Increased Framingham Coronary Heart Disease Risk Score in dementia caregivers relative to non-caregiving controls.
BACKGROUND
Elderly individuals who provide care to a spouse suffering from dementia bear an increased risk of coronary heart disease (CHD).


OBJECTIVE
To test the hypothesis that the Framingham CHD Risk Score would be higher in dementia caregivers relative to non-caregiving controls.


METHODS
We investigated 64 caregivers providing in-home care for their spouse with Alzheimer's disease and 41 gender-matched non-caregiving controls. All subjects (mean age 70 +/- 8 years, 75% women, 93% Caucasian) had a negative history of CHD and cerebrovascular disease. The original Framingham CHD Risk Score was computed adding up categorical scores for age, blood lipids, blood pressure, diabetes, and smoking with adjustment made for sex.


RESULTS
The average CHD risk score was higher in caregivers than in controls even when co-varying for socioeconomic status, health habits, medication, and psychological distress (8.0 +/- 2.9 vs. 6.3 +/- 3.0 points, p = 0.013). The difference showed a medium effect size (Cohen's d = 0.57). A relatively higher blood pressure in caregivers than in controls made the greatest contribution to this difference. The probability (area under the receiver operator curve) that a randomly selected caregiver had a greater CHD risk score than a randomly selected non-caregiver was 65.5%.


CONCLUSIONS
Based on the Framingham CHD Risk Score, the potential to develop overt CHD in the following 10 years was predicted to be greater in dementia caregivers than in non-caregiving controls. The magnitude of the difference in the CHD risk between caregivers and controls appears to be clinically relevant. Clinicians may want to monitor caregiving status as a routine part of standard evaluation of their elderly patients' cardiovascular risk.
von Känel
Roland
R
Department of General Internal Medicine, Division of Psychosomatic Medicine, University Hospital, Berne, Switzerland.
Mausbach
Brent T
BT
Patterson
Thomas L
TL
Dimsdale
Joel E
JE
Aschbacher
Kirstin
K
Mills
Paul J
PJ
Ziegler
Michael G
MG
Ancoli-Israel
Sonia
S
Grant
Igor
I
D000368:Aged; D017028:Caregivers / Q000523:psychology; D016022:Case-Control Studies; D003327:Coronary Disease / Q000209:etiology*; D003704:Dementia / Q000150:complications / Q000523:psychology / Q000628:therapy*; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D012959:Socioeconomic Factors; D013315:Stress, Psychological