Biomarkers of Stress in African American and White Caregivers: A Feasibility Study

PRINCIPAL INVESTIGATOR:
Kimberly A. Brownley, PhD, Assistant Professor

ABSTRACT:
Prior studies in predominantly Caucasian samples indicate that in-home caregiving for family members with Alzheimer’s disease and other forms of dementia is stressful, and that the cost of that stress burden can manifest in physical and psychological illness in the caregiver (1-4). For example, caregiver stress is associated with hypertension, depression, and deleterious alterations in immune function. African Americans suffer higher rates of Alzheimer’s disease, and their in-home caregivers are more likely to underutilize formal support services and to maintain work duties outside the home thus adding to their overall stress burden (5-10).  Despite this, little is known about the specific nature and consequences of caregiver burden in African American families. Of particular concern is how the stress of caregiving affects cardiovascular disease (CVD) risk for African Americans, who appear to be more susceptible to processes linked to CVD even after taking into account disparities in access to care and other socioeconomic factors. African American women, who comprise the majority of in-home caregivers in African American families, are especially vulnerable to CVD-related conditions such as diabetes and hypertension (11-18). To better understand CVD risk among African American caregivers, longitudinal studies that incorporate in-home assessments of changes in CVD risk factors are needed. In preparation for these types of studies, this application proposes a pilot study of biomarkers of CVD risk in participants enrolled in the ongoing “Cultural Meanings and Reasons for Caregiving in African American and White Caregivers” study, which is a phone-based interview study designed to understand cultural values and beliefs that influence and shape the caregiver role; it seeks to characterize caregiver strain, coping, service utilization, and spirituality, as well as the health status of the care recipient. The study will obtain these measures in 200 caregiver participants (100 Black, 100 White) living in North Carolina.  Pilot funds are specifically requested to cover the expenses associated with assessing CVD risk biomarkers in these participants. The proposed study has two aims. Specific Aim1 is to establish feasibility of our methods. Specific Aim 2 is to obtain biomarkers of four cornerstones of CVD risk: hypertension, dyslipidemia, diabetes, and depression. These data, along with detailed feasibility data, will be used to inform and support a subsequent R01 level application to the National Institutes of Health, which is tentatively planned for early 2011.