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Vulnerable Caregivers of Alzheimer Disease Patients Have a Deficit in ß₂-Adrenergic Receptor Sensitivity and Density

Received July 11, 2003; revised August 27, 2003; accepted September 4, 2003. From the Departments of Psychiatry (PJM,KAA,JED,CJP,SAI,TLP,IG) and Medicine (MGZ), University of California San Diego, and the VA Medical Center, La Jolla, California (SAI,TLP,IG). Send correspondence to Paul J. Mills, Ph.D., UCSD Medical Center, 200 West Arbor Drive, San Diego, CA 92103-0804. e-mail: pmills{at}ucsd.edu
© 2004 American Association for Geriatric Psychiatry

Objective: The chronic stress of caregiving may lead to sympathetic nervous system activation and immune suppression. ß₂-adrenergic receptors are expressed on all immune cells and contribute to the stress-induced loss of immune-cell function. The authors examined the effects of being a spousal caregiver of a patient with Alzheimer disease (AD) on the lymphocyte ß₂-adrenergic receptor. Methods: One hundred and six women and men, spousal caregivers and non-caregivers, participated (mean age: 71.5 years). Caregivers were classified as either vulnerable or non-vulnerable on the basis of the amount of care required by the patient relative to the amount of respite the caregiver received during the previous 6 months. ß₂-adrenergic receptor sensitivity (cyclic-AMP response to isoproterenol stimulation) and density (radioligand binding) were determined by use of whole lymphocytes. Results: Vulnerable caregivers had reduced ß₂-adrenergic receptor sensitivity and density when compared with their non-vulnerable counterparts or with non-caregivers. Conclusion: The findings indicate that for more vulnerable caregivers, the stress of caregiving leads to a loss of lymphocyte ß₂-adrenergic receptors. This finding may be relevant to previous observations of clinically-relevant reduced immunity in highly stressed caregivers of AD patients.

Key Words: Caregivers • Alzheimer Disease • ß₂-Adrenergic Receptors • Immunity

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