In the introduction to his new book, Keep Sharp, Sanjay Gupta makes an alarming claim.
“How can a spouse remain healthy while caring for a partner with dementia (caregivers have a much higher risk of developing the disease)?” he writes.
Good luck trying to gloss over that parenthetical remark. More than 11 million Americans provide unpaid care for people with dementia. According to Gupta, a neurosurgeon and CNN chief medical correspondent, they’re more likely to suffer later for sacrificing now.
Is it true?
Research shows that caregivers, at least those in their 60s and up, face somewhat higher risk. But it’s tough to quantify the risk or prove that caregiving itself can cause dementia.
A study published in the May 2010 issue of the Journal of the American Geriatrics Society focused on the impact of chronic stress on caregivers’ health.
“It’s one of the few studies to look at the role that stress plays in triggering dementia,” said Peter Rabins, M.D., professor emeritus of psychiatry and medicine at the Johns Hopkins University School of Medicine.
Author of Is It Alzheimer’s? and other books on dementia, Rabins teamed with Utah State University researchers to conduct the study. They followed 1,221 married couples age 65 and older in rural Utah and tracked their mental status at periodic intervals over many years.
Some enrollees wound up caregiving for a spouse with dementia. Those caregivers were six times more likely to get dementia compared with people whose spouses remained dementia-free.
The researchers sought to eliminate or control the influence of other variables such as genetic risk and environmental factors, Rabins says. But he notes that the couples were mostly white and many were Mormons.
“So they were not representative of the population as a whole,” he said.
Moreover, caregivers aren’t blank slates. Their lifestyle in the years before their spouse got dementia factors into their risk of facing cognitive decline.
“Exposure itself is not enough,” said Peter Vitaliano, Ph.D., professor of psychiatry and behavioral sciences at the University of Washington School of Medicine in Seattle.
He highlights what he calls “vulnerabilities” that individuals carry with them for years prior to becoming a caregiver. Examples include obesity, hypertension and other untreated health issues.
He adds that a couple married for 30 years may share a lifestyle that’s not necessarily healthy, perhaps mirroring each other’s poor diet and lack of exercise. If one of them gets dementia, it stands to reason the spouse may be at higher risk, too.
“Then there’s the chronic stress of caregiving,” Vitaliano said. “Your previous life has a huge influence on how you’ll react to caregiving. If you had high blood pressure before you became a caregiver, it can go through the roof” as you struggle to help a demented spouse.
Here’s the good news: Caregivers can lower their odds of getting dementia by taking steps to improve their wellness.
“There is clear evidence of what caregivers can do to decrease their own stress, demoralization and depression,” Rabins said.
For starters, educate yourself about the disease. Learning more about how your spouse’s brain will deteriorate won’t alleviate your stress, but at least you will gather scientifically valid information to help you make wise decisions and gain a sense of control.
To cope emotionally, accept help wherever you find it. Stubborn caregivers sometimes assume that they must do everything, so they reject formal or informal counseling or other forms of practical assistance.
Meanwhile, maintain your friendships and other social networks. Fight off exhaustion and isolation so that you keep in touch with allies who can listen and offer support.
“There’s also a physical impact on caregivers,” Rabins said. They’re more likely to skip checkups with their doctor, neglect their medicines and not refill their prescriptions.
Regular exercise, both cardiovascular conditioning as well as activities that increase mindfulness (such as yoga and meditation), increases your overall health and helps control your blood pressure and blood lipid levels.
“It’s important to reduce anger and resentment feelings,” Vitaliano said. “Improve your mood. Uplifting your spirits” won’t guarantee you’ll never get dementia, but it will lower your chronic stress. And that in turn gives you more strength and resilience to provide loving care.