title: Regular physical activity moderates cardiometabolic risk in Alzheimer's caregivers.
abstract: BACKGROUND
  Dementia caregivers have an increased risk of cardiovascular disease, and it is possible that metabolic disturbances contribute to this risk. Regular physical exercise reduces cardiometabolic risk, but caregivers may have less opportunity to engage in such activity. We hypothesized that regular physical activity would moderate cardiometabolic risk in dementia caregivers.
  
  
  METHODS
  One hundred and fifteen Alzheimer's caregivers and 54 noncaregiving controls were assessed for medical history and health habits. Physical activity was defined as the number of days per week participants performed light (score = 0-4), moderate (score = 0-4), or vigorous (score = 0-4) exercise (total score = 0-12). A cardiometabolic risk score was calculated by adding standardized z-scores of five metabolic syndrome components: body mass index, triglycerides, HDL cholesterol, systolic blood pressure, and glucose.
  
  
  RESULTS
  Caregivers were less physically active than noncaregivers (mean ± SD = 5.1 ± 3.0 vs 6.3 ± 2.7, P = 0.008). A significant caregiver status × physical activity interaction was found for the standardized cardiometabolic risk score controlling for gender, age, education, smoking, alcohol consumption, health problems, cholesterol-lowering medication, negative affect, role overload, and fasting state (P = 0.035). Among participants with low levels of physical activity, caregivers had greater cardiometabolic risk score than noncaregivers (0.58 ± 0.31 vs -1.23 ± 0.54, P = 0.017); no group difference emerged in participants with high levels of physical activity (P = 0.81).
  
  
  CONCLUSIONS
  Cardiometabolic risk was particularly high in caregivers reporting reduced levels of regular physical activity. Intervention studies aimed at increasing physical activity in caregivers seem warranted to examine whether that would possibly lower cardiometabolic risk to the level of noncaregivers.
authors.affiliation: Division of Psychosomatic Medicine, Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland. roland.vonkaenel@insel.ch
authors.forename: Roland
authors.initials: R
authors.lastname: von Känel
authors.forename: Brent T
authors.initials: BT
authors.lastname: Mausbach
authors.forename: Joel E
authors.initials: JE
authors.lastname: Dimsdale
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Mills
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Patterson
authors.forename: Sonia
authors.initials: S
authors.lastname: Ancoli-Israel
authors.forename: Michael G
authors.initials: MG
authors.lastname: Ziegler
authors.forename: Susan K
authors.initials: SK
authors.lastname: Roepke
authors.forename: Alexandrea L
authors.initials: AL
authors.lastname: Harmell
authors.forename: Matthew
authors.initials: M
authors.lastname: Allison
authors.forename: Igor
authors.initials: I
authors.lastname: Grant
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000453:epidemiology; D000544:Alzheimer Disease; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D017028:Caregivers / Q000523:psychology* / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology*; D009043:Motor Activity; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D013315:Stress, Psychological / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D011795:Surveys and Questionnaires
references.citation: Sports Med. 2004;34(6):371-418
references.pmid: 15157122
references.citation: Circulation. 2007 Sep 11;116(11):1306-17
references.pmid: 17846344
references.citation: Diabetes Care. 2007 Apr;30(4):872-7
references.pmid: 17392548
references.citation: Hypertension. 2003 Dec;42(6):1206-52
references.pmid: 14656957
references.citation: Prev Chronic Dis. 2006 Oct;3(4):A118
references.pmid: 16978493
references.citation: Obes Rev. 2010 Jul;11(7):492-507
references.pmid: 19895413
references.citation: Am J Prev Med. 2003 Feb;24(2):113-9
references.pmid: 12568816
references.citation: Prev Med. 1997 Mar-Apr;26(2):162-9
references.pmid: 9085384
references.citation: J Hum Hypertens. 2007 Aug;21(8):625-32
references.pmid: 17476291
references.citation: Circulation. 2003 Jun 24;107(24):3109-16
references.pmid: 12821592
references.citation: Am J Alzheimers Dis Other Demen. 2008 Apr-May;23(2):132-42
references.pmid: 18174315
references.citation: Ann Epidemiol. 2007 Oct;17(10):782-90
references.pmid: 17697786
references.citation: Gerontology. 2008;54(3):131-7
references.pmid: 18204247
references.citation: Health Psychol. 1998 Nov;17(6):520-9
references.pmid: 9848802
references.citation: Mayo Clin Proc. 2006 Dec;81(12):1615-20
references.pmid: 17165640
references.citation: Arch Gen Psychiatry. 2002 Oct;59(10):877-83
references.pmid: 12365874
references.citation: Diabetes Care. 2005 Jul;28(7):1769-78
references.pmid: 15983333
references.citation: J Pers Soc Psychol. 1988 Jun;54(6):1063-70
references.pmid: 3397865
references.citation: J Gerontol A Biol Sci Med Sci. 2007 May;62(5):563-9
references.pmid: 17522363
references.citation: Circulation. 2009 Oct 20;120(16):1640-5
references.pmid: 19805654
references.citation: Diabetes Care. 2005 Sep;28(9):2289-304
references.pmid: 16123508
references.citation: Psychosom Med. 2002 May-Jun;64(3):458-68
references.pmid: 12021419
references.citation: Health Psychol. 2007 Sep;26(5):539-44
references.pmid: 17845105
references.citation: Br J Psychiatry. 1982 Jun;140:566-72
references.pmid: 7104545
references.citation: J Psychosom Res. 1999 Mar;46(3):215-27
references.pmid: 10193912
references.citation: Psychol Bull. 2003 Nov;129(6):946-72
references.pmid: 14599289
references.citation: Ann Behav Med. 2005 Feb;29(1):29-36
references.pmid: 15677298
references.citation: J Am Acad Child Adolesc Psychiatry. 2003 Dec;42(12):1524-9
references.pmid: 14627890
references.citation: BMJ. 2006 Mar 4;332(7540):521-5
references.pmid: 16428252
references.citation: Arch Intern Med. 2005 Dec 12-26;165(22):2644-50
references.pmid: 16344423
references.citation: Ann Behav Med. 1997 Spring;19(2):110-6
references.pmid: 9603685
references.citation: Prev Med. 1997 Mar-Apr;26(2):155-61
references.pmid: 9085383
references.citation: Psychosom Med. 2002 May-Jun;64(3):418-35
references.pmid: 12021416
references.citation: J Am Diet Assoc. 2001 Jan;101(1):28-34; quiz 35-6
references.pmid: 11209581
references.citation: Circulation. 2005 Oct 25;112(17):2735-52
references.pmid: 16157765
references.citation: J Phys Act Health. 2008 Mar;5(2):294-307
references.pmid: 18382038
references.citation: J Pediatr Psychol. 2002 Jan-Feb;27(1):87-96
references.pmid: 11726683
references.citation: Gerontologist. 1990 Oct;30(5):583-94
references.pmid: 2276631
references.citation: Neurology. 1993 Nov;43(11):2412-4
references.pmid: 8232972