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Aging Clinical and Experimental Research

, Volume 30, Issue 2, pp 119–132 | Cite as

Impact of caregiving for older people and pro-inflammatory biomarkers among caregivers: a systematic review

  • Florence Potier
  • Jean-Marie Degryse
  • Marie de Saint-Hubert
Review

Abstract

Introduction

Evidence suggests that providing care for an older loved one may present a risk to the health of the caregiver. To understand the link between the psychosocial stress of caregiving and damage to the health of caregivers, numerous studies have assessed the presence of inflammatory biomarkers among caregivers. These biomarkers are measured to understand the relationships between the social stress of caregiving and the health of caregivers.

Objective

To provide a complete summary of the current literature regarding the most clinically relevant pro-inflammatory biomarkers associated with caregiving.

Methods

We searched articles in MEDLINE and EMBASE from January 1980 to 30 April 2016 for all studies that assessed biomarkers (cortisol, interleukin-6 and c-reactive protein) among caregivers of community-dwelling older persons. The quality of the selected studies was assessed by two reviewers using the STROBE or CONSORT checklist.

Results

Twenty-four studies were included. Most of the studies were cross-sectional and focused on dementia caregiving. Increases in biomarkers were associated with problems such as disturbed sleep, burden or pain and caregiving characteristics, including daily stressors and the duration of caregiving. Cognitive-behavioural therapy and participation in leisure activities were associated with significantly lower levels of cortisol and IL-6, respectively.

Discussion

We found little evidence concerning the association between caregiving status and biomarkers of stress and inflammation. We discuss potential sources of bias and suggest some directions for further research. This stress model can be expanded by taking into account the positive aspects of caregiving and the potential resources of caregivers.

Keywords

Caregiving Biomarkers Inflammation Chronic stress Allostatic load 

Notes

Compliance with ethical standards

Funding

Fond d’innovation sociale “Germaine Tillion”, Wallonie. The funding source was not involved in this review.

Conflict of interest

The author(s) declare that they have no competing interests.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

For this type of study formal consent is not required.

Supplementary material

40520_2017_765_MOESM1_ESM.pdf (191 kb)
Appendix 1. Concept of allostasis to understand the health consequences of caregiving stress. In response to a stressful stimulus, the main mediators of allostasis are released and support the adaptation. The response depends on the nature of the stimulus and on characteristics of the individual. Allostasis defines health as a state of responsiveness and optimal fluctuation to adapt to the demands of the environment. If the stressful situation remains, the consumption of resources is needed to reach a new state of balance; this price is called the “allostatic load”. (PDF 190 KB)
40520_2017_765_MOESM2_ESM.docx (14 kb)
Appendix 2. Search strategy (DOCX 14 KB)
40520_2017_765_MOESM3_ESM.docx (17 kb)
Appendix 3. Qualification of the articles with the STROBE statement tool. Numbers 1 to 22 correspond to the criteria of the STROBE statement tool. “+” means present, “-“ means not present and “?” means unclear. The quality of reporting is heterogeneous, with scores between 13 and 23/23. Several items were missing in a majority of the studies: presentation of the study design, description of potential sources of bias and explanation about the study size. (DOCX 16 KB)
40520_2017_765_MOESM4_ESM.docx (14 kb)
Appendix 4. Qualification of the articles with the CONSORT statement tool. Numbers 1 to 25 correspond to the criteria of the CONSORT statement tool. “+” means present, “-“ means not present, “?” means unclear and “NA” means non-applicable. (DOCX 13 KB)

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Copyright information

© Springer International Publishing Switzerland 2017

Authors and Affiliations

  1. 1.Department of GeriatricsCentre Hospitalier Universitaire Université Catholique de Louvain NamurNamurBelgium
  2. 2.Institute of Health and SocietyUniversité Catholique de LouvainBrusselsBelgium
  3. 3.Department of Public Health and Primary CareKatholieke Universiteit LeuvenLeuvenBelgium

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