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For many years health professionals have speculated that stress can lower a person's immune response to disease. A new study appears to lend scientific proof to those speculations. This study comes from Ohio State University and the results will appear in the November/December issue of the Journal of Psychosomatic Medicine.

This latest study is just one of many that have looked at immune response to stress, but it is the first to have such important findings for the senior adult and elderly population.

The study looked at how well a pneumonia vaccination will protect the elderly patients that receive the shot as recommended. The results of the study are especially important as bacterial pneumonia and the influenza that can cause it are the fourth leading causes of death for people over the age of 75.

There were 52 participants in the study, all older adults who had never received a pneumonia vaccine before. Of this group three-quarters were women. This group of participants was divided into three groups. Eleven participants were currently the primary caregiver for a spouse who was suffering from dementia, and thirteen were former caregivers whose spouses had since died. The remaining 28 participants had never been caregivers and became the control group.

Stress caused by dealing with the day to day needs of loved ones with dementia has been well documented and is of great concern with a rapidly aging population. Previous studies have shown that this type of chronic stress can impair the caregiver's immune system.

All study participants were given psychological tests to evaluate their current level of stress, and they also had blood drawn for various lab tests that evaluated their immune status. After the pre-study tests were completed all participants received a vaccine that helps protect against pneumococcal pneumonia. This bacterial infection is the most common cause of pneumonia in people who have had influenza. The blood tests were then repeated at intervals of two weeks, one month, three months and six months after they had received the pneumonia vaccination.

The blood tests showed that all the participants had a positive response at first to the vaccine. A positive response is measured by the levels of an antibody that the body produces in response to the vaccine. In subsequent blood tests the immune response of the former caregivers and those who had never been caregivers remained at the same level. But at the end of the six months of the study the current caregivers - who remained in a very stressful caregiving situation - showed a dramatic drop in their immune response.

Implications For Caregivers

This study points out the need and importance of support and assistance from the community and society as a whole for those family caregivers who are providing much needed care for their loved ones. Without these caregivers the health care system might well be overwhelmed with the care of patients with dementia. As the population ages the need for support will become more acute. In his announcement proclaiming November as National Family Caregivers Month, President Clinton noted "Caregivers often pay an emotional and physical price as well as a financial one. Few enjoy any free time because they must juggle the demands of home and work while meeting the special needs of the individuals in their care. Many do not have the support of other family members or friends and consequently experience depression, a sense of isolation, and the stress of knowing they must carry out their important duties alone. Studies have indicated that such caregiver stress can have a physical consequence, contributing to a higher mortality rate among elderly caregivers who themselves have a history of chronic illness." His proposal for a National Family Caregiver Support Program to provide respite care and other support should help to ease the stress of caregiving.

In the meantime the lead author of the study report, Ron Glaser of Ohio State University suggests that all elderly Americans avoid getting their annual flu and pneumonia shots while they are under stress in order to receive the greatest benefit from the vaccination. If they are highly stressed they should reschedule the shots until they have been able to deal with and reduce the stressful situation.

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