A hypercoagulable stress response might contribute to the increased cardiovascular
risk in Alzheimer’s caregivers.
(1) To evaluate whether coping
processes affect hemostatic reactivity to acute psychological stress and (2) whether these effects differ substantially between caregivers and noncaregivers.
Sixty elderly community-dwelling spousal caregivers of patients with Alzheimer’s disease and 33 noncaregiving controls completed the revised Ways of Coping
Questionnaire to assess approach
/problem-solving versus avoidant coping
processes. Participants were administered an acute stress test that required them to deliver a 3-minute speech challenge to the interviewer on an assigned topic. The hypercoagulability marker D-dimer
was measured at three time points: baseline, immediately postspeech, and during recovery (15 minutes postspeech).
Multivariate analysis of covariance revealed that subjects who endorsed greater levels of approach coping
had decreased levels of D-dimer
at all time points (p
= .048). A significant three-way interaction between planful problem solving, caregiver status, and the temporal pattern of D-dimer
was found (p
= .004), indicating that caregivers with low levels of planful problem solving exhibited greater increases in D-dimer
from baseline to speech and recovery time points relative to controls. No relationship between avoidant coping
These findings suggest the possibility that approach
and problem-solving coping
processes buffer the impact of acute psychological stressors on procoagulant activity. It remains to be seen whether interventions that increase approach
/problem-solving processes might produce salutary effects among caregiving
APP = approach coping; AVD = avoidant coping; BMI = body mass index; CGS = caregiver status; DD = D-dimer; HAM-D = Hamilton Rating Scale for Depression; HARS = Hamilton Anxiety Rating Scale; MANCOVA = multivariate analysis of covariance; PPS = planful problem solving; WOC = Ways of Coping; UCSD = University of California San Diego; HLM = hierarchical linear modeling.