Exaggerated Plasma Fibrin Formation (D-Dimer) in Elderly Alzheimer Caregivers as Compared to Noncaregiving Controls

Vol. 51, No. 1, 2005

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Experimental Section

Exaggerated Plasma Fibrin Formation (D-Dimer) in Elderly Alzheimer Caregivers as Compared to Noncaregiving Controls
Roland von Känel^a,c, Joel E. Dimsdale^a, Karen A. Adler^a, Thomas L. Patterson^a,b, Paul J. Mills^a, Igor Grant^a,b

^aDepartment of Psychiatry, University of California, San Diego, Calif., and
^bSan Diego Veterans Affairs Healthcare System, La Jolla, Calif., USA;
^cDepartment of General Internal Medicine, University Hospital Bern, Bern, Switzerland

Address of Corresponding Author

Gerontology 2005;51:7-13 (DOI: 10.1159/000081428)

Key Words

Alzheimer caregivers
Psychological stress
Cardiovascular disease
Blood coagulation
Fibrinolysis

Abstract

Background: The chronic stress of providing care for a spouse suffering from Alzheimer's disease has been associated with an increased risk for coronary artery disease and overall mortality. Procoagulant changes are kindled by mental stress, and they are prospectively associated with atherothrombotic events. Objective: To examine whether dementia caregivers would show greater coagulation activity and less fibrinolytic capacity than noncaregiving controls. Methods: Subjects were 48 (30 female and 18 male) elderly (mean age ± SD, 72 ± 9 years) community-dwelling spousal Alzheimer caregivers and 20 noncaregiving age- and gender-matched controls. Plasma levels of thrombin-antithrombin III, fibrin D-dimer, von Willebrand factor, tissue-type plasminogen activator, and plasminogen activator inhibitor 1 were measured. Results: D-dimer, a marker of fibrin formation and degradation, was significantly higher in caregivers than in controls (688 ± 575 vs. 406 ± 157 ng/ml, p = 0.021). Plasma levels of the four other hemostasis variables were not significantly different between the two groups. Controlling for the classic cardiovascular risk factors body mass index, hypertension status, smoking status, hypercholesterolemia, type II diabetes, and medication potentially affecting hemostasis did not change results. Conclusion: The findings suggest that Alzheimer caregivers have an increased fibrin turnover as compared to noncaregiving controls independent of common confounders of hemostasis. Such an elevated clotting diathesis might contribute to increased cardiovascular risk and overall mortality with dementia caregiving strain.

Author Contacts

Igor Grant, MD
Department of Psychiatry, University of California
9500 Gilman Drive
La Jolla, CA 92093-0680 (USA)
Tel. +1 858 534 3652, Fax +1 858 534 7723, E-Mail igrant@ucsd.edu

Article Information

Received: May 14, 2003
Accepted: February 24, 2004
Number of Print Pages : 7
Number of Figures : 1, Number of Tables : 2, Number of References : 44

Medline Abstract (ID 15591750)

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