The Relationship Between Circulating Interleukin-6 Levels and Future Health Service Use in Dementia Caregivers
| Autor: | Brent T. Mausbach, Carlos Vara-García, Taylor Bos, Sonia Ancoli-Israel, Roland von Känel, Matthew A. Allison, Joel E. Dimsdale, Christopher Pruitt, Igor Grant, Paul J. Mills, Thomas L. Patterson, Gabrielle Decastro, Michael G. Ziegler |
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| Přispěvatelé: | University of Zurich, Mausbach, Brent T |
| Rok vydání: | 2019 |
| Předmět: |
Male
Aging Psychological intervention Medical and Health Sciences 3202 Applied Psychology 2738 Psychiatry and Mental Health 0302 clinical medicine 80 and over Medicine CVD = cardiovascular disease Chronic stress BMI = body mass index older adults Applied Psychology Psychiatry Aged 80 and over Emergency Service education.field_of_study biology Health Services Middle Aged Psychiatry and Mental health Mental Health Caregivers MCS = mental composite score Female PCS = physical composite score Emergency Service Hospital medicine.medical_specialty emergency department Population 610 Medicine & health Stress Article Hospital 03 medical and health sciences Clinical Research Internal medicine Behavioral and Social Science Acquired Cognitive Impairment Dementia Humans ADLQ = Activities of Daily Living Questionnaire education Interleukin 6 TNF-alpha = tumor necrosis factor alpha Aged IL-6=interleukin 6 Proportional hazards model business.industry Interleukin-6 Tumor Necrosis Factor-alpha Prevention Psychology and Cognitive Sciences Neurosciences biomarkers healthcare use Patient Acceptance of Health Care medicine.disease Mental health Brain Disorders 030227 psychiatry Good Health and Well Being 10057 Klinik für Konsiliarpsychiatrie und Psychosomatik inflammation biology.protein Psychological business Body mass index 030217 neurology & neurosurgery Stress Psychological Follow-Up Studies |
| Zdroj: | Psychosom Med Psychosomatic medicine, vol 81, iss 7 |
| ISSN: | 1534-7796 |
| Popis: | OBJECTIVE Older adults are among the most frequent users of emergency departments (EDs). Nonspecific symptoms, such as fatigue and widespread pain, are among the most common symptoms in patients admitted at the ED. Interleukin 6 (IL-6) and tumor necrosis factor α (TNF-α) are inflammation biomarkers associated with chronic stress (i.e., dementia caregiving) and nonspecific symptoms. This study aimed to determine whether IL-6 and TNF-α were prospectively associated with ED risk in dementia caregivers (CGs). METHODS Participants were 85 dementia CGs, who reported during three assessments (3, 9, and 15 months after enrollment) if they had visited an ED for any reason. Cox proportional hazards models were used to examine the relations between resting circulating levels of IL-6 and TNF-α obtained at enrollment and subsequent risk for an ED visit, adjusting for age, sex, use of ED 1 month before enrollment, physical and mental health well-being, body mass index, and CG demands. RESULTS (log) IL-6 significantly predicted ED visits during the 15-month follow-up (B = 1.96, SE = 0.82, p = .017). For every (log) picogram per milliliter increase in IL-6, the risk of visiting an ED was 7.10 times greater. TNF-α was not associated with subsequent ED visits. Exploratory analyses suggested that CGs with levels of IL-6 above the 80th percentile and experiencing high CG demands were at highest risk of an ED visit. CONCLUSIONS IL-6 levels and CG demands may be useful for predicting vulnerability for future ED visits. Although further studies should be conducted to replicate and extend these findings, interventions that successfully modify inflammation markers, including the underlying pathophysiology related to stress and/or comorbid illnesses, may be useful in preventing costly and detrimental outcomes in this population. |
| Databáze: | OpenAIRE |
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