title: Does caring for a spouse with dementia promote cognitive decline? A hypothesis and proposed mechanisms.
abstract: OBJECTIVE
  To discuss why spouse caregivers (CGs) of people with dementia may be at higher risk for cognitive problems and decline than demographically similar people not caring for a spouse with dementia (noncaregivers; NCGs).
  
  
  METHODS
  Literature review.
  
  
  METHODS
  Community.
  
  
  METHODS
  Older adults caring for a family member (primarily spouses) with dementia.
  
  
  METHODS
  Cognitive, psychosocial, physiological, and behavioral.
  
  
  RESULTS
  This article reports a review of the literature examining relationships between CG status and cognitive problems in the context of a theoretical model of chronic stress. The model suggests that spouse CGs may be at higher risk of cognitive impairment or dementia than NCG spouses in response to several mediators, including psychosocial (e.g., depression, loneliness, social isolation, sleep problems), behavioral (e.g., exercise, diet), and physiological (e.g., metabolic syndrome and inflammation) variables.
  
  
  CONCLUSIONS
  This research has important implications because it considers modifiable risk factors for dementia that, if unchecked, may compromise the lives of CGs and their ability to function. It is hoped that an understanding of such stress-mediator-cognitive processes will help clinicians, researchers, policy-makers, and stakeholders mitigate what may be characterized as an "ironic tragedy"-dementia in both members of the caregiving dyad-if left unchecked.
authors.affiliation: Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA. pvital@uw.edu
authors.forename: Peter P
authors.initials: PP
authors.lastname: Vitaliano
authors.forename: Michael
authors.initials: M
authors.lastname: Murphy
authors.forename: Heather M
authors.initials: HM
authors.lastname: Young
authors.forename: Diana
authors.initials: D
authors.lastname: Echeverria
authors.forename: Soo
authors.initials: S
authors.lastname: Borson
mesh_terms: D003072:Cognition Disorders / Q000209:etiology*; D003704:Dementia / Q000451:nursing*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008962:Models, Theoretical; D012307:Risk Factors; D018454:Spouses / Q000523:psychology*