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1. Sleep Disturbance, Norepinephrine, and D-Dimer Are All Related in Elderly Care-givers of People With Alzheimer Disease

Author

Brent T. Mausbach, Thomas L. Patterson, Joel E. Dimsdale, Michael G. Ziegler, Igor Grant, Susan Calleran, Kirstin Aschbacher, Paul J. Mills, Sonia Ancoli-Israel, and Roland von Känel

Subjects
Male, Sleep Wake Disorders, medicine.medical_specialty, Epinephrine, Polysomnography, Arousal, Fibrin Fibrinogen Degradation Products, Norepinephrine (medication), Norepinephrine, Catecholamines, Sleep Apnea Syndromes, Alzheimer Disease, Risk Factors, Physiology (medical), Internal medicine, medicine, Humans, Aged, Sleep disorder, medicine.diagnostic_test, medicine.disease, Cross-Sectional Studies, Endocrinology, Caregivers, Cardiovascular Diseases, Catecholamine, Cardiology, Female, Neurology (clinical), Alzheimer's disease, Sleep onset, Psychology, medicine.drug
Abstract

Study Objective: Caregiving for a relative with Alzheimer disease has been associated with sympathoadrenal medullary arousal and morbidity and mortality. In this study, we examined if sleep disturbance of elderly caregivers was associated with physiologic markers of cardiovascular risk, including plasma norepinephrine, epinephrine, and the hemostasis marker D-dimer. Design: Cross-sectional. Setting: Community-based sample of elderly caregivers of spouses with Alzheimer disease assessed within their homes. Participants: A sample of 40 elderly spousal caregivers of patients with Alzheimer disease. Measurements and Results: Participants underwent in-home full-night polysomnography and had plasma assayed for norepinephrine and epinephrine. Using multiple regression analyses and controlling for a number of cardiovascular risk factors (e.g., age, sex, blood pressure, body mass index), increased wake after sleep onset was positively associated with norepinephrine levels (β = .35; t = 2.45, df = 32, p = .020) and plasma Ddimer (β = .31; t = 2.18, df = 29, p = .038). Further, plasma norepinephrine was significantly associated with D-dimer (β = .34; t = 2.11, df = 29, p = .044). Additional analyses indicated that norepinephrine accounted for 28% of the relationship between wake after sleep onset and D-dimer. No association was observed between sleep variables and epinephrine. Conclusions: These findings provide preliminary evidence that sleep disturbance may contribute to morbidity in caregivers through sympathoadrenal medullary arousal and downstream physiologic effects such as

Published
2006
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2. Free Communication Abstracts

Author

Bruce F. O'Hara, Yasuichiro Fukuda, H. Adami, T. Calarese, Tina M. Devlin, Tamar Shochat, R. M. Frieboes, Majda Taoudi Benchekroun, Ramalingam Vetrivelan, H. Danker-Hopfe, Robert W. McCarley, Dinesh Pal, Juan C. Toledo, I. Haimov, Fabio Moroni, Ennio A. Vivaldi, Melvi Methippara, D. Balakrishnan, Christopher E. Kline, Giovanna Zoccoli, R. Griffiths, G. Zoccoli Wild, Jasonm Passafiume, S. C. Veasey, M. Rivero, Oren Sachs, Leon Lack, Shawn D. Youngstedt, Priyattam J. Shiromani, Csóka Szilvia, H. Murck, A. M. Walker, Tsuneharo Miki, S. Esteban, Isabella Heuser, Yoshiyuki Ueno, M. B. Calzavara, D. A. Grant, Noor Alam, Deependra Kumar, Sallinen Mikael, Paul J. Mills, Mark Dunleavy, A. Nictren, P. Fenik, Rachida Roky, Lyudmila I. Kiyashchenko, Naoki Ochiai, A. Turner, Barry Taylor, G. Pillar, Michael Gradisar, Dennis McGinty, Jerome M. Siegel, Peter M Parslow, Velayudhan Mohan Kumar, F. Regen, Kis TamÁs, Mitsuaki Yamamoto, J.-S. Kang, Frank Desarnaud, Susan Calleran, Hans Dorn, Yuichi Inoue, H. E. Kuenzel, Ruben Guzman-Marin, Emilia Sforza, Seema Rai, Norihito Katayama, I. Rukhadze, Dung Viet Nguyen, Joel E. Dimsdale, Adrián Ocampo-Garcés, Helen Wright, Tomoyuki Kuwaki, Feng Xu, I. Gvilia, A. Steiger, Muhammad-Tariq Bashir, P. Cassaglia, Eric Murillo-Rodríguez, Yasuo Hishikawa, Richard Harding, David Shitrit, Birendra Nath Mallick, Igor Grant, Satoshi Hozumi, Hironobu Yaegashi, A. L. Vyssotski, E. Klann, T. Portnoy, Havrán Linda, I. Tuin, Lázár Alpár Sándor, Keisuke Yamamoto, Mitsuyuki Nakao, Heidi Louise Richardson, U. Voss, K. Puvanendran, Nir Peled, Amit Biswas, P. Storrs, Yasuhiro Matsumoto, Rajagopalan Srividya, M. Gogichadze, Elena I. Rodionova, U. Ziemann, Michele Ferrara, Luigi De Gennaro, R. Peled, Claudia Bentancor, Maria Concetta Pellicciari, Elke De Valck, O. Tzischinsky, K. R. Kessler, H. Dorn, Barbara Galland, Shamini Jain, R. Szymusiak, Richard R. Bootzin, Radhika Basheer, Ivan N. Pigarev, Akira Nakamura, R. Hsu, Y. Y. Lai, Jefferson da Luz Costa, Frussa-Filho, Noriko Matsuura, R. V. Rial, Lalini Ramanathan, Ken D. O'Halloran, Härmä Mikko, C. di Perri, Tetsuo Shimizu, Prashan T. Kaul, D. F. Kripke, R. Edwin, N. Breznitz, Rama Maganti, A. Gagliano, Fabiana Fratello, Masashi Yanagisawa, Sunil Kumar, G. Auburger, Peretz Lavie, Keng-Tee Chew, Kohtoku Satoh, Isabela B. Antunes, Hiroshi Iwasaki, R. Epstein, I. A. Antonijevic, Ryoji Aritomi, M. C. Batista, Ausaf A. Farooqui, Daiki Ishiura, Evan Tan, Joseph De Koninck, Dmitry Gerashchenko, Kazuo Mishima, Jennene Maria Wild, Mordechai R. Kramer, Gerald A. Marks, M. Xu, Wei Zhang, Melinda Sverteczki, H. P. Lipp, I. Aricò, P. O. Kosenko, Michael Schredl, K. Held, Alain Buguet, L. Lin, R. Naveh, O. Tzchishinsky, Florian Chapotot, G.-X. Zhan, Velayadhan Mohan Kumar, Kc Hsieh, Orla P. Hornung, Francesca Regen, Olivier Mairesse, M. C. Barriga, F. Mckenna, K. Hume, Brahim Benaji, Ekaterina V. Levichkina, Rigó Péter, Naomi Adachi, Ronald Szymusiak, Hruda Nanda Mallick, Mark R. Zielinski, G. Mento, Christian C. Birabil, Marisa Pedemonte, Monica L. Andersen, S. Shiloh, Yumiko Mishima, Etsunori Fujita, Alejandro Bassi, O. I. Lyamin, L. Kong, Juliana C. Perry, Megumi Kaji, P. J. Shiromani, Robert E. Strecker, Russell E. Poland, C. Blanco-Centurion, A. Lee, S. Thirunavukkarasu, H. Steinmetz, Adrian M. Walker, Akihiro Kawauchi, R. Silvestri, P. Herer, Yukihiko Kayama, Takuma Tozawa, J. P. N. Mishra, Kohji Murata, F. Serrano, Thomas L. Patterson, Raymond Cluydts, S. Aparicio, Daniel A. Grant, M. L. Andersen, Donncha Lane, Ambika Prasad K. Mahapatra, Marie Goulden, Rosemary S.C. Horne, Alexander A. Loshkarev, S. Shiromani, Yumi Ogura, Boris Y. Mileykovskiy, D. Pratico, Giuseppe Curcio, D. Mcginty, Michael G. Ziegler, Aidan Bradford, C. Garau, Kirstin Aschbacher, M. C. Nicolau, Carlos Blanco-Centurion, Yasuro Takahashi, T. M. Pokidchenko, Ricardo A. Velluti, J. L. Lapierre, Sergio Tufik, B. Morales, Emmanuel Mignot, T. Basishvili, Heidi Danker-Hopfe, Kamalesh K. Gulia, Seiji Nishino, Yoshimasa Koyama, L. Ling, Bódizs Robert, B. S. Virudhagirinathan, N. Emukhvari, Sonia Ancoli-Israel, Toby Bramwell, Peter Theuns, Cristina Marzano, Ben-Shiang Den, Shigehiko Kaneko, S. Tufik, Uma Rao, Lianqi Liu, Tsutomu Kamei, and L. M. Mukhametov

Subjects
Health psychology, medicine.medical_specialty, Neuropsychology and Physiological Psychology, Psychotherapist, Neurology, Physiology, Physiology (medical), medicine, Human physiology, Psychology
Published
2005
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3. Carotid plaque in Alzheimer caregivers and the role of sympathoadrenal arousal

Author

Michael G. Ziegler, Thomas L. Patterson, Elizabeth A. Chattillion, Roland von Känel, Matthew A. Allison, Joel E. Dimsdale, Igor Grant, Paul J. Mills, Alexandrea L. Harmell, Susan Calleran, Susan K. Roepke, and Sonia Ancoli-Israel

Subjects
Adult, Carotid Artery Diseases, Male, medicine.medical_specialty, Epinephrine, Disease, Coronary Artery Disease, Article, Arousal, Body Mass Index, Basal (phylogenetics), Norepinephrine, Alzheimer Disease, Risk Factors, Internal medicine, Medicine, Humans, Applied Psychology, Aged, Ultrasonography, business.industry, Stressor, Plaque, Atherosclerotic, Psychiatry and Mental health, Caregivers, Spouse, Physical therapy, Catecholamine, Cardiology, Female, business, Stress, Psychological, medicine.drug
Abstract

To test the hypothesis that those who provide care for a spouse diagnosed with Alzheimer's disease would have increased prevalence of carotid artery plaque compared with noncaregiving controls and that prolonged sympathoadrenal arousal to acute stress would relate to this difference. Providing care for a spouse with Alzheimer's disease has been associated with an increased risk of coronary heart disease, potentially due to the impact of caregiving stress on the atherosclerotic disease process.Participants were 111 spousal caregivers (74 ± 8 years of age; 69% women) to patients with Alzheimer's disease and 51 noncaregiving controls (75 ± 6 years of age; 69% women). Inhome assessment of carotid artery plaque via B-mode ultrasonography was conducted. Plasma catecholamine response to an acute speech stressor task was also measured.Logistic regression indicated that caregiving status (i.e., caregiver versus noncaregiver) was associated significantly with a 2.2 times greater odds for the presence of plaque independent of other risk factors of atherosclerosis (95% confidence interval, 1.01-4.73, p = .048). Decreased recovery to basal levels of epinephrine after a psychological stress task was associated significantly with the presence of plaque in caregivers, but not in noncaregivers. Norepinephrine recovery post stressor was not associated with plaque in either group.Caregivers had a higher frequency of carotid plaque compared with noncaregivers. Poorer epinephrine recovery after acute stress was associated with the presence of plaque in caregivers but not in noncaregivers. A prolonged sympathoadrenal response to acute stress might enhance the development of atherosclerosis in chronically stressed Alzheimer caregivers.

Published
2011

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