title: Longitudinal relationship of low leisure satisfaction but not depressive symptoms with systemic low-grade inflammation in dementia caregivers.
abstract: OBJECTIVE
  This study aimed to further elucidate the biobehavioral mechanisms linking dementia caregiving with an increased cardiovascular disease risk. We hypothesized that both elevated depressive symptoms and a behavioral correlate of depression, low leisure satisfaction, are associated with systemic inflammation.
  
  
  METHODS
  We studied 121 elderly Alzheimer's disease caregivers who underwent 4 annual assessments for depressive symptoms, leisure satisfaction, and circulating levels of inflammatory markers. We used mixed-regression analyses controlling for sociodemographic and health-relevant covariates to examine longitudinal relationships between constructs of interest.
  
  
  RESULTS
  There were inverse relationships between total leisure satisfaction and tumor necrosis factor-α (TNF-α; p = .047), interleukin-8 (IL-8; p < .001), and interferon-γ (IFG; p = .020) but not with IL-6 (p = .21) and C-reactive protein (p = .65). Lower enjoyment from leisure activities was related to higher levels of TNF-α (p = .045), IL-8 (p < .001), and IFG (p = .002), whereas lower frequency of leisure activities was related only to higher IL-8 levels (p = .023). Depressive symptoms were not associated with any inflammatory marker (all p values > .17). Depressive symptoms did not mediate the relationship between leisure satisfaction and inflammation.
  
  
  CONCLUSIONS
  Lower satisfaction with leisure activities is related to higher low-grade systemic inflammation. This knowledge may provide a promising way of improving cardiovascular health in dementia caregivers through behavioral activation treatments targeting low leisure satisfaction.
authors: Correspondence should be addressed to Roland von Känel, Department of General Internal Medicine, Division of Psychosomatic Medicine, Bern University Hospital, Inselspital, CH-3010 Bern, Switzerland. E-mail: roland.vonkaenel@insel.ch.
authors: Roland
authors: R
authors: von Känel
authors: Brent T
authors: BT
authors: Mausbach
authors: Paul J
authors: PJ
authors: Mills
authors: Joel E
authors: JE
authors: Dimsdale
authors: Thomas L
authors: TL
authors: Patterson
authors: Sonia
authors: S
authors: Ancoli-Israel
authors: Michael G
authors: MG
authors: Ziegler
authors: Matthew
authors: M
authors: Allison
authors: Elizabeth A
authors: EA
authors: Chattillion
authors: Igor
authors: I
authors: Grant
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000451:nursing*; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology / Q000276:immunology; D017028:Caregivers / Q000523:psychology*; D003863:Depression / Q000209:etiology / Q000276:immunology / Q000523:psychology*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000209:etiology / Q000276:immunology / Q000523:psychology*; D007899:Leisure Activities / Q000523:psychology*; D008137:Longitudinal Studies; D008297:Male; D010549:Personal Satisfaction; D011569:Psychiatric Status Rating Scales
chemical_list: D015415:Biomarkers
keywords: Biomarkers; Blood coagulation; Cardiovascular disease; Depression; Inflammation; Psychological stress.
references: Biol Psychiatry. 2007 Aug 15;62(4):314-20
references: 17434456
references: Gerontologist. 1997 Feb;37(1):40-5
references: 9046704
references: J Pers. 2009 Dec;77(6):1747-76
references: 19796062
references: Clin Psychol Rev. 2007 Apr;27(3):318-26
references: 17184887
references: Cardiovasc Res. 2009 Dec 1;84(3):353-60
references: 19617600
references: J Am Coll Cardiol. 2010 Jun 8;55(23):2599-606
references: 20513601
references: J Gerontol B Psychol Sci Soc Sci. 2013 Nov;68(6):927-30
references: 23231831
references: J Gerontol B Psychol Sci Soc Sci. 2013 Nov;68(6):921-6
references: 23241850
references: Nature. 2002 Dec 19-26;420(6917):868-74
references: 12490960
references: J Behav Ther Exp Psychiatry. 2008 Dec;39(4):459-66
references: 18294613
references: Epidemiology. 1990 Jan;1(1):43-6
references: 2081237
references: Am J Prev Med. 2002 Jul;23(1):51-61
references: 12093424
references: Eur Neuropsychopharmacol. 2008 Mar;18(3):230-3
references: 17681762
references: Am J Psychiatry. 2011 Sep;168(9):913-20
references: 21724664
references: Curr Vasc Pharmacol. 2006 Jul;4(3):205-13
references: 16842138
references: Gerontology. 2008;54(3):131-7
references: 18204247
references: Circulation. 2003 Oct 21;108(16):1917-23
references: 14568885
references: J Gerontol B Psychol Sci Soc Sci. 2011 May;66(3):302-6
references: 21335421
references: Nat Rev Cardiol. 2012 Sep;9(9):526-39
references: 22733213
references: Dis Markers. 2009;26(5-6):217-25
references: 19773611
references: Psychol Aging. 1991 Dec;6(4):569-78
references: 1777145
references: Swiss Med Wkly. 2012 Jan 20;142:w13502
references: 22271452
references: J Abnorm Psychol. 1975 Dec;84(6):729-31
references: 1194539
references: Sleep. 1991 Aug;14(4):331-8
references: 1947597
references: Psychosom Med. 2009 Feb;71(2):171-86
references: 19188531
references: Health Psychol. 2007 Sep;26(5):539-44
references: 17845105
references: Histopathology. 2007 Apr;50(5):535-46
references: 17394488
references: J Pers Soc Psychol. 1986 Dec;51(6):1173-82
references: 3806354
references: Gerontology. 2012;58(4):354-65
references: 22133914
references: J Abnorm Psychol. 1978 Dec;87(6):644-54
references: 739087
references: Psychol Bull. 2003 Nov;129(6):946-72
references: 14599289
references: BMJ. 1998 Apr 18;316(7139):1236-8
references: 9553006
references: Prev Chronic Dis. 2006 Oct;3(4):A118
references: 16978493
references: Health Psychol. 2012 Jul;31(4):433-40
references: 22486550
references: Biol Psychiatry. 2010 Mar 1;67(5):446-57
references: 20015486
references: BMC Med. 2012 Jun 29;10:66
references: 22747645
references: Heart. 2010 Feb;96(3):173-6
references: 19861300
references: Circ Res. 2001 Oct 26;89(9):763-71
references: 11679405
references: Nat Rev Cardiol. 2009 Jun;6(6):410-7
references: 19421244
references: Am J Prev Med. 1994 Mar-Apr;10(2):77-84
references: 8037935
references: Gerontologist. 1990 Oct;30(5):583-94
references: 2276631
references: J Gerontol B Psychol Sci Soc Sci. 2013 Jul;68(4):504-12
references: 23033358