Chronic stress in elderly carers of dementia patients and antibody response to influenza vaccination

Vedhara, Kavita; Cox, Nigel Km; Wilcock, Gordon; Perks, PA; Hunt, Moira; Anderson, Stephen J.; Lightman, Stafford; Shanks, Nola

doi:10.1016/s0140-6736(98)06098-x

Cited by 430 publications

(318 citation statements)

References 20 publications

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“…There was also a negative correlation between mean resting cortisol concentrations and antibody response to one viral strain [47]. In contrast, basal salivary cortisol and antibody response to hepatitis B vaccination have been found to be correlated positively [72] and a null result has recently been observed for influenza vaccination [53].…”

Section: Hypothalamic-pituitary-adrenal Axismentioning

confidence: 90%

“…Another study has also found that spousal care-givers displayed poorer antibody responses to influenza vaccination compared with controls [47]. However, caregivers are likely to differ from controls in a number of respects other than psychological stress, such as experiencing more physical strain.…”

Section: Thymus-dependent Vaccinationsmentioning

confidence: 96%

“…Without such steps, the role of health behaviour as a mediator between stress and health may continue to be underestimated. In terms of more direct mechanisms, larger studies of basal cortisol, with more detailed diurnal profiles, or, perhaps, 24-hour urinary cortisol, are necessary to reconcile the contradictory findings reported thus far [47,72]. Additionally, further investigations should test the stress reactivity hypothesis proposed by Cacioppo and colleagues [78].…”

Section: Theoretical Studiesmentioning

confidence: 96%

“…Some studies have adopted a between-group comparison of high and low stress participants [44,47,56], which has the advantage of examining more chronic, enduring stressors than those commonly assessed in questionnaire-based studies. However, as with all between-group assessments, it is critical to control for as many extraneous variables as possible.…”

Section: Theoretical Studiesmentioning

confidence: 99%

“…Many studies did not control for health behaviours [41,47,50,54,76]; the vast majority of the studies that do [34, 37-39, 44, 53, 56, 57] use less-than-optimal brief retrospective questionnaires. In order to fully address the potential role of health behaviours, more investigators could include detailed day-by-day assessments as were performed in the exemplary study of Pressman and colleagues [52] or objective measures of health behaviours, such as cotinine to assess cigarette smoking.…”

Section: Theoretical Studiesmentioning

confidence: 99%

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Antibody response to vaccination and psychosocial stress in humans: relationships and mechanisms

Burns

Carroll

Ring

et al. 2003

Vaccine

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The purpose of this review is to determine the effects of psychosocial stress on antibody response to vaccination in humans, consider possible mechanisms, and identify agenda for future research. Studies of the association between stress and vaccination response in humans were reviewed. There is evidence of a negative association between stress and antibody response to vaccination, which is most apparent with thymusdependent vaccines and when measured at extended times after vaccination. Preliminary findings implicate the hypothalamic-pituitary-adrenal axis and sympathetic nervous system as potential mechanisms, although a role for unhealthy behaviours cannot be discounted at this stage. Results to date are sufficiently indicative to direct future research to untangling their theoretical ramifications, as well as realising their clinical implications.

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Section: Hypothalamic-pituitary-adrenal Axismentioning

confidence: 90%

Section: Thymus-dependent Vaccinationsmentioning

confidence: 96%

Section: Theoretical Studiesmentioning

confidence: 96%

Section: Theoretical Studiesmentioning

confidence: 99%

Section: Theoretical Studiesmentioning

confidence: 99%

See 3 more Smart Citations

Antibody response to vaccination and psychosocial stress in humans: relationships and mechanisms

Burns

Carroll

Ring

et al. 2003

Vaccine

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Caregiving, Mortality, and Mobility Decline<subtitle>The Health, Aging, and Body Composition (Health ABC) Study</subtitle>

et al. 2008

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Background: Although caregivers report more stress than noncaregivers, few studies have found greater health decline in older caregivers. We hypothesized that caregivers may be more physically active than noncaregivers, which may protect them from health decline. Methods:The sample included 3075 healthy adults from the Health, Aging, and Body Composition (Health ABC) Study. They were aged 70 to 79 years in April 1997 to June 1998 and resided in Memphis, Tennessee, or Pittsburgh, Pennsylvania. Caregivers (680 [22.1%]) were participants who provided regular care or assistance for a child or a disabled or sick adult. Outcomes included allcause mortality and incident mobility limitation (defined as difficulty walking one-quarter mile or climbing 10 steps on 2 consecutive semiannual contacts) during 8 years. Total physical activity included daily routine, exercise, and caregiving activity.Results: Overall, 20.6% of caregivers died and 50.9% de-veloped mobility limitations vs 22.0% and 48.9% of noncaregivers, respectively. Associations differed by race and sex. Mortality and mobility limitation rates were 1.5 times higher in white caregivers (eg, among white female caregivers, adjusted hazard ratio for mortality, 1.6; 95% confidence interval, 1.0-2.5) but not for black female caregivers vs noncaregivers (adjusted hazard ratio for mortality, 0.9; 95% confidence interval, 0.5-1.4). Physical activity mediated these associations in most race-sex groups. High-intensity caregivers (ie, caregiving Ն24 hours per week) had elevated rates of decline when adjusted for physical activity but lower rates when not adjusted for activity. Conclusion:Older white caregivers have poorer health outcomes than black female caregivers. Physical activity appears to mask the adverse effects of high-intensity caregiving in most race-sex groups.

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Mild Depressive Symptoms Are Associated With Amplified and Prolonged Inflammatory Responses After Influenza Virus Vaccination in Older Adults

Glaser¹,

Robles²,

Sheridan³

et al. 2003

Arch Gen Psychiatry

227

156

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Chronic stress in elderly carers of dementia patients and antibody response to influenza vaccination

Cited by 430 publications

References 20 publications

Antibody response to vaccination and psychosocial stress in humans: relationships and mechanisms

Antibody response to vaccination and psychosocial stress in humans: relationships and mechanisms

Caregiving, Mortality, and Mobility Decline<subtitle>The Health, Aging, and Body Composition (Health ABC) Study</subtitle>

Mild Depressive Symptoms Are Associated With Amplified and Prolonged Inflammatory Responses After Influenza Virus Vaccination in Older Adults

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