Psychosocial and behavioral pathways of metabolic syndrome in cancer caregivers

Abstract

Cancer caregivers are at increased risk for cardiovascular disease (CVD) and mortality. The aims of this study were to examine psychosocial and behavioral predictors of metabolic syndrome, an intermediate endpoint of CVD. Cancer caregivers were administered a battery of questionnaires assessing sociodemographic characteristics, depressive symptoms, perceived stress, caregiver quality of life, sleep, physical activity, alcohol and tobacco use, social support, relationship quality, and loneliness. Metabolic syndrome was defined using the American Heart Association guidelines and the National Cholesterol Education Program's Adult Treatment Panel (ATP) III, which includes the presence of at least three of the following abnormalities: blood pressure, glucose, abdominal girth, high-density lipoprotein (HDL), and triglycerides. Of the 104 caregivers, 77% were female, 94% were Caucasian, and the mean age was 59.5 (SD=12.8). Of the 104 caregivers, 35.6% reported depressive symptoms in the clinical range of the Center for Epidemiologic Studies-Depression (CES-D) and 69.2% reported Perceived Stress Scale scores at least one standard deviation above the general population norms. A total of 16.3% of caregivers currently used tobacco, 28.8% consumed alcohol, and 26.7% were overweight (BMI=25-29.9) and 48.5% were obese (BMI≥30). Forty-nine percent of the caregivers met the criteria for metabolic syndrome. After age, gender, and race were adjusted, the following remained as significant predictors of metabolic syndrome: low levels of caregiver quality of life (Odds Ratio (OR)=1.067; 95% CI, 1.019-1.117; P=.006), high levels of hostility (OR=1.142; 95% CI, 1.030-1.267; P=.012), and current alcohol use (OR=4.193; 95% CI, 1.174-14.978; P=.027). Development of interventions to reduce the risk of metabolic syndrome in cancer caregivers is recommended.