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A Prospective Assessment of the Biological Burden of Stress in Caregivers: Impact on Cognitive Performance, Mood and the Benefits of Mindfulness

HSE predictions highlight that by 2036, the 65+ demographic in society will constitute 20% of the population. This has obvious and serious consequences for our already struggling healthcare system but less appreciated and understudied is the additive strain that will likely emerge due to the increasing requirement for family dementia caregivers. The stress involved in this social responsibility brings with it a biological burden characterised to date by low-level inflammation and cardiovascular problems. The mental health sequelae of caregiving require more detailed study. Moreover, we have recently shown that stress-related disorders associated with immune activation can produce alterations in cognitive performance.
One mechanism through which stress and inflammation can converge to alter both mood and cognition is through altered metabolism of the essential amino acid tryptophan. Tryptophan is a precursor to both serotonin, a target of antidepressant medication, and a variety of neuroactive agents produced along the kynurenine metabolic pathway with relevance for cognitive performance such as quinolinic acid and kynurenic acid. In this study, we propose to determine whether the physiological impact of caregiving also extends to alterations in tryptophan metabolism and to probe the relevance of such alterations to perturbations in mood and cognition. We will also establish how family dementia caregiving impacts on the acute stress response using the Trier Social Stress Test (TSST). Clarification will also be obtained on whether the available strategies to combat the stress of caregiving, such as mindfulness-based stress reduction paradigms, can ameliorate the biological and behavioural consequences which do emerge.
By advancing our understanding of the wide-ranging health implications of family dementia caregiving and the stress-reduction strategies used to counteract them, it is envisaged that the benefits of this study will be manifold and extend to the individuals involved in caregiving, to society as a whole and to the healthcare system.