Preliminary Evidence of Higher Production of LPS-induced Proinflammatory Cytokines in Retired Versus Employed Dementia Caregivers.

OBJECTIVE

Nearly half of all informal (unpaid) family caregivers for patients with Alzheimer disease or related dementias (ADRD) are employed. We test competing hypotheses on the role of employment for ADRD spousal caregivers, as some evidence suggests that stress from work and caregiving will have an additive effect. Other evidence suggests that psychological resources generated at work may buffer stress at home. Psychological stress is associated with immune dysregulation; we examined the role of employment status on proinflammatory cytokine production.

METHODS

We tested competing hypotheses cross-sectionally in a sample of 113 ADRD spousal caregivers, including 26 employed caregivers (working full-time or part-time) and 87 retired caregivers. We examined the effect of employment status on a composite of monocyte-stimulated interleukin-6, tumor necrosis factor-α, and interleukin-1 beta in unadjusted models and in models adjusting for covariates.

RESULTS

Employed ADRD spousal caregivers had lower composite proinflammatory cytokine production than retired ADRD spousal caregivers. In exploratory follow-up analyses, neither caregiver depressive symptoms, anticipatory grief, nor negative affect explained the impact of employment status on proinflammatory cytokine production.

CONCLUSIONS

Employed ADRD caregivers had lower proinflammatory cytokine production than retired ADRD caregivers. There may be many reasons for this finding; employed ADRD caregivers have another domain to fulfill their psychological needs, may benefit financially, and may exhibit better coping than their retired counterparts. Future investigations should examine psychological mechanisms for protecting caregivers' health through positive work experiences to employ such experiences in retired caregivers.