age-associated increased interleukin-6 gene expression, late-life diseases, and frailty. Ann Rev Med 51:245–270

    Article  PubMed  Google Scholar 

  • Ferrucci L, Guralnik JM, Cavazzini C, Bandinelli S, Lauretani F, Bartali B et al (2003) The frailty syndrome: a critical issue in geriatric oncology. Crit Rev Oncol/Hematol 46:127–137

    Article  Google Scholar 

  • Ferrucci L, Harris T, Guralnik J, Tracy R, Corti M, Cohen H et al (1999) Serum IL-6 level and the development of disability in older persons. J Am Geriatr Soc 47:639–646

    PubMed  CAS  Google Scholar 

  • Gallagher D, Rose J, Rivera P, Lovett S, Thompson LW (1989) Prevalence of depression in family caregivers. Gerontologist 29:449–456

    Article  PubMed  CAS  Google Scholar 

  • Gallagher S, Phillips AC, Drayson MT, Carroll D (2009a) Caregiving for children with developmental disabilities is associated with a poor antibody response to influenza vaccination. Psychosom Med 71:341–344

    Article  Google Scholar 

  • Gallagher S, Phillips AC, Drayson MT, Carroll D (2009b) Parental caregivers of children with developmental disabilities mount a poor antibody response to pneumococcal vaccination. Brain Behav Immun 23:338–346

    Article  Google Scholar 

  • Glaser R, Kiecolt-Glaser JK (1994) Stress-associated immune modulation and its implications for reactivation of latent herpesviruses. In Glaser R, Jones J (eds) Human herpesvirus infections, Dekker, New York, p 245–270

    Google Scholar 

  • Glaser R, Kiecolt-Glaser JK (1997) Chronic stress modulates the virus-specific immune response to latent herpes simplex virus type 1. Ann Behav Med 19:78–82

    Article  PubMed  CAS  Google Scholar 

  • Glaser R, Kiecolt-Glaser JK (2005) Stress-induced immune dysfunction: Implications for health. Nature Rev Immunol 5:243–251

    Article  CAS  Google Scholar 

  • Glaser R, Kiecolt-Glaser PK, Marucha PT, MacCallum RC, Laskowski, BF, Malarkey WB (1999) Stress-related changes in proinflammatory cytokine production in wounds. Arch Gen Psychiatr 56:450–456

    Article  PubMed  CAS  Google Scholar 

  • Glaser R, Sheridan J, Malarkey WB, MacCallum RC, Kiecolt-Glaser JK (2000) Chronic stress modulates the immune response to a pneumococcal pneumonia vaccine. Psychosom Med 62:804–807

    PubMed  CAS  Google Scholar 

  • Godbout JP, Glaser R (2006) Stress-induced immune dysregulation: Implications for wound healing, infectious disease and cancer. J Neuroimmune Pharmacol 1:421–427

    Article  PubMed  Google Scholar 

  • Harris TB, Ferrucci L, Tracy RP, Corti MC, Wacholder S, Ettinger WH, Jr et al (1999) Associations of elevated interleukin-6 and C-reactive protein levels with mortality in the elderly. Am J Med 106:506–512

    Article  PubMed  CAS  Google Scholar 

  • Kiecolt-Glaser J (2009) Psychoneuroimmunology: Psychology’s gateway to the biomedical future. Perspect Psychol Sci 4(367)

    Google Scholar 

  • Kiecolt-Glaser J, Dura J, Speicher C, Trask O, Glaser R (1991) Spousal caregivers of dementia victims: Longitudinal changes in immunity and health. Psychosom Med 53:345

    PubMed  CAS  Google Scholar 

  • Kiecolt-Glaser J, Glaser R (1995) Psychoneuroimmunology and health consequences: Data and shared mechanisms. Psychosom Med 57(269)

    Google Scholar 

  • Kiecolt-Glaser J, Glaser R, Shuttleworth E, Dyer C, Ogrocki P, Speicher C (1987) Chronic stress and immunity in family caregivers of Alzheimer’s disease victims. Psychosom Med 49(523)

    Google Scholar 

  • Kiecolt-Glaser JK, Glaser R (2010) Psychological stress, telomeres, and telomerase. Brain Behav Immun 24:529–530

    Article  PubMed  Google Scholar 

  • Kiecolt-Glaser JK, Glaser R, Gravenstein S, Malarkey WB, Sheridan J (1996) Chronic stress alters the immune response to influenza virus vaccine in older adults. Proc Natl Acad Sci USA 93:3043–3047

    Article  PubMed  CAS  Google Scholar 

  • Kiecolt-Glaser JK, Marucha PT, Malarkey WB, Mercado AM, Glaser R (1995) Slowing of wound healing by psychological stress. Lancet 346:1194–1196

    Article  PubMed  CAS  Google Scholar 

  • Kiecolt-Glaser JK, Marucha PT, Malarkey WB, Mercado AM, Glaser R (1995) Slowing of wound healing by psychological stress. Lancet 346:1194–1196

    Article  PubMed  CAS  Google Scholar 

  • Kiecolt-Glaser JK, Preacher KJ, MacCallum RC, Atkinson C, Malarkey WB, Glaser R (2003) Chronic stress and age-related increases in the proinflammatory cytokine IL-6. Proc Natl Acad Sci USA 100:9090–9095

    Article  PubMed  CAS  Google Scholar 

  • Lee S, Colditz GA, Berkman LF, Kawachi I (2003) Caregiving and risk of coronary heart disease in US women—a prospective study. Am J Prevent Med 24:113–119

    Article  Google Scholar 

  • Levine M, Beattie BL, McLean DM, Corman D (1987) Characterization of the immune response to trivalent influenza vaccine in elderly men. J Am Geriatr Soc 35:609–615

    PubMed  CAS  Google Scholar 

  • Libby P (2002) Inflammation in atherosclerosis. Nature 420:868–874

    Article  PubMed  CAS  Google Scholar 

  • Lovell B, Moss M, Wetherell M (2012) The psychosocial, endocrine and immune consequences of caring for a child with autism or ADHD. Psychoneuroendocrinology 37:534–542

    Google Scholar 

  • Lowry SF (1993) Cytokine mediators of immunity and inflammation. Arch Surg 28:1235–1241

    Article  Google Scholar 

  • Mahoney R, Regan C, Katona C, Livingston G (2005) Anxiety and depression in family caregivers of people with Alzheimer disease: the LASER-AD study. Am J Geriatr Psychiatry 13:795

    PubMed  Google Scholar 

  • Mason J (1968) A review of psychoendocrine research on the sympathetic-adrenal medullary system. Psychosom Med 30:631

    PubMed  Google Scholar 

  • Miller G, Cohen S, Ritchey A (2002) Chronic psychological stress and the regulation of pro-inflammatory cytokines: a glucocorticoid-resistance model. Health Psychol 21:531–541

    Article  PubMed  Google Scholar 

  • Mohamed-Ali V, Pinkney J, Coppack S (1998) Adipose tissue as an endocrine and paracrine organ. Intl J Obes 22:1145–1158

    Article  CAS  Google Scholar 

  • Nahmias A, Roizman B (1973) Infection with herpes-simplex viruses 1 and 2. New Engl Jf Med 289:781–789

    Article  CAS  Google Scholar 

  • Padgett DA, Marucha PT, Sheridan JF (1998) Restraint stress slows cutaneous wound healing in mice. Brain Behav Immun 12:64–73

    Article  PubMed  CAS  Google Scholar 

  • Pawelec G, Derhovanessian E, Larbi A, Strindhall J, Wikby A (2009) Cytomegalovirus and human immunosenescence. Rev Med Virol 19:47–56

    Article  PubMed  CAS  Google Scholar 

  • Pawelec G, Solana R (1997) Immunosenescence. Immunol Today 18:514–516

    Article  PubMed  CAS  Google Scholar 

  • Pedersen BK, Febbraio MA (2008) Muscle as an endocrine organ: focus on muscle-derived interleukin-6. Physiol Rev 88:1379–1406

    Article  PubMed  CAS  Google Scholar 

  • Robson SC, Shephard EG, Kirsch RE (1994) Fibrin degradation product D-dimer induces the synthesis and release of biologically-active IL-1-beta, IL-6 and plasminogen-activator inhibitros from monocytes in-vitro. [Article]. Brit J Haematol 86:322–326

    Article  CAS  Google Scholar 

  • Rohleder N, Marin TJ, Ma R, Miller GE (2009) Biologic cost of caring for a cancer patient: Dysregulation of pro- and anti-inflammatory signaling pathways. J Clin Oncol 27:2909–2915

    Article  PubMed  Google Scholar 

  • Schulz R, Beach S (1999) Caregiving as a risk factor for mortality: the caregiver health effects study. J Am Med Assoc 282:2215

    Article  CAS  Google Scholar 

  • Shaw WS, Patterson TL, Ziegler MG, Dimsdale JE, Semple SJ, Grant I (1999) Accelerated risk of hypertensive blood pressure recordings among Alzheimer caregivers. J Psychosom Res 46:215–227

    Article  PubMed  CAS  Google Scholar 

  • Simon NM, Smoller JW, McNamara KL, Maser RS, Zalta AK, Pollack MH et al (2006) Telomere shortening and mood disorders: preliminary support for a chronic stress model of accelerated aging. Biol Psychiatr 60:432–435

    Article  CAS  Google Scholar 

  • Smith NM, Bresee JS, Shay DK, Uyeki TM, Cox NJ, Strikas RA (2006) Prevention and control of influenza: recommendations of the advisory committee on immunization practices (ACIP). MMWR Recomm Rep 55:1–42

    PubMed  Google Scholar 

  • Taylor Jr D, Ezell M, Kuchibhatla M, Østbye T, Clipp E. (2008) Identifying trajectories of depressive symptoms for women caring for their husbands with dementia. J Am Geriatr Soc 56:322–327

    Article  Google Scholar 

  • Thompson WW, Shay DK, Weintraub E, Brammer L, Cox N, Anderson LJ et al (2003) Mortality associated with influenza and respiratory syncytial virus in the United States. J Am Med Assoc 289:179–186

    Article  Google Scholar 

  • Vedhara K, Cox NK, Wilcock GK, Perks P, Hunt M, Anderson S et al (1999) Chronic stress in elderly carers of dementia patients and antibody response to influenza vaccination. Lancet 353:627–631

    Article  PubMed  CAS  Google Scholar 

  • von Kanel R, Ancoli-Israel S, Dimsdale JE, Mills PJ, Mausbach BT, Ziegler MG et al (2010) Sleep and biomarkers of atherosclerosis in elderly Alzheimer caregivers and controls. Gerontology 56:41–50

    Article  PubMed  Google Scholar 

  • von Kanel R, Dimsdale JE, Mills PJ, Ancoli-Israel S, Patterson TL, Mausbach BT et al (2006) Effect of Alzheimer caregiving stress and age on frailty markers interleukin-6, C-reactive protein, and D-dimer. J Gerontol A 61:963–969

    Article  Google Scholar 

  • Walston J, McBurnie MA, Newman A, Tracy RP, Kop WJ, Hirsch CH et al (2002) Frailty and activation of the inflammation and coagulation systems with and without clinical comorbidities: results from the cardiovascular health study. Arch Intern Med 162:2333–2341

    Article  PubMed  Google Scholar 

  • Webster JC, Cidlowski JA (1994) Downregulation of the glucocorticoid receptor. A mechanism for physiological adaptation to hormones. Ann NY Acad Sci 746:216–220

    Article  PubMed  CAS  Google Scholar 

  • Webster JI, Tonelli L, Sternberg EM (2002) Neuroendocrine regulation of immunity. Ann Rev Immunol 20:125–163

    Article  CAS  Google Scholar 

  • Wimo A, von Strauss E, Nordberg G, Sassi F, Johansson L (2002) Time spent on informal and formal care giving for persons with dementia in Sweden. Health Policy 61:255–268

    Article  PubMed  Google Scholar 

  • Zarit SH, Reever KE, Bach-Peterson J (1980) Relatives of the impaired elderly: Correlates of feelings of burden. Gerontologist 20:649–655

    Article  PubMed  CAS  Google Scholar 

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Author information

Authors and Affiliations

  1. Division of Oral Biology, College of Dentistry, Institute for Behavioral Medicine Research, College of Medicine, The Ohio State University, Columbus, OH, USA

    Jeanette M. Bennett

  2. Institute for Behavioral Medicine Research, College of Medicine, The Ohio State University, Columbus, OH, USA

    Christopher P. Fagundes

  3. Departments of Psychiatry and Psychology, Institute for Behavioral Medicine Research, College of Medicine, The Ohio State University, Columbus, OH, USA

    Janice K. Kiecolt-Glaser

  4. Department of Psychology, The University of North Carolina at Charlotte, 9201 University City Blvd, 28223, Charlotte, NC, USA

    Jeanette M. Bennett

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  1. Jeanette M. Bennett
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  2. Christopher P. Fagundes
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  3. Janice K. Kiecolt-Glaser
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Correspondence to Jeanette M. Bennett .

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Editors and Affiliations

  1. University of Amsterdam, Oudezijds Achterburgwal 237, Amsterdam, 1012 DL, Netherlands

    Jos A. Bosch

  2. University of Birmingham, Edgbaston, Birmingham, B15 2TT, United Kingdom

    Anna C. Phillips

  3. University of Birmingham, Edgbaston, Birmingham, B15 2TT, United Kingdom

    Janet M. Lord

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Bennett, J.M., Fagundes, C.P., Kiecolt-Glaser, J.K. (2013). The Chronic Stress of Caregiving Accelerates the Natural Aging of the Immune System. In: Bosch, J., Phillips, A., Lord, J. (eds) Immunosenescence. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-4776-4_3

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