Behavioral activation for smoking cessation and mood management following a cardiac event: results of a pilot randomized controlled trial.

Background: Smoking cessation following hospitalization for Acute Coronary Syndrome (ACS) significantly reduces subsequent mortality. Depressed mood is a major barrier to cessation post-ACS. Although existing counseling treatments address smoking and depression independently in ACS patients, no integrated treatment addresses both.

Why does placement of persons with Alzheimer's disease into long-term care improve caregivers' well-being? Examination of psychological mediators.

Caregiving for individuals with Alzheimer's disease is associated with chronic stress and elevated symptoms of depression. Placement of the care receiver (CR) into a long-term care setting may be associated with improved caregiver well-being; however, the psychological mechanisms underlying this relationship are unclear. This study evaluated whether decreases in activity restriction and increases in personal mastery mediated placement-related reductions in caregiver depressive symptoms.

Depressed mood predicts pulmonary rehabilitation completion among women, but not men.

Background: As many as 30% of patients who start pulmonary rehabilitation (PR) fail to complete it, and depressed mood has been associated with PR non-completion. Depression is more common in women than men with COPD and historically women with COPD have been under studied. However, no studies to date have investigated gender-specific predictors of PR completion.

Association between hospice care and psychological outcomes in Alzheimer's spousal caregivers.

Context: Dementia care giving can lead to increased stress, physical and psychosocial morbidity, and mortality. Anecdotal evidence suggests that hospice care provided to people with dementia and their caregivers may buffer caregivers from some of the adverse outcomes associated with family caregiving in Alzheimer's Disease (AD).

Objectives: This pilot study examined psychological and physical outcomes among 32 spousal caregivers of patients with AD.

A randomized clinical trial of Behavioral Activation (BA) therapy for improving psychological and physical health in dementia caregivers: results of the Pleasant Events Program (PEP).

Dementia caregiving is associated with elevations in depressive symptoms and increased risk for cardiovascular diseases (CVD). This study evaluated the efficacy of the Pleasant Events Program (PEP), a 6-week Behavioral Activation intervention designed to reduce CVD risk and depressive symptoms in caregivers. One hundred dementia family caregivers were randomized to either the 6-week PEP intervention (N = 49) or a time-equivalent Information-Support (IS) control condition (N = 51).

Reduced activity restriction buffers the relations between chronic stress and sympathetic nervous system activation.

Objectives: Caregivers of dementia patients are at risk for developing cardiovascular disease (CVD), and this risk increases the longer they provide care. Greater perceptions that caregiving restricts social/recreational activities (i.e.

Longitudinal relationship of low leisure satisfaction but not depressive symptoms with systemic low-grade inflammation in dementia caregivers.

Objectives: This study aimed to further elucidate the biobehavioral mechanisms linking dementia caregiving with an increased cardiovascular disease risk. We hypothesized that both elevated depressive symptoms and a behavioral correlate of depression, low leisure satisfaction, are associated with systemic inflammation.

Method: We studied 121 elderly Alzheimer's disease caregivers who underwent 4 annual assessments for depressive symptoms, leisure satisfaction, and circulating levels of inflammatory markers.

A comparison of psychosocial outcomes in elderly Alzheimer caregivers and noncaregivers.

Objective: To conduct an analysis of the stress, coping, and mood consequences of Alzheimer caregiving.

Design: Cross-sectional.

Setting: Community-based study.

Pleasant events, activity restriction, and blood pressure in dementia caregivers.

Objective: A combination of high engagement in pleasurable activities and low perceived activity restriction is potentially protective for a number of health and quality of life outcomes. This study tests the newly proposed Pleasant Events and Activity Restriction (PEAR) model to explain level of blood pressure (BP) in a sample of elderly dementia caregivers.

Methods: This cross-sectional study included 66 caregivers, ≥55 years of age, providing in-home care to a relative with dementia.

A longitudinal analysis of the relations among stress, depressive symptoms, leisure satisfaction, and endothelial function in caregivers.

Objective: Stress and depressive symptoms have been associated with impaired endothelial function as measured by brachial artery flow-mediated dilation (FMD), possibly through repeated and heightened activation of the sympathetic nervous system. Behavioral correlates of depression, such as satisfaction with leisure activities (i.e.

Sleep in spousal Alzheimer caregivers: a longitudinal study with a focus on the effects of major patient transitions on sleep.

Study Objectives: Findings on sleep disturbances in family dementia caregivers are conflicting. We studied the longitudinal effects of dementia caregiving and major transitions in the caregiving situation on caregivers' sleep and the effect of moderating variables.

Design And Setting: Community-based longitudinal study with assessments about once a year for up to three years.

Effect of chronic dementia caregiving and major transitions in the caregiving situation on kidney function: a longitudinal study.

Objective: To estimate the glomerular filtration rate (GFR) in relation to the chronic stress of dementia caregiving and major transitions in the caregiving situation.

Methods: We longitudinally assessed 119 people serving as caregivers for their spouses with Alzheimer's disease and 58 noncaregiving controls for a period of up to 3 years (mean of 2.8 assessments per participant).

Multiple mediators of the relations between caregiving stress and depressive symptoms.

Objective: This study tested a model for explaining how stress is associated with depressive symptoms in a sample of spouse caregivers of patients with Alzheimer's disease. It was hypothesized that more depressive symptoms would be significantly correlated with both 'primary' caregiver stressors (i.e.

Leisure activities, caregiving demands and catecholamine levels in dementia caregivers.

This study examined whether satisfaction from leisure activities moderates the relationship between caregiving demands (i.e., hours per day spent caring for a spouse with dementia) and resting levels of the catecholamines norepinephrine (NE) and epinephrine (EPI).

Effect of Alzheimer caregiving on circulating levels of C-reactive protein and other biomarkers relevant to cardiovascular disease risk: a longitudinal study.

Background: Providing care to a spouse with Alzheimer's disease (AD) may contribute to cardiovascular disease (CVD). The acute phase reactant C-reactive protein (CRP) is a well-established biomarker of an increased CVD risk.

Objective: To investigate the hypothesis that dementia caregiving is associated with elevated circulating levels of CRP and possibly other biomarkers of CVD risk.

Cardiometabolic effects in caregivers of nursing home placement and death of their spouse with Alzheimer's disease.

Objectives: To test the hypothesis that cardiometabolic risk is attenuated when caregivers are relieved of caregiving stress when the caregiving recipient transitions out of the home.

Design: Longitudinal.

Setting: Participants' homes.

Relationship between chronic stress and carotid intima-media thickness (IMT) in elderly Alzheimer's disease caregivers.

The stress associated with providing care for a spouse diagnosed with Alzheimer's disease can have adverse effects on cardiovascular health. One potential explanation is that chronic caregiving stress may contribute to the development of atherosclerosis. The purpose of this study was to determine whether the duration that one has provided care is associated with the degree of atherosclerotic burden, as measured by carotid artery intima-media thickness (IMT).

Activity restriction and depression in medical patients and their caregivers: a meta-analysis.

Depression commonly occurs in conjunction with a variety of medical conditions. In addition, family members who care for patients with medical diagnoses often suffer from depression. Therefore, in addition to treating illnesses, physicians and other healthcare professionals are often faced with managing secondary mental health consequences.

PEAR model and sleep outcomes in dementia caregivers: influence of activity restriction and pleasant events on sleep disturbances.

Background: Sleep disturbance is a common consequence of providing care to a loved one with Alzheimer's disease (AD). We explored the usefulness of the Pleasant Events and Activity Restriction (PEAR) model for predicting multiple domains of sleep disturbance.

Methods: Our sample consisted of 125 spousal AD caregivers.

Psychological protective factors across the lifespan: implications for psychiatry.

Although there are many challenges in operationally defining and measuring positive psychological constructs, there is accumulating evidence that optimism, resilience, positive attitudes toward aging, and spirituality are related to reduced risk for morbidity and mortality in older age. This article reviews the definition, measurement, associations, and putative mechanisms of selected positive psychological constructs on subjective and objective indicators of health with a focus on the latter half of the lifespan.

A review of the psychobiology of dementia caregiving: a focus on resilience factors.

The recent aging trend in the United States has resulted in exponential growth in the number of informal dementia caregivers. Caring for a family member with dementia has been associated with negative health outcomes that are likely related to physiologic changes resulting from stress. However, caregiving is not always associated with health morbidity.

Carotid plaque in Alzheimer caregivers and the role of sympathoadrenal arousal.

Objectives: To test the hypothesis that those who provide care for a spouse diagnosed with Alzheimer's disease would have increased prevalence of carotid artery plaque compared with noncaregiving controls and that prolonged sympathoadrenal arousal to acute stress would relate to this difference. Providing care for a spouse with Alzheimer's disease has been associated with an increased risk of coronary heart disease, potentially due to the impact of caregiving stress on the atherosclerotic disease process.

Methods: Participants were 111 spousal caregivers (74 ± 8 years of age; 69% women) to patients with Alzheimer's disease and 51 noncaregiving controls (75 ± 6 years of age; 69% women).

Influence of caregiver burden on the association between daily fluctuations in pleasant activities and mood: A daily diary analysis.

Much research has focused on behavioral activation and its effect on depression, but less is known about the effects of leisure activities on the two distinct affective domains of depression: positive affect (PA) and negative affect (NA). Furthermore, individual factors (i.e.

Functional interactions between the nucleus tractus solitarius (NTS) and nucleus accumbens shell in modulating memory for arousing experiences.

The shell division of the nucleus accumbens receives noradrenergic input from neurons in the nucleus of the solitary tract (NTS) that transmit information regarding fluctuations in peripheral hormonal and autonomic activity. Accumbens shell neurons also receive converging inputs from limbic areas such as the hippocampus and amygdala that process newly acquired information. However, few studies have explored whether peripheral information regarding changes in emotional arousal contributes to memory processing in the accumbens.