Employment Status, Psychosocial Functioning, and Chronic Inflammation Among Dementia Spousal Caregivers

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Project Summary/Abstract Caregiving for a spouse with Alzheimer's disease and related dementias (ADRD) is an extreme, chronic stressor. There are 16 million informal (i.e., unpaid) ADRD caregivers in America; ADRD caregivers have chronically elevated inflammation relative to their non-caregiver counterparts1–3. Chronic inflammation is a risk factor for cardiovascular disease, atherosclerosis, type II diabetes, some cancers, fatigue, depression, premature aging, mortality, and Alzheimer's disease. ADRD caregivers often need to balance their caregiving duties with their employment responsibilities, as about half of all ADRD caregivers work over 20 hours per week4,5. To understand the impact of employment on ADRD caregivers’ psychosocial functioning and chronic inflammation, researchers must utilize theories and methods from occupational health psychology and psychoneuroimmunology. Compared to retired caregivers, employed caregivers experience two chronic stressors: employment and caregiving. Therefore, employed spousal caregivers may experience higher perceived stress than retired counterparts due to an additive effect of work stress plus caregiving stress. Working necessitates various demands and takes up a significant portion of time – time that could be used to care for their spouse or for their own rest and leisure. The time associated with employment, plus caregiving, may also result in employed caregivers evaluating their caregiving as more burdensome. This study aims to test the hypothesis that employment plus caregiving is related to poorer psychosocial functioning (i.e., perceived stress and subjective caregiver burden) and higher proinflammatory cytokine markers. Although inflammation has been implicated in studies of caregivers, very few studies have examined the inflammatory responses of caregivers’ workplace experiences6. Specific Aims: (1) To examine the role of employment status for ADRD spousal caregivers’ chronic inflammation. (2) To examine the role of employment status for ADRD spousal caregivers’ psychosocial functioning (i.e., perceived stress and caregiver burden). (3) To explore psychosocial functioning as mediators between employment status and chronic inflammation. Concurrent with an R01 project funded by NIA, this project will examine employment, psychosocial functioning, and chronic inflammation in a longitudinal study of 180 ADRD spousal caregivers (90 employed, 90 retired). Investigation of the relationship between employment and inflammation would further understanding of the role of employment as a risk factor for caregivers’ health. Results will yield important information for tailoring health interventions for ADRD caregivers. This proposed project will also introduce the applicant to psychoneuroimmunology and enable her research pipeline which will integrate occupational health psychology and psychoneuroimmunology.