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在有矛盾情绪和破坏性行为的痴呆症家庭照顾者中,C 反应蛋白、白细胞介素 6 和 D-二聚体与纵向关联。

Longitudinal associations in dementia family caregivers of ambivalent feelings and disruptive behaviors with C-reactive protein, interleukin-6, and D-dimer.

机构信息

Departamento de Psicologia, Universidad Rey Juan Carlos.

Department of Psychiatry, University of California, San Diego.

出版信息

Health Psychol. 2024 Nov;43(11):833-841. doi: 10.1037/hea0001352. Epub 2024 Aug 15.

Abstract

OBJECTIVE

Caregivers' ambivalent feelings toward the care recipient have been found to be associated with depression and anxiety. There is no research linking caregivers' ambivalent feelings and cardiovascular risk. This study was aimed to analyze longitudinally the effect of ambivalence on caregivers' cardiovascular risk, defined by circulating levels of high-sensitivity C-reactive protein, interleukin-6 (IL-6), and D-dimer.

METHOD

Participants were 121 dementia family caregivers who were assessed three times during a 2-year period. Sociodemographic and health variables, behavioral and psychological symptoms of dementia (BPSD), ambivalent feelings, and C-reactive protein (CRP), IL-6, and D-dimer values were assessed. Mixed linear models were used to analyze the association between variables, including testing whether ambivalent feelings moderated the links between BPSD and biomarkers.

RESULTS

Increases over time in D-dimer were associated with increases in ambivalence, older age, female gender, and body mass index (BMI). Increases over time in CRP were associated with increases in BMI, older age, female gender, and the interaction of BPSD with caregivers' ambivalent feelings. The moderation analysis showed that increased BPSD was significantly associated with increased CRP when caregivers experienced high levels of ambivalence ( = .006). In contrast, BPSD were not significantly associated with CRP when caregivers experienced low levels of ambivalence ( = .73). Increases in IL-6 were associated with female gender and BMI. The tested model explained 42.85%, 33.15%, and 5.36% of longitudinal variance in CRP, D-dimer, and IL-6 levels, respectively.

CONCLUSION

The findings suggest that high ambivalent feelings are relevant for understanding cardiovascular vulnerability in dementia caregivers. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

摘要

目的

研究发现,照顾者对照顾对象的矛盾情绪与抑郁和焦虑有关。目前还没有研究将照顾者的矛盾情绪与心血管风险联系起来。本研究旨在分析矛盾情绪对照顾者心血管风险的纵向影响,心血管风险由循环高敏 C 反应蛋白、白细胞介素 6(IL-6)和 D-二聚体水平定义。

方法

研究对象为 121 名痴呆症家庭照顾者,他们在 2 年期间接受了 3 次评估。评估了社会人口学和健康变量、行为和心理症状的痴呆症(BPSD)、矛盾情绪以及 C 反应蛋白(CRP)、IL-6 和 D-二聚体值。混合线性模型用于分析变量之间的关联,包括测试矛盾情绪是否调节 BPSD 和生物标志物之间的联系。

结果

D-二聚体随时间的增加与矛盾情绪、年龄增长、女性性别和体重指数(BMI)的增加有关。CRP 随时间的增加与 BMI、年龄增长、女性性别以及 BPSD 与照顾者矛盾情绪的相互作用有关。调节分析表明,当照顾者经历高水平的矛盾情绪时,BPSD 的增加与 CRP 的增加显著相关(=0.006)。相反,当照顾者经历低水平的矛盾情绪时,BPSD 与 CRP 无显著相关性(=0.73)。IL-6 的增加与女性性别和 BMI 有关。所测试的模型分别解释了 CRP、D-二聚体和 IL-6 水平的纵向方差的 42.85%、33.15%和 5.36%。

结论

研究结果表明,强烈的矛盾情绪与痴呆症照顾者的心血管脆弱性有关。(PsycInfo 数据库记录(c)2024 APA,保留所有权利)。

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