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Are there Sex Differences in Emotional and Biological Responses in Spousal Caregivers of Patients with Alzheimer’s Disease?

South Texas Veterans Health Care System, Department of Medicine at the University of Texas Health Science Center, San Antonio

Sharon L. Lewis, RN, PhD, FAAN

Schools of Nursing and Medicine, University of Texas Health Science Center, San Antonio, Geriatric Research, Education, and Clinical Center, South Texas Veterans Health Care System, San Antonio, lewissl{at}uthscsa.edu

Margaret R. Murphy, RN, MS, FNP

School of Nursing at the University of Texas Health Science Center, San Antonio

Jennifer M. Hale, BBA

University of Texas Health Science Center, San Antonio

Paula H. Blackwell, BS, MBA, MT(ASCP)

University of Texas Health Science Center, San Antonio

Gayle J. Acton, RN, PhD

School of Nursing, University of Texas at Austin

Dorothy H. Clough, RN, PhD

University of New Mexico, Albuquerque

Graham J. Patrick, PhD, ARNP, BCIA-C

Seattle University School of Nursing, Washington

Peter N. Bonner, MS

Data and Statistics, Inc., Boerne, Texas

The purpose of this study was to compare emotional and biological responses of men and women who are spousal caregivers of patients with Alzheimer’s disease (AD). Quality-of-life measurements, bioinstrumentation data, and immunophenotype assessments were obtained from female and male spousal caregivers of patients with AD. Spousal caregivers (women, n = 45 with average age 69.7; men, n = 16 with average age 71.4 years) completed questionnaires that assessed psychosocial variables. Blood was drawn and lymphocyte subsets (including natural killer [NK] cell number) were determined using flow cytometry. The degree of relaxation was determined measuring muscle tension (EMG) in the frontalis and trapezius muscles, skin conductance, skin temperature, and heart rate. Male spousal caregivers, as compared to female spousal caregivers, had significantly lower levels of stress, depression, caregiver burden (subjective), anxiety, anger-hostility, and somatic symptoms and higher levels of mental health, sense of coherence, NK cell number, and social and physical functioning. There were no statistically significant differences between the 2 groups in social support, coping resources, or T, T suppressor, or activated T cells. Women had more T helper cells and fewer NK cells than men. Men had fewer manifestations of a physiological stress response, as indicated by bioinstrumentation parameters. Unique sex-specific issues need to be considered when strategies are implemented to assist the increasing number of caregivers as our society ages.

Key Words: sex • caregivers • spouse • stress • coping • immune • biofeedback • bioinstrumentation

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