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  • Title: Coping processes and hemostatic reactivity to acute stress in dementia caregivers.
    Author: Aschbacher K, Patterson TL, von Känel R, Dimsdale JE, Mills PJ, Adler KA, Ancoli-Israel S, Grant I.
    Journal: Psychosom Med; 2005; 67(6):964-71. PubMed ID: 16314602.
    Abstract:
    BACKGROUND: A hypercoagulable stress response might contribute to the increased cardiovascular risk in Alzheimer's caregivers. OBJECTIVES: (1) To evaluate whether coping processes affect hemostatic reactivity to acute psychological stress and (2) whether these effects differ substantially between caregivers and noncaregivers. METHODS: Sixty elderly community-dwelling spousal caregivers of patients with Alzheimer's disease and 33 noncaregiving controls completed the revised Ways of Coping Questionnaire to assess approach/problem-solving versus avoidant coping processes. Participants were administered an acute stress test that required them to deliver a 3-minute speech challenge to the interviewer on an assigned topic. The hypercoagulability marker D-dimer was measured at three time points: baseline, immediately postspeech, and during recovery (15 minutes postspeech). RESULTS: Multivariate analysis of covariance revealed that subjects who endorsed greater levels of approach coping had decreased levels of D-dimer at all time points (p = .048). A significant three-way interaction between planful problem solving, caregiver status, and the temporal pattern of D-dimer was found (p = .004), indicating that caregivers with low levels of planful problem solving exhibited greater increases in D-dimer from baseline to speech and recovery time points relative to controls. No relationship between avoidant coping and D-dimer was found. CONCLUSIONS: These findings suggest the possibility that approach and problem-solving coping processes buffer the impact of acute psychological stressors on procoagulant activity. It remains to be seen whether interventions that increase approach/problem-solving processes might produce salutary effects among caregiving populations.
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