Cardiometabolic effects in caregivers of nursing home placement and death of their spouse with Alzheimer's disease.

OBJECTIVES: To test the hypothesis that cardiometabolic risk is attenuated when caregivers are relieved of caregiving stress when the caregiving recipient transitions out of the home.
DESIGN: Longitudinal.
SETTING: Participants' homes. PARTICIPANTS: One hundred nineteen spousal caregivers of a patient with Alzheimer's disease (AD) and 55 noncaregiving controls (mean age of entire sample 75 ± 8, 68% women). MEASUREMENTS: Participants underwent up to three yearly assessments of metabolic syndrome (MetS) factors related to adiposity, dyslipidemia, hypertension, and hyperglycemia. Changes in the total number of MetS factors (range: 0-5) 3 months after caregiver transitions were evaluated using random regression models with fixed and time-variant effects for sociodemographic and health-related covariates.
RESULTS: Caregivers had a greater number of MetS factors over time than noncaregivers (1.78 ± 0.13 vs 1.36 ± 0.18, P = .008), which, after the death of the spouse, dropped by 0.46 ± 0.16 (P = .003) being no longer different from those of noncaregivers; this effect was most prominently related to decreases in triglycerides (-22.2 ± 11.0 mg/dL, P = .03), systolic blood pressure (-6.2 ± 2.6 mmHg, P = .02), and diastolic blood pressure (-3.4 ± 1.5 mmHg, P = .03). Placement of the spouse decreased the number of MetS factors only in caregivers with lower levels of depressive symptoms (-0.48 ± 0.18, P = .01) and sleeping difficulties (-0.42 ± 0.18, P = .02) but not in caregivers with higher levels in these measures at postplacement.
CONCLUSION: High cardiometabolic risk in caregivers decreased to the level of that of noncaregivers within 3 months of death of the spouse with AD, although placement, a transition in the course of dementia caregiving, did not benefit cardiovascular health in highly distressed caregivers.