Personal Mastery is Associated With Reduced Sympathetic Arousal in Stressed Alzheimer Caregivers

Objectives Spousal caregivers of Alzheimer's disease patients are at increased risk for cardiovascular disease, possibly via sympathetic response to stressors and subsequent catecholamine surge. Personal mastery (i.e., belief that one can manage life's obstacles) may decrease psychological and physiological response to stressors. This study examines the relationship between mastery and sympathetic arousal in elderly caregivers, as measured by norepinephrine (NE) reactivity to an acute psychological stressor. Design Cross-sectional. Setting Data were collected by a research nurse in each caregiver's home. Participants Sixty-nine elderly spousal Alzheimer caregivers (mean age: 72.8 years) who were not taking β-blocking medication. Intervention After assessment for mastery and objective caregiving stressors, caregivers underwent an experimental speech task designed to induce sympathetic arousal. Measurements Mastery was assessed using Pearlin's Personal Mastery scale and Alzheimer patient functioning was assessed using the Clinical Dementia Rating Scale, Problem Behaviors Scale, and Activities of Daily Living Scale. Plasma NE assays were conducted using pre- and postspeech blood draws. Results Multiple regression analyses revealed that mastery was significantly and negatively associated with NE reactivity ( B = −9.86, t (61) = −2.03, p = 0.046) independent of factors theoretically and empirically linked to NE reactivity. Conclusions Caregivers with higher mastery had less NE reactivity to the stressor task. Mastery may exert a protective influence that mitigates the physiological effects of acute stress, and may be an important target for psychosocial interventions in order to reduce sympathetic arousal and cardiovascular stress among dementia caregivers.