Effects of placement and bereavement on psychological well-being and cardiovascular risk in Alzheimer's caregivers:: A longitudinal analysis
Effects of placement and bereavement on psychological well-being and cardiovascular risk in Alzheimer's caregivers:: A longitudinal analysis
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DOI：
10.1016/j.jpsychores.2006.10.011
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发表时间：
2007-04-01
影响因子：
4.7
通讯作者：
Grant, Igor
中科院分区：
文献类型：
--
作者：
Mausbach, Brent T.;Aschbacher, Kirstin;Grant, Igor
目的：我们研究了阿尔茨海默氏症照顾者转变的影响（即，安置和丧亲）对心理结果和血浆D-二聚体水平的影响，D-二聚体是与心血管风险增加相关的凝血级联反应的终产物。方法：采用前瞻性研究方法，对126名老年痴呆症患者的配偶照顾者进行为期5年的评估。我们使用随机回归模型来评估我们的结果随着时间的推移而发生的不连续变化，重点是照顾者转变对心理和身体健康的影响。结果：过渡后，护理人员在超负荷和掌握方面立即得到改善，并且这些改善会随着时间的推移而保持。在配偶安置后，抑郁症状也立即显著下降。D-二聚体随时间显著升高，但在转换后6个月开始显著下降。结论：照顾者的转变似乎产生直接和长期的心理健康的照顾者的“正常化”。这种正常化似乎也与D-二聚体的"下游"减少有关。(c)2007年爱思唯尔公司All rights reserved.
Objective: We examined the impact of Alzheimer caregiver transitions (i.e., placement and bereavement) on psychological outcomes and on plasma D-dimer levels, an end product of the coagulation cascade associated with increased cardiovascular risk. Methods: This was a prospective study in which 126 spousal caregivers of Alzheimer's patients were assessed each year for 5 years. We used random regression models to evaluate discontinuous change in our outcomes over time, with emphasis on the impact of caregiver transitions on psychological and physical wellbeing. Results: Caregivers experienced immediate improvement in overload and mastery following transitions, and these improvements were maintained over time. There was also a significant drop in depressive symptoms immediately following placement of spouses. D-dimer rose significantly over time but began to significantly decline at 6-months posttransitions. Conclusions: Caregiver transitions appear to produce immediate and long-term "normalization" of psychological health in caregivers. This normalization also appears related to "downstream" reductions in D-dimer. (c) 2007 Elsevier Inc. All rights reserved.