Does type of disease matter? Gender differences among Alzheimer's and Parkinson's disease spouse caregivers.

PURPOSE OF STUDY: Mental health outcomes are widely reported among spouse caregivers, with wives generally faring worse than husbands. We hypothesized that gender differences would not be as strong in a cognitively intact group because caring for cognitively intact spouses may involve less severe reciprocity losses. We also examined gender differences in coping strategies within each group. DESIGN AND METHOD: 175 spouse caregivers for patients with Alzheimer's disease (AD; n = 88) and Parkinson's disease (PD; n = 87) were interviewed. Participants completed perceived stress (PSS), depression (CES-D), state anxiety (STAI, Form Y), and coping strategies (WCCL-R) measures. RESULTS: Wives in the AD group reported significantly worse mental health outcomes than husbands, while wives and husbands in the PD group showed no differences. AD caregiving wives were less likely than husbands to use problem-focused coping strategies. There were no significant gender differences in either group for social support or emotion-focused coping. IMPLICATIONS: Loss of reciprocity in marital relationships may affect women more negatively than men. Future studies that address underlying mechanisms of gender differences and focus on similar caregiving situations and contexts deserve attention.

Coping with disease-related stressors in Parkinson's disease.

This study examines three categories of disease-related stressors (i.e., physical, cognitive, psychosocial), differential coping, and mental and physical health outcomes in individuals with Parkinson's disease (PD). Findings show that tremors, lack of mental energy, and being dependent on others were the most stressful symptoms in each category. Although there was evidence that PD patients match coping efforts to types of stressors, emotional regulation was the most common coping strategy. Hierarchical regression analyses show that disease-related variables influence every domain of quality of life, whereas the effects of coping are more selective. Specifically, the use of distancing was related to poorer mental and physical health outcomes. Findings focus attention on the disease-related stressors that create the experience of being chronically ill.

Personality counts for a lot: predictors of mental and physical health of spouse caregivers in two disease groups.

The purpose of this study were to examine the influence of personality on mental and physical health of spouse caregivers and to determine whether there were differences in such influences depending on disease context. The disease contexts compared were Alzheimer's disease (AD) and Parkinson's disease (PD; with no coexisting dementia)--both chronic, degenerative diseases of later life. It was predicted that personality would be related to mental and physical health, directly and indirectly, and that AD caregivers would have higher levels of perceived stress and worse mental and physical health outcomes. Participants in the study were 175 caregivers (88 AD; 87 PD) living at home with their ill spouses. The data provided an excellent fit to the hypothesized model of the relationships between personality, disease group, social support, perceived stress, and mental and physical health. Seventy-eight percent of the variance in mental health was accounted for and 35% of the variance in physical health was explained. Personality had significant direct and indirect effects on mental health and significant indirect effects on physical health. As predicted, AD caregivers had significantly worse mental health than PD caregivers; however, AD caregivers had better physical health than PD caregivers, controlling for other variables in the model. These results are discussed in relation to the existing caregiving and behavioral medicine literature. Future research should include different domains of personality--states and longer term self-regulatory processes in addition to traits--to advance models of caregiving processes further.

Genomic sequence and transcription start site for the human gamma-glutamyl carboxylase.

The human gene for gamma-glutamyl carboxylase is 13 kb in length and contains 15 exons. Transcription starts at a cytosine 217 base pair upstream of the first codon. There are two major transcripts in all tissues examined. They are distinguished by the presence of an Alu sequence in the 3' nontranslated end of the longer species. Relative mRNA levels for 12 bovine tissues are presented.

Personality and coping among caregivers of spouses with dementia.

Personality factors and coping strategies were examined among a sample of spouse caregivers. Fifty spouse caregivers of patients diagnosed with Alzheimer's disease or a related dementia completed the NEO-FFI, a personality inventory designed to measure traits identified in the five-factor trait model, and a revised measure of the Ways of Coping Checklist. Results from a series of multivariate regressions showed that personality traits explained 60% of the variance in emotion-focused coping, 30% of variance in problem-focused coping, and 15% of variance associated with social support coping. Discussion focuses on the usefulness of including personality characteristics of the caregiver in formulating models of the caregiving coping process.

The Malmö polymorphism of coagulation factor IX, an immunologic polymorphism due to dimorphism of residue 148 that is in linkage disequilibrium with two other F.IX polymorphisms.

A mouse monoclonal antibody (MAB 9.9) to coagulation factor IX (F.IX) detects a polymorphism in the plasma of normal people. Its epitope has been narrowed down to less than 6 amino acids in the activation peptide of the X-linked F.IX protein. The activation peptide contains a dimorphism--Thr:Ala--at position 148 of the protein. Using synthetic oligonucleotides, we have demonstrated that (1) the F.IX which reacts with 9.9 has Thr at position 148 and (2) that which does not has Ala. Positive reactors (148thr) are designated Malmö A, and negative reactors (148ala) are designated Malmö B. The plasma levels of AA women are indistinguishable from those of A men, and both B men and BB women are null against MAB 9.9. The plasma level of Malmö A in AB women is approximately half that of AA women, and "lyonization" is clearly operating in the heterozygotes. The dimorphism is in strong linkage disequilibrium with two other intragenic RFLPs, TaqI and XmnI. Furthermore, intragenic crossing-over--including double crossing-over--appears to have occurred between the three sites. Seven of the eight possible haplotypes have been identified, five in men and two others in women. The immunoassay that identifies approximately 50% of the AB women in the pool of Malmö A females with 95% confidence identifies men unambiguously as A or B. The assay would be very useful for population-genetic studies of the Malmö epitope if the studies were limited to men.