title: Increased Framingham Coronary Heart Disease Risk Score in dementia caregivers relative to non-caregiving controls.
abstract: 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.
authors.affiliation: Department of General Internal Medicine, Division of Psychosomatic Medicine, University Hospital, Berne, Switzerland.
authors.forename: Roland
authors.initials: R
authors.lastname: von Känel
authors.forename: Brent T
authors.initials: BT
authors.lastname: Mausbach
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Patterson
authors.forename: Joel E
authors.initials: JE
authors.lastname: Dimsdale
authors.forename: Kirstin
authors.initials: K
authors.lastname: Aschbacher
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Mills
authors.forename: Michael G
authors.initials: MG
authors.lastname: Ziegler
authors.forename: Sonia
authors.initials: S
authors.lastname: Ancoli-Israel
authors.forename: Igor
authors.initials: I
authors.lastname: Grant
mesh_terms: 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