Rede de apoio social, resiliência e marcadores imunológicos em idosos cuidadores de pacientes com demência

• Ano de defesa: 2009
• Autor(a) principal: Lampert, Simone Steyer
• Orientador(a): Bauer, Moisés Evandro
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Pontifícia Universidade Católica do Rio Grande do Sul; Porto Alegre
• Palavras-chave em Português: GERONTOLOGIA; GERIATRIA; ENVELHECIMENTO; IDOSOS; DEMÊNCIA; CUIDADORES; PSICONEUROIMUNOLOGIA
• Link de acesso: http://hdl.handle.net/10923/3603

Introduction: The daily care of demented patients constitutes a naturalistic model of chronic stress. The study of psychoneuroimmunological aspects involved with chronic stress response and their relation with potential protective factors, like social support and resilience, shed some light to the discovery of efficient preventive interventions in the elderly. Methods: Twenty caregivers between 55 and 78 years old (64. 7 ± 7. 18) and 20 noncaregivers between 54 and 84 years old (70. 35 ± 9. 18) were recruited. Depression, anxiety and stress inventories were used to measure emotional distress. The resilience and social support diagram inventories were evaluated as potential protective factors to stress. Awakening cortisol levels were measured across three points (awakening, 30 minutes and 60 minutes later) and two points (16h and 21h) across the day. Peripheral blood samples were collected in the morning to evaluate T-cell proliferation and cellular sensitivity to dexamethasone (DEX).Results: Caregivers were more stressed and depressed than controls (p < 0. 0001). Cortisol levels were lower in caregivers (p < 0. 0001) and showed a progressive decline at 30-60 min following awakening (p < 0. 0001). There were no differences regarding lymphocyte proliferation and sensitivity to glucocorticoids. The social support and resilience variables were inversely correlated with depression (p < 0. 0001) and stress (p<0. 05) in the caregiver group. However, these variables were not correlated to neuroendocrine and immunological responses. Conclusions: Chronic stress is related to significant emotional distress in caregivers. Lower levels of cortisol response and high exhaustion scores on stress inventory could be related to adrenal and psychological overdrive in caregivers. The psychoneuroendocrine responses were not correlated to immunological changes. Resilience and social support reduced some chronic stress effects on emotional distress.