OBJECTIVE: To estimate the glomerular filtration rate (GFR) in relation to the chronic stress of dementia caregiving and major transitions in the caregiving situation. METHODS: We longitudinally assessed 119 people serving as caregivers for their spouses with Alzheimer's disease and 58 noncaregiving controls for a period of up to 3 years (mean of 2.8 assessments per participant). At baseline, the mean (standard deviation [SD]) age of all participants was 74.5 (7.5) years. Random regression models with fixed and time-variant effects for psychosocial factors, risk factors of chronic kidney disease, and caregiving transitions were used to evaluate changes over time in estimated GFR. RESULTS: The change in GFR did not differ between caregivers and controls during follow-up (p = .77). Further analyses revealed that GFR declined disproportionately after placement of the spouse in a nursing home at 3 months after placement (-4.9 [2.2] mL/min per 1.73 m(2); p = .03). Post hoc analyses showed that this effect was stronger in caregivers with hypertension compared with those without hypertension (-5.7 [3.1] versus -2.4 [3.4] mL/min per 1.73 m(2)), as well as in caregivers with diastolic blood pressure (BP) levels at 1 SD above the mean than in those with diastolic BP levels at 1 SD below the mean (-8.3 [2.9] versus -1.4 [2.7] mL/min per 1.73 m(2)). CONCLUSIONS: Kidney function did not differ between caregivers and controls over time. However, GFR had impaired at 3 months after a major caregiving transition. Because the effect of placement of the spouse with Alzheimer's disease on the decline in GFR was moderated by BP, it might be confined to caregivers who experience increased sympathetic activation after placement.
OBJECTIVE: To estimate the glomerular filtration rate (GFR) in relation to the chronic stress of dementia caregiving and major transitions in the caregiving situation. METHODS: We longitudinally assessed 119 people serving as caregivers for their spouses with Alzheimer's disease and 58 noncaregiving controls for a period of up to 3 years (mean of 2.8 assessments per participant). At baseline, the mean (standard deviation [SD]) age of all participants was 74.5 (7.5) years. Random regression models with fixed and time-variant effects for psychosocial factors, risk factors of chronic kidney disease, and caregiving transitions were used to evaluate changes over time in estimated GFR. RESULTS: The change in GFR did not differ between caregivers and controls during follow-up (p = .77). Further analyses revealed that GFR declined disproportionately after placement of the spouse in a nursing home at 3 months after placement (-4.9 [2.2] mL/min per 1.73 m(2); p = .03). Post hoc analyses showed that this effect was stronger in caregivers with hypertension compared with those without hypertension (-5.7 [3.1] versus -2.4 [3.4] mL/min per 1.73 m(2)), as well as in caregivers with diastolic blood pressure (BP) levels at 1 SD above the mean than in those with diastolic BP levels at 1 SD below the mean (-8.3 [2.9] versus -1.4 [2.7] mL/min per 1.73 m(2)). CONCLUSIONS: Kidney function did not differ between caregivers and controls over time. However, GFR had impaired at 3 months after a major caregiving transition. Because the effect of placement of the spouse with Alzheimer's disease on the decline in GFR was moderated by BP, it might be confined to caregivers who experience increased sympathetic activation after placement.
Authors: Katia López Revuelta; Fernando J García López; Fernando de Alvaro Moreno; Jordi Alonso Journal: Nephrol Dial Transplant Date: 2004-07-13 Impact factor: 5.992
Authors: Richard Schulz; Steven H Belle; Sara J Czaja; Kathleen A McGinnis; Alan Stevens; Song Zhang Journal: JAMA Date: 2004-08-25 Impact factor: 56.272
Authors: Judith T Moskowitz; Elaine O Cheung; Karin E Snowberg; Alice Verstaen; Jennifer Merrilees; John M Salsman; Glenna A Dowling Journal: Health Psychol Date: 2019-05 Impact factor: 4.267
Authors: Brent T Mausbach; Elizabeth A Chattillion; Jennifer Ho; Laura M Flynn; Denisse Tiznado; Roland von Känel; Thomas L Patterson; Igor Grant Journal: Psychol Aging Date: 2014-08-18
Authors: Alice Verstaen; Judith T Moskowitz; Karin E Snowberg; Jennifer Merrilees; Glenna A Dowling Journal: Open Access J Clin Trials Date: 2018-02-07
Authors: Patrick Bidulka; Søren Viborg Vestergaard; Admire Hlupeni; Anders Kjærsgaard; Angel Y S Wong; Sinéad M Langan; Sigrun Alba Johannesdottir Schmidt; Susan Lyon; Christian Fynbo Christiansen; Dorothea Nitsch Journal: PLoS One Date: 2021-09-23 Impact factor: 3.240
Authors: M Eugenia Estrada Fernández; Ana I Gil Lacruz; Marta Gil Lacruz; Antonio Viñas López Journal: Aten Primaria Date: 2017-04-19 Impact factor: 1.137