Caregivers of family members with dementia experience more health problems than noncaregivers

Higher level of stress hormones and lower antibody production increase risk for diabetes, hypertension and influenza

WASHINGTON – More than five million caregivers of persons with dementia exist in the United States (AARP, 1988) and no quantitative review has been conducted on the physical health correlates of caring for a family member with dementia until now. In a meta-analysis of 23 studies examining self-reported health and physiological functioning in caregivers of persons with dementia, researchers found that caregivers had higher stress hormones, lower resistance to some viruses and reported poorer health than noncaregivers who were similar in age and sex. This finding is reported on in the November issue of Psychological Bulletin, published by the American Psychological Association (APA).

Psychologist Peter P. Vitaliano, Ph.D., of the University of Washington and colleagues examined 23 studies involving 3,072 participants – ages 55 to 75 years – over a 38 year period to compare the physical health of caregivers demographically matched with noncaregivers on 11 health categories – self-reported health, chronic illnesses, physical symptoms, medication use, health service use, functional cellular immunity, antibodies, enumerative immunity, stress hormones, cardiovascular function and metabolic function. The authors found that caregivers had a 23 percent higher level of stress hormones and a 15 percent lower level of antibody responses than noncaregivers.

Overtime, caregivers' elevated stress hormones can lead to physiological problems such as elevated blood pressure and glucose levels, said Dr. Vitaliano, which can increase their risk for hypertension and diabetes. Furthermore, poorer antibody production for older caregivers may also increase their risk for influenza even if they receive flu shots, said Vitaliano.

Female caregivers reported more health problems but they did not exhibit higher hormone, cardiovascular or metabolic disease risk than male caregivers, said the authors. "Women report more health problems than men in many situations," explain the authors. "This may be because women are more aware of their problems and are more likely to report them when they exist. This finding may not be unique to caregiving." Also, reported health is strongly related to psychological distress, which say the authors, is higher in women than men, and likewise reported more by female caregivers than male caregivers.

Older caregivers also reported more health problems than younger caregivers but did not differ with the younger caregivers in physiological risk. A reason for this, say the authors, is that as age increases, reports of physical illness and disabilities also increase and they are related to general distress and the distress of caring for an ill spouse or family member.

According to the authors, this meta-analysis does not allow one to infer definitively that caregiving is hazardous to one's health but does have clinical implications for the millions of caregivers. "As the population ages, caregivers will play an even greater role in society and interventions that help caregivers maintain their health will not only benefit the care recipients but society as well," said Dr. Vitaliano.

Article: "Is Caregiving Hazardous to One's Physical Health? A Meta-Analysis," Peter P. Vitaliano, Ph.D., and James M. Scanlan, Ph.D., University of Washington; Jianping Zhang, Ph.D., Indiana University-Purdue University, Indianapolis; Psychological Bulletin, 129, No. 6.

Full text of the article is available from the APA Public Affairs Office or at

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