title: Neuro-oncology family caregivers are at risk for systemic inflammation.
abstract: Prolonged periods of family caregiving can induce stress levels that may negatively influence caregiver health. However, the physiologic effect of psychological distress in oncology family caregivers has received little attention. Therefore we aimed to determine longitudinal profiles of inflammatory cytokines (IL-6 and IL-1ra) in neuro-oncology caregivers and identify associations between psychological distress and cytokine levels. Depressive symptoms, anxiety, caregiver burden and blood were collected from 108 adult caregivers at adult patients' diagnosis, 4-, 8-, and 12-months. Trajectory analyses of log transformed cytokine levels were performed. Multiple logistic regression analyses evaluated the impact of psychological distress on cytokine levels. For both cytokines, two distinct populations were identified, neither of which changed over time. High IL-1ra was associated with male caregivers with anxiety (OR = 1.7; 95 %CI 1.06-2.83) and obese caregivers (BMI = 40) who felt burdened due to disrupted schedules (OR = 1.3; 95 %CI 1.02-1.77). Conversely, caregivers with a healthy weight (BMI = 25) who felt burdened due to disrupted schedules were less likely to have high IL-1ra (OR = 0.71; 95 %CI 0.54-0.92). Caregivers ≤30 years old with lower self-esteem from caregiving were 1.16 times (95 %CI 1.04-1.30) more likely to have high IL-6. Analysis demonstrated groups of family caregivers with high and low levels of systemic inflammation and these levels did not change longitudinally over the care trajectory. Poor physical health in family caregivers may have a negative impact on the burden placed on the healthcare system in general and on the well-being of neuro-oncology patients in particular.
authors.affiliation: School of Nursing, University of Pittsburgh, 336 Victoria Bldg, 3500 Victoria St., Pittsburgh, PA, 15261, USA. prs11@pitt.edu.
authors.forename: Paula R
authors.initials: PR
authors.lastname: Sherwood
authors.affiliation: School of Nursing, University of Pittsburgh, 336 Victoria Bldg, 3500 Victoria St., Pittsburgh, PA, 15261, USA.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Price
authors.affiliation: School of Nursing, University of Pittsburgh, 336 Victoria Bldg, 3500 Victoria St., Pittsburgh, PA, 15261, USA.
authors.forename: Jason
authors.initials: J
authors.lastname: Weimer
authors.affiliation: School of Nursing, University of Pittsburgh, 336 Victoria Bldg, 3500 Victoria St., Pittsburgh, PA, 15261, USA.
authors.forename: Dianxu
authors.initials: D
authors.lastname: Ren
authors.affiliation: School of Nursing, University of Pittsburgh, 336 Victoria Bldg, 3500 Victoria St., Pittsburgh, PA, 15261, USA.
authors.forename: Heidi S
authors.initials: HS
authors.lastname: Donovan
authors.affiliation: Department of Family Medicine, Michigan State University, Clinical Ctr, Tower B, 788 Service Road, Room B120, East Lansing, MI, 48824, USA.
authors.forename: Charles W
authors.initials: CW
authors.lastname: Given
authors.affiliation: College of Nursing, Michigan State University, C383 Life Sciences Bldg, 1355 Bogue St., East Lansing, MI, 48824, USA.
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Given
authors.affiliation: Office of the Provost, University of Pittsburgh, 212 Forbes Ave, Pittsburgh, PA, 15261, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Schulz
authors.affiliation: School of Nursing, University of Pittsburgh, 336 Victoria Bldg, 3500 Victoria St., Pittsburgh, PA, 15261, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Prince
authors.affiliation: School of Nursing, University of Pittsburgh, 415 Victoria Bldg, Pittsburgh, PA, 15261, USA.
authors.forename: Catherine
authors.initials: C
authors.lastname: Bender
authors.affiliation: School of Nursing, University of Pittsburgh, 336 Victoria Bldg, 3500 Victoria St., Pittsburgh, PA, 15261, USA.
authors.forename: Florien W
authors.initials: FW
authors.lastname: Boele
authors.affiliation: School of Psychology, University of Pittsburgh, 3490 O'Hara St., Pittsburgh, PA, 15261, USA.
authors.forename: Anna L
authors.initials: AL
authors.lastname: Marsland
mesh_terms: D000328:Adult; D000367:Age Factors; D001007:Anxiety / Q000097:blood / Q000150:complications / Q000276:immunology; D015415:Biomarkers / Q000097:blood; D017028:Caregivers / Q000523:psychology*; D017281:Cost of Illness; D003863:Depression / Q000097:blood / Q000150:complications / Q000276:immunology; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000453:epidemiology* / Q000523:psychology; D053590:Interleukin 1 Receptor Antagonist Protein / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000628:therapy*; D009765:Obesity / Q000097:blood / Q000150:complications / Q000276:immunology / Q000523:psychology; D012307:Risk Factors; D012649:Self Concept; D012737:Sex Factors; D013315:Stress, Psychological / Q000097:blood / Q000150:complications / Q000276:immunology; D013997:Time Factors
chemical_list: D015415:Biomarkers; C507763:IL1RN protein, human; C508600:IL6 protein, human; D053590:Interleukin 1 Receptor Antagonist Protein; D015850:Interleukin-6
keywords: Brain tumor; Caregiver; IL-1ra; IL-6; Immune; Psychological health