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Effects of leisure activities at home on perceived care burden and the endocrine system of caregivers of dementia patients: a randomized controlled study

Published online by Cambridge University Press:  20 August 2015

Akemi Hirano ,
Hiroyuki Umegaki ,
Yusuke Suzuki ,
Toshio Hayashi  and
Masafumi Kuzuya
Akemi Hirano*
Affiliation:
Department of Adult Nursing, School of Nursing & Health, Aichi Prefectural University, Tohgoku, Kamishidami, Moriyama-Ku, Nagoya, Aichi, 463-8502, Japan
Hiroyuki Umegaki
Affiliation:
Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Showa, Nagoya, Aichi, 466-8550, Japan
Yusuke Suzuki
Affiliation:
Department of Comprehensive Community Care Systems, Nagoya University Graduate School of Medicine, Showa, Nagoya, Aichi, 466-8550, Japan
Toshio Hayashi
Affiliation:
Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Showa, Nagoya, Aichi, 466-8550, Japan
Masafumi Kuzuya
Affiliation:
Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Showa, Nagoya, Aichi, 466-8550, Japan
*
Correspondence should be addressed to: Akemi Hirano, R.N., Ph.D. Department of Adult Nursing, School of Nursing & Health, Aichi Prefectural University, Tohgoku, Kamishidami, Moriyama-Ku, Nagoya, Aichi, 463-8502, Japan. Phone: +(81-52)-736-1401; Fax: +(81-52)-736-1415. Email: hirano@med.nagoya-u.ac.jp.
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Abstract

Background:

Psychological stress associated with caregiving is thought to underlie the high incidence of hypertension, ischemic heart disease, and mortality, as well as reduced immune function, among caregivers of dementia patients. Here, we examined the effects of periodic leisure activities performed by caregivers of dementia patients with care recipients at home on perceived care burden and levels of stress hormones.

Methods:

Participants were 42 caregivers aged ≥ 65 years of patients diagnosed with Alzheimer's dementia. They were randomly assigned to intervention and non-intervention groups. The intervention group underwent a leisure activity program (30 min/3 times/week for 24 weeks) with the care recipient, and the control group underwent normal care activities.

Results:

The Zarit Burden Interview (ZBI) score, a subjective indicator of care burden, significantly decreased after intervention in the intervention group (p < 0.05), whereas no difference was observed in the control group. No significant changes were observed in adrenaline, noradrenaline, dopamine, and cortisol levels in both groups.

Conclusions:

The lack of changes in stress hormone levels despite a decrease in subjective care burden in the intervention group might be explained by the effects of the chosen leisure activity on the neuroendocrine system. Our findings suggest that periodic leisure activities can reduce perceived care burden among caregivers of dementia patients. However, in order to evaluate accurately the effects of leisure activities of the present study, long-term follow-up of both caregivers and care recipients is necessary. The Nagoya University Department of Medicine Ethics Committee Clinical Trials Registry Number is 1290.

Keywords

dementiacare burdenregular leisure activityinterventioncatecholamine
Type
Research Article
Information
International Psychogeriatrics , Volume 28 , Issue 2 , February 2016 , pp. 261 - 268
Copyright
Copyright © International Psychogeriatric Association 2015 

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References

Amaral, D. G. (2002). The primate amygdala and the neurobiology of social behavior: implications for understanding social anxiety. Biological Psychiatry, 51, 11–17.Google Scholar
APA (American Psychiatric Association). (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn, Washington, DC: APA Press.Google Scholar
Burgio, L. (2003). Impact of two psychosocial interventions on white and African American family caregivers of individuals with dementia. The Gerontologist, 43, 568–579.CrossRefGoogle ScholarPubMed
Cannon, W. B. (1935). Stresses and strains of homeostasis. The American Journal of the Medical Sciences, 189, 1–14.Google Scholar
Chrousos, G. P. (2009). Stress and disorders of the stress system. Nature reviews. Endocrinology, 5, 374–381.Google Scholar
Daniel, A. and Manigandan, C. (2005). Efficacy of leisure intervention groups and their impact on quality of life among people with spinal cord injury. International Journal of Rehabilitation Research, 28, 43–48.Google Scholar
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-mental state”: a practical method for grading the cognitive state of patients for clinicians. Journal of Psychiatric Research, 12, 189–198.Google Scholar
Glaser, R. and Kiecolt-Glaser, J. K. (2005). Stress-induced immune dysfunction: implications for health. Nature Reviews. Immunology, 5, 243–251.Google Scholar
Hirano, A. et al. (2011a). Association between the caregiver's burden and physical activity in community-dwelling caregivers of dementia patients. Archives of Gerontology and Geriatrics, 52, 295–298.Google Scholar
Hirono, S. et al. (1997). Japanese neuropsychiatric inventory. Cranial Nerves, 49, 266–271.Google ScholarPubMed
Jiang, W. et al. (1996). Mental stress-induced myocardial ischemia and cardiac events. JAMA, 275, 1651–1656.Google Scholar
Jin, P. (1992). Efficacy of Tai Chi, brisk walking, meditation, and reading in reducing mental and emotional stress. Journal of Psychosomatic Research, 36, 361–370.Google Scholar
Kirschbaum, C. and Hellhammer, D. H. (1989). Salivary cortisol in psychobiological research: an overview. Neuropsychobiology, 22, 150–169.Google Scholar
Kuroda, A., Tanaka, K., Kobayashi, R., Ito, T., Ushiki, A. and Nakamura, K. (2007). Effect of care manager support on health-related quality of life of caregivers of impaired elderly: one-year longitudinal study. Industrial Health, 45, 402–408.Google Scholar
Mausbach, B. T., Harmell, A. L., Moore, R. C. and Chattillion, E. A. (2011). Influence of caregiver burden on the association between daily fluctuations in pleasant activities and mood: a daily diary analysis. Behaviour Research and Therapy, 49, 74–79.Google Scholar
Mausbach, B. T., Patterson, T. L., Rabinowitz, Y. G., Grant, I. and Schulz, R. (2007). Depression and distress predict time to cardiovascular disease in dementia caregivers. Health Psychology, 26, 539–544.Google Scholar
Muraki, I. et al. (2008). Caregiver burden for impaired elderly Japanese with prevalent stroke and dementia under long-term care insurance system. Cerebrovascular Diseases, 25, 234–240.Google Scholar
Onishi, J., Suzuki, Y., Umegaki, H., Nakamura, A., Endo, H. and Iguchi, A. (2005). Influence of behavioral and psychological symptoms of dementia (BPSD) and environment of care on caregiver's burden. Archives of Gerontology and Geriatrics, 41, 159–168.Google Scholar
Rudolph, D. L. and McAuley, E. (1995). Self-efficacy and salivary cortisol responses to acute exercise in physically active and less active adults. Journal of Sport & Exercise Psychology, 17, 206–213.Google Scholar
Rudolph, D. L. and McAuley, E. (1998). Cortisol and affective responses to exercise. Journal of Sports Sciences, 16, 121–128.Google Scholar
Schulz, R. and Beach, S. R. (1999). Caregiving as a risk factor for mortality the caregiver health effects study. JAMA, 282, 2215–2219.Google Scholar
Shaw, W. S., Patterson, T. L., Ziegler, M. G., Dimsdale, J. E., Semple, S. J. and Grant, I. (1999). Accelerated risk of hypertensive blood pressure recordings among Alzheimer caregivers. Journal of Psychosomatic Research, 46, 215–227.Google Scholar
Suzuki, H. (2004). The function of leisure. Humanity and Environment Bulletin, First Issue, 135–146.Google Scholar
Tanaka, M., Tsuda, A., Yokoo, H., Yoshida, M., Ida, Y. and Nishimura, H. (1990). Involvement of the brain noradrenaline system in emotional changes caused by stress in rats. Annals of the New York Academy of Sciences, 597, 159–174.CrossRefGoogle ScholarPubMed
Tranel, D., Gullickson, G., Koch, M. and Adolphs, R. (2006). Altered experience of emotion following bilateral amygdala damage. Cognitive Neuropsychiatry, 11, 219–232.Google Scholar
Von, Kanel. R., Dimsdale, J. E., Adler, K. A., Patterson, T. L., Mills, P. J. and Grant, I. (2005). Exaggerated plasma fibrin formation (D-Dimer) in elderly alzheimer caregivers as compared to noncaregiving controls. Gerontology, 51, 7–13.Google Scholar
Voorrips, L. E., Ravelli, A. C., Dongelmans, P.C., Deurenberg, P. and Van Staveren, W. A. (1991). A physical activity questioner for the elderly. Medicine and Science in Sports and Exercise, 23, 974–979.Google Scholar
Wilz, G. and Fink-Heitz, M. (2008). Assisted vacation for men with dementia and their caregiving spouses: evaluation of health-related effects. The Gerontologist, 48, 115–120.Google Scholar
Zarit, S. H., Reever, K. E. and Bach-Peterson, J. (1980). Relatives of the impaired elderly: correlates of feelings of burden. The Gerontologist, 20, 649–655.Google Scholar