Personal mastery is associated with reduced sympathetic arousal in stressed Alzheimer caregivers.
OBJECTIVE
Spousal caregivers of Alzheimer's disease patients are at increased risk for cardiovascular disease, possibly via sympathetic response to stressors and subsequent catecholamine surge. Personal mastery (i.e., belief that one can manage life's obstacles) may decrease psychological and physiological response to stressors. This study examines the relationship between mastery and sympathetic arousal in elderly caregivers, as measured by norepinephrine (NE) reactivity to an acute psychological stressor.


METHODS
Cross-sectional.


METHODS
Data were collected by a research nurse in each caregiver's home.


METHODS
Sixty-nine elderly spousal Alzheimer caregivers (mean age: 72.8 years) who were not taking beta-blocking medication.


METHODS
After assessment for mastery and objective caregiving stressors, caregivers underwent an experimental speech task designed to induce sympathetic arousal.


METHODS
Mastery was assessed using Pearlin's Personal Mastery scale and Alzheimer patient functioning was assessed using the Clinical Dementia Rating Scale, Problem Behaviors Scale, and Activities of Daily Living Scale. Plasma NE assays were conducted using pre- and postspeech blood draws.


RESULTS
Multiple regression analyses revealed that mastery was significantly and negatively associated with NE reactivity (B = -9.86, t (61) = -2.03, p = 0.046) independent of factors theoretically and empirically linked to NE reactivity.


CONCLUSIONS
Caregivers with higher mastery had less NE reactivity to the stressor task. Mastery may exert a protective influence that mitigates the physiological effects of acute stress, and may be an important target for psychosocial interventions in order to reduce sympathetic arousal and cardiovascular stress among dementia caregivers.
Roepke
Susan K
SK
Department of Psychiatry, University of California at San Diego, La Jolla, CA 92093-0680, USA.
Mausbach
Brent T
BT
Aschbacher
Kirstin
K
Ziegler
Michael G
MG
Dimsdale
Joel E
JE
Mills
Paul J
PJ
von Känel
Roland
R
Ancoli-Israel
Sonia
S
Patterson
Thomas L
TL
Grant
Igor
I
D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000628:therapy*; D017028:Caregivers / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009638:Norepinephrine / Q000097:blood; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D013315:Stress, Psychological / Q000209:etiology / Q000517:prevention & control* / Q000523:psychology*; D011795:Surveys and Questionnaires
D009638:Norepinephrine