Longitudinal associations in dementia family caregivers of ambivalent feelings and disruptive behaviors with C-reactive protein, interleukin-6, and D-dimer.

Abstract

Caregivers' ambivalent feelings toward the care recipient have been found to be associated with depression and anxiety. There is no research linking caregivers' ambivalent feelings and cardiovascular risk. This study was aimed to analyze longitudinally the effect of ambivalence on caregivers' cardiovascular risk, defined by circulating levels of high-sensitivity C-reactive protein, interleukin-6 (IL-6), and D-dimer. Participants were 121 dementia family caregivers who were assessed three times during a 2-year period. Sociodemographic and health variables, behavioral and psychological symptoms of dementia (BPSD), ambivalent feelings, and C-reactive protein (CRP), IL-6, and D-dimer values were assessed. Mixed linear models were used to analyze the association between variables, including testing whether ambivalent feelings moderated the links between BPSD and biomarkers. Increases over time in D-dimer were associated with increases in ambivalence, older age, female gender, and body mass index (BMI). Increases over time in CRP were associated with increases in BMI, older age, female gender, and the interaction of BPSD with caregivers' ambivalent feelings. The moderation analysis showed that increased BPSD was significantly associated with increased CRP when caregivers experienced high levels of ambivalence (p = .006). In contrast, BPSD were not significantly associated with CRP when caregivers experienced low levels of ambivalence (p = .73). Increases in IL-6 were associated with female gender and BMI. The tested model explained 42.85%, 33.15%, and 5.36% of longitudinal variance in CRP, D-dimer, and IL-6 levels, respectively. The findings suggest that high ambivalent feelings are relevant for understanding cardiovascular vulnerability in dementia caregivers. (PsycInfo Database Record (c) 2024 APA, all rights reserved).