Caregiving stress and burden associated with cardiometabolic risk in family caregivers of individuals with cancer

Abstract

Chronic stress is a well-established risk factor for cardiometabolic disease. Caregiving for individuals with cancer is perceived as a chronic stressor yet research on the risk for cardiometabolic disease in this population, opposed to the elderly and those with Alzheimer’s disease, is limited. Additionally, few studies have explored the early physiological changes that occur in family caregivers suggesting an elevated risk for illness. This cross-sectional study was designed to examine levels of cardiometabolic risk biomarkers and their correlates in caregivers of patients with colorectal cancer. Caregivers completed questionnaires that measure exposures to stress and vulnerability factors, psychological distress, and health habits as potential correlates. Traditional lipid and nontraditional lipoprotein particle biomarkers (e.g. concentration and size for all lipoprotein classes) were assayed from blood serum. Caregivers (N = 83, mean age = 49.8, 73% female) displayed levels of cardiometabolic biomarkers that suggest an elevated risk for cardiometabolic disease. Caregivers who were Hispanic, married, highly educated, employed, reported more hours spent caregiving daily, experienced higher caregiver burden associated with the lack of family support and impact on schedule, and psychological distress, demonstrated an elevated risk for cardiometabolic disease; primarily determined by nontraditional lipid biomarkers – large TRL-P, LDL-P, small HDL-P, large HDL-P, TRL-Z, LDL-Z and HDL-Z. These findings suggest that traditional lipid biomarkers may not be robust enough to detect early physiological changes associated with cardiometabolic disease risk in family caregivers. Moreover, findings reiterate the importance of assessing caregiver burden and providing evidence-based interventions to manage caregiving stress with the potential to improve caregivers’ cardiometabolic health.

Keywords:

• Cancer caregivers
• caregiving stress
• cardiometabolic biomarkers
• nontraditional lipoprotein particle

Acknowledgement

The authors thank Gwenyth Wallen, RN, PhD, Stephen Klagholz, MS, and all the families who participated in this investigation.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This research was supported by the American Cancer Society [121909-RSG-12-042-01-CPPB]. The writing of this manuscript was supported by National Institute of Nursing Research [R01NR016838] to YK.

Notes on contributors

Lena J. Lee

Lena J. Lee, PhD, RN is a nurse scientist at National Institutes of Health Clinical Center, Bethesda, MD, USA.

Youngmee Kim

Youngmee Kim, PhD is a professor at University of Miami, Department of Psychology, Coral Gables, FL, USA.

Robert Shamburek

Robert Shamburek, MD is a clinician/scientist at National Heart, Lung, and Blood Institute, Bethesda, MD, USA.

Alyson Ross

Alyson Ross, PhD, RN was a nurse scientist at National Institutes of Health Clinical Center, Bethesda, MD, USA.

Li Yang

Li Yang, PhD is a statistician at National Institutes of Health Clinical Center, Bethesda, MD, USA.

Margaret F. Bevans

Margaret F. Bevans is a director, Office of Research Nursing at National Institutes of Health Clinical Center, Bethesda, MD, USA.