Skip to main content
Log in

Lymphocyte Proliferation Is Associated with Gender, Caregiving, and Psychosocial Variables in Older Adults

  • Published:
Journal of Behavioral Medicine Aims and scope Submit manuscript

Abstract

We examined lymphocyte responses to mitogens [phytohemagglutinin (PHA), concanavalin A, pokeweed] in spouse caregivers of persons with Alzheimer's disease (n = 82; mean age = 69.4) and noncaregiver spouses (n = 83) group matched on age and gender. Data were collected at study entry (T1) and 15–18 months later (T2). In men (n = 52), a depressed mood factor was negatively related to all mitogen responses at T1 and PHA at T2. Loneliness was the most important variable in the depressed mood factor. No relationships occurred in women (n = 113). At T2 an anger expression factor (anger-out − anger-control) was negatively related to all mitogen responses in caregivers. Anger-out was the most important variable for anger expression. Depressed mood at T1 predicted residualized changes in PHA at T2 in men. In conclusion, men with higher depressed mood and caregivers with higher anger expression may be at risk for lower proliferation responses.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

REFERENCES

  • Akiskal, H. S., Khani, M. K., and Scott-Strauss, A. (1979). Cyclothymic temperamental disorders. Psychiatr. Clin. North Am. 2: 527–554.

    Google Scholar 

  • Allen, M. T., Stoney, C. M., Owens, J. F., and Matthews K. A. (1993). Hemodynamic adjustments to laboratory stress: The influence of gender and personality. Psychosom. Med. 55: 505–507.

    Google Scholar 

  • American Psychiatric Association (1980). Diagnostic and Statistical Manual of Mental Disorders, 3rd ed., APA, Washington, DC.

    Google Scholar 

  • Andreoli, A. V., Keller, S. E., Rabaeus, M., Marin, P., Bartlett, J. A., and Taban, C. (1993). Depression and immunity: Age, severity, and clinical course. Brain Behav. Immun. 7: 279–292.

    Google Scholar 

  • Anesi, A., Franciotta, D., DiPaolo, E., Zardini, E., Melzi d'Eril, G., and Zerbi, F. (1994). PHA stimulated cellular immune function and t-lymphocyte subsets in major depressive disorders. Funct. Neurol. 9: 17–22.

    Google Scholar 

  • Beck, A. T., and Beck, R. W. (1972). Screening depressed patients in family practice: A rapid technique. Postgrad. Med. 52: 81–85.

    Google Scholar 

  • Bleiker, E.M. A., vanderPloeg, H. M., Hendriks, J. H. C. L., and Ader, H. J. (1996). Personality factors and breast cancer. J. Natl. Cancer Inst. 88: 1478–1482.

    Google Scholar 

  • Castle, S., Wilkins, S., Heck, E., Tanzy, K., and Fahey, J. (1995). Depression in caregivers of demented patients is associated with altered immunity: Impaired proliferative capacity, increased CD8+, and a cytotoxicity marker (CD56+ CD8+). Clin. Exp. Immunol. 101: 487–493.

    Google Scholar 

  • Chappell, N. L. (1990). Aging and social care. In Binstock, R. H., and George, L. S. (eds.), Handbook of Aging and the Social Sciences, 3rd ed., Academic Press, New York, pp. 438–454.

    Google Scholar 

  • Christensen, A. J., Edwards, D. L., Wiebe, J. S., Benotsch, E. G., McKelvey, L., Andrews, M., and Lubaroff, D. M. (1996). Effect of verbal self-disclosure on natural killer cell activity: Moderating influence of cynical hostility. Psychosom. Med. 58: 150–155.

    Google Scholar 

  • Cohen, C., Teresi, J., and Holmes, D. (1985). Social networks, stress, and physical health: A longitudinal study of an inner-city elderly population. J. Gerontol. 40: 478–486.

    Google Scholar 

  • Cohen, P., Pine, D. S., Must, A., Kasen, S., and Brook, J. (1998). Prospective associations between somatic illness and mental illness from childhood to adulthood. Am. J. Epidemiol. 147: 232–239.

    Google Scholar 

  • Connidis, I. A., and Davies, L. (1990). Confidants and companions in later life. J. Gerontol. Soc. Sci. 45: 141–149.

    Google Scholar 

  • Davies, H., Priddy, J. M., and Tinklenberg, J. R. (1986). Support groups for male caregivers of Alzheimer's patients. Clin. Gerontol. 5: 385–395.

    Google Scholar 

  • Dressler, W. W., Grell, G. A. C., Gallagher, P. N., and Viteri, F. E. (1992). Social factors mediating social class differences in blood pressure in a Jamaican community. Soc. Sci. Med. 35: 1233–1244.

    Google Scholar 

  • Felsten, G. (1996). Five-factor analysis of Buss-Durkee hostility inventory neurotic hostility and expressive hostility factors: Implications for health psychology. J. Person. Assess. 67: 179–194.

    Google Scholar 

  • Fernandez-Ballesteros, R., Ruiz, M. A., and Garde, S. (1998). Emotional expression in healthy women and those with breast cancer. Br. J. Health Psychol. 3: 41–50.

    Google Scholar 

  • Folstein, M. F., Folstein, E., and McHugh, P. R. (1975). Mini-Mental State: A practical method for grading the cognitive state of patients for the clinician. J. Psychiatr. Res. 12: 189–198.

    Google Scholar 

  • Ford, D. E., Mead, L. A., Chang, P. P., Cooper-Patrick, L., Wang, N. Y., and Klag, M. J. (1998). Depression is a risk factor for coronary artery disease in men: The precursors study. Arch. Intern. Med. 158: 1422–1426.

    Google Scholar 

  • Fox, M., Gibbs, M., and Auerbach, D. (1985). Age and gender dimensions of friendship. Psychol. Women Q. 9: 489–501.

    Google Scholar 

  • Frankenhaeuser,M. (1991). The psychophysiology of sex differences as related to occupational status. In Frankenhaeuser, M., Lundberg, U., and Chesney, M. (eds.), Women, Work and Health: Stress and Opportunities, Plenum, New York. pp. 39–61.

    Google Scholar 

  • Gillin, J. L., Mills, P. J., Nelesen, R. A., Dillon, E., Ziegler, M. G., and Dimsdale, J. E. (1996). Race and sex differences in cardiovascular recovery from acute stress. Int. J. Psychophysiol. 23: 83–90.

    Google Scholar 

  • Guidi, L., Bartoloni, C., Frasca, D., Antico, L., Pili, R., Cursi, F., Tempesta, E., Rumi, C., Menini, E., and Carbonin, P. (1991). Impairment of lymphocyte activities in depressed aged subjects. Mech. Age. Dev. 60: 13–24.

    Google Scholar 

  • Hamilton, M. (1960). A rating scale for depression. J. Neurol. Neurosurg. Psychiatry 23:56–62.

    Google Scholar 

  • Hanken, M. A. (1989). A study of physician performance in a physician oriented in-patient clinical record system. (Doctoral dissertation, University of Washington). Dissert. Abstr. Int. 50–12a: 3823.

    Google Scholar 

  • Haynes, S. G., Feinleib, M., and Kannel, W. B. (1980). The relationship of psychosocial factors to coronary heart disease in the Framingham Study. Eight year incidence of coronary heart disease. Am. J. Epidemiol. 111: 37–58.

    Google Scholar 

  • Herbert, T. B., and Cohen, S. (1993). Depression and immunity:Ameta-analytic review. Psychol Bull. 113: 472–486.

    Google Scholar 

  • Herbert, T. B., Coriell, M., and Cohen, S. (1994). Analysis of lymphocyte proliferation data: Do different approaches yield the same results? Brain Behav. Immun. 8: 153–162.

    Google Scholar 

  • Irwin, M. R., Brown. M., Patterson, T., Hauger, R., Mascovich, A., and Grant, I. (1991). Neuropeptide Y and natural killer cell activity: Findings in depression and Alzheimer caregiver stress. FASEB J. 5: 3100–3107.

    Google Scholar 

  • Irwin, M., Hauger, R., Patterson, T. L., Semple, S., Ziegler, M., and Grant, I. (1997). Alzheimer caregiver stress: Basal natural killer cell activity, pituitary-adrenal cortical function, and sympathetic tone. Ann. Behav. Med. 19: 83–90.

    Google Scholar 

  • Jackson, C. G., Ochs, H. D., and Wedgwood, R. J. (1979). Immune response of a patient with deficiency of the fourth component of complement and systemic lupus erythematosus. N. Engl. J. Med. 300: 1124–1129.

    Google Scholar 

  • Keenan, R. J., Uknis, M. E., Pham, S. M., Spichty, K., Duquesnoy, R. J., Griffith, B. P., and Zeevi A. (1992). Mitogen responses of lymphocytes from lung transplant recipients-Correlation with rejection and infection. Transplantation 54: 241–245.

    Google Scholar 

  • Kessler, R. C., and McLeod, J. D. (1985). Social support and mental health in community samples. In Cohen, S., and Syme, S. L. (eds.), Social Support and Health, Academic Press, New York, pp. 219–240.

    Google Scholar 

  • Kiecolt-Glaser, J. K., Dura, J. R., Speicher, C. E., Trask, O. J., and Glaser, R. (1991). Spousal caregivers of dementia victims: Longitudinal changes in immunity and health. Psychosom. Med. 53: 345–362.

    Google Scholar 

  • Kiecolt-Glaser, J. K., Malarkey, W. B., Chee, M., Newton, T., Caciopppo, J. T., Mao, H. Y., and Glaser, R. (1993). Negative behavior during martial conflict is associated with immunological down-regulation. Psychosom. Med. 55: 410–412.

    Google Scholar 

  • Kiecolt-Glaser, J. K., Page, G. G., Marucha, P. T., MacCallum, R. C., and Glaser, R. (1998). Psychological influences on surgical recovery. Perspectives from psychoneuroimmunology. Am. Psychol. 53: 1209–1218.

    Google Scholar 

  • King, A. C., Oka, R. K., and Young, D. R. (1994). Ambulatory blood pressure and heart rate responses to the stress of work and caregiving in older women. J. Gerontol. 49: 239–245.

    Google Scholar 

  • Kouzis, A., Eaton, W. W., and Leaf, P. J. (1995). Psychopathology and mortality in the general population. Soc. Psychiatry Psychiatr. Epidemiol. 30: 165–170.

    Google Scholar 

  • Kramer, T. R., Moore, R. J., Shippee, R. L., Friedl, K. E., Martinez-Lopez, L., Chan, M. M., and Askew, W. E. (1997). Effects of food restriction in military training on t-lymphocyte responses. Int. J. Sports Med. 18: 84–90.

    Google Scholar 

  • Lazarus, R. S., and Folkman, S. (1984). Stress, Appraisal, and Coping, Springer, New York.

    Google Scholar 

  • Levy, E. M., Borrelli, D. J., Mirin, S. M., Salt, P., Knapp, P. H., Peire, C., Fox, B. H., and Black, P. H. (1991). Biological measures and cellular immunological function in depressed psychiatric inpatients. Psychiatry Res. 36: 157–167.

    Google Scholar 

  • Lewis, S. L., Clough, D., and Patrick, G. L. (1998). Effects of relaxation therapy on relaxation response and immune function. Paper presented at the Society of Behavioral Medicine Meeting, New Orleans, LA.

  • Lin, S. T., Yang, C. P., and Liang, D. C. (1993). Health status of patients with childhood acute lymphoblastic leukemia in continuous complete remission for over five years. J. Formosa Med. Assoc. 92: 702–710.

    Google Scholar 

  • Lloyd, A., Hickie, I., Hickie, C., Dwyer, J., and Wakefield, D. (1992). Cell-mediated immunity in patients with chronic fatigue syndrome, healthy control subjects and patients with major depression. Clin. Exp. Immunol. 87: 76–79.

    Google Scholar 

  • Mariani, E., Roda, P., Mariani, A. R., Vitale, M., Degrassi, A., Papa, S., and Facchini, A. (1990). Age-associated changes in CD8+ and CD16+ cell reactivity: Clonal analysis. Clin. Exp. Immunol. 81: 479–484.

    Google Scholar 

  • Markovic, N., Matthews, K. A., Huston, S. L., Egbagbe, E., Ukoli, F. A., and Bunker, C. H. (1995). Blood pressure reactivity to stress varies by hypertensive status and sex in Nigerians. Am. J. Epidemiol. 142: 1020–1028.

    Google Scholar 

  • McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D., and Stadlan, E. M. (1984). Clinical diagnosis of Alzheimer's disease: Report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's disease. Neurology 34: 939–944.

    Google Scholar 

  • Melichar, B., Jandik, P., Krejsek, J., Solichova, D., Drahosova, M., Skopec, F., Mergancova, J., and Voboril, Z. (1996). Mitogen induced lymphocyte proliferation and systemic immune activation in cancer patients. Tumori 82: 218–220.

    Google Scholar 

  • Miller, S. B., Dolgoy, L., Friese, M., and Sita, A. (1996). Dimensions of hostility and cardiovascular response to interpersonal stress. J. Psychosom. Res. 41: 81–95.

    Google Scholar 

  • Mills, P. J., Dimsdale, J. E., Nelesen, R. A., and Dillon, E. (1996). Psychological characteristics associated with acute stressor-induced leukocyte subset redistribution. J. Psychosom. Res. 40: 417–423.

    Google Scholar 

  • Mills, P. J., Ziegler, M. G., Patterson, T., Dimsdale, J. E., Hauger, R., Irwin, M., and Grant, I. (1997). Plasma catecholamine and lymphocyte β2-adrenergic receptor alterations in elderly Alzheimer caregivers under stress. Psychosom. Med. 59: 251–256.

    Google Scholar 

  • Moldin, S. O., Scheftner, W. A., Rice, J. P., Nelson, E., Knesevich, M., and Akiskal, H. (1993). Association between major depressive disorder and physical illness. Psychol. Med. 23: 755–761.

    Google Scholar 

  • Nathanson, C. A. (1990). The gender-mortality differential in developed countries: Demographic and sociocultural dimensions. In Ory, M. G., and Warner, J. R. (eds.), Gender, Health, and Longevity: Multidisciplinary Perspectives, Springer, New York. pp. 3–24.

    Google Scholar 

  • Ochs, H. D., Slichter, S. J., Harker, L. A., VonBehrens, W. E., Clark, R. A., and Wedgwood, R. J. (1980). The Wiskott-Aldrich syndrome: Studies of lymphocytes, granulocytes, and platelets. Blood 55: 243–252.

    Google Scholar 

  • Puckett, C. D. (1993). The Educational Annotation of ICD-9-CM, 4th ed. Channel, Reno, NV.

    Google Scholar 

  • Richner, J., Ambinder, E. P., Hoffman, K., Feuer, E. J., and Bekesi, C. (1991). Number of helper T cells and phytohemagglutinin stimulation correlate in cancer patients. Cancer Immunol. Immunother. 34: 138–142.

    Google Scholar 

  • Robins, L. N., Helzer, J. E., Croughan, J., and Ratcliff, K. (1981). National Institute of Mental Health Diagnostic Interview Schedule: Its history, characteristics and validity. Arch. Gen. Psychiatry 38: 81–389.

    Google Scholar 

  • Russell, D., Peplau, L. A., and Cutrona, C. E. (1980). The Revised UCLA Loneliness Scale: Concurrent and discriminant validity evidence. J. Person. Soc. Psychol. 39: 472–480.

    Google Scholar 

  • Russo, J., Vitaliano, P. P., Brewer, D., Katon, W., and Becker, J. (1995). Psychiatric disorders in spouse caregivers of care-recipients with Alzheimer's disease and matched controls: A diathesis-stress model of psychopathology. J. Abnorm. Psychol. 104: 197–204.

    Google Scholar 

  • Saito,T., Shimoda, K., Shigemitsu,Y., Kinoshita, T., Kuwahara, A., Miyahara, M., and Kobayashi, M. (1991). Complications of infection and immunologic status after surgery for patients with esophageal cancer. J. Surg. Oncol. 48: 21–27.

    Google Scholar 

  • Scanlan, J. M., Laudenslager,M. L., and Jones, J. (1994). Stress, anger and social support: Relationships with immunity and illness in medical students. Paper presented at the meeting of the Psychoneuroimmunology Society, Key Biscayne, FL.

  • Scanlan, J. M., Vitaliano, P. P., Ochs, H. D., Savage, M. V., and Borson, S. (1998). CD4 and CD8 counts are associated with interactions of gender and psychosocial stress. Psychosom. Med. 60: 644–653.

    Google Scholar 

  • Siegman, A. W., Anderson, R. A., Herbst, J., Boyle, S., and Wilkinson, J. (1992). Dimensions of anger-hostility and cardiovascular reactivity in provoked and angered men. J. Behav. Med. 15: 257–272.

    Google Scholar 

  • Siegman, A. W., and Snow, S. C. (1997). The outward expression of anger, the inward experience of anger and CVR: The role or vocal expression. J. Behav. Med. 20: 29–45.

    Google Scholar 

  • Smith, T. W., and Christensen, A. J. (1992). Hostility, health, and social contexts. In Friedman, H. S. (ed.), Hostility, Coping, and Health, American Psychological Association, Washington, DC, pp. 33–48.

    Google Scholar 

  • Spielberger, C. D., Jacobs, G., Russell, S., and Crane, R. (1983). Assessment of anger: The State-Trait Anger Scale. Vol. 2. In Butcher, J. N., and Spielberger, C. D. (eds.), Advances in Personality Assessment, Lawrence Erlbaum, Hillsdale, NJ.

    Google Scholar 

  • Spielberger, C. D., Johnson, E. G., Russell, S. S., Crane, R. J., Jacobs, G. A., and Worden, T. J. (1985). The experience and expression of anger: Construction and validation of an anger expression scale. In Chesney, M. A., and Rosenman, R. H. (eds.), Anger and Hostility in Cardiovascular and Behavioral Disorders, Hemisphere, New York, pp. 5–30.

    Google Scholar 

  • Spurrell, M. T., and Creed, F. H. (1993). Lymphocyte response in depressed patients and subjects anticipating bereavement. Br. J. Psychiatry 162: 60–64.

    Google Scholar 

  • Stephens, M. A. P., Kinney, J. M., and Ogrocki, P. K. (1991). Stressors and well-being among caregivers to older adults with dementia: The in-home versus nursing home experience. Gerontologist 31: 217–223.

    Google Scholar 

  • Suarez, E. C., Harlan, E., Peoples, M. C., and Williams, R. B. (1993). Cardiovascular and emotional responses in women: The role of hostility and harassment. Health Psychol. 12: 459–468.

    Google Scholar 

  • Suarez, E. C., Kuhn, C. M., Schanberg, S. M., Williams, R. B., and Zimmermann, E. A. (1998). Neuroendocrine, cardiovascular, and emotional responses of hostile men: The role of interpersonal challenge. Psychosom. Med. 60: 78–88.

    Google Scholar 

  • Thomas, C., and Kelman, H. R. (1990). Gender and the use of health services among elderly persons. In Ory, M. G., and Warner, H. R. (eds.), Gender, Health, and Longevity: Multidisciplinary Perspectives, Springer, New York. pp. 137–156.

    Google Scholar 

  • Todarello, O., Casamassima, A., Marinaccio, M., La-Pesa, M. W., Caradonna, L., Valentino, L., and Marinaccio, L. (1994). Alexithymia, immunity and cervical intraepithelial neoplasia: A pilot study. Psychother. Psychosom. 61: 199–204.

    Google Scholar 

  • Todarello, O., Casamassima, A., Daniele, S., Marinaccio, M., Fanciullo, F., Valentino, L., Tedesco, N., Wiesel, S., Simone, G., and Marinaccio, L. (1997). Alexithymia, immunity and cervical intraepithelial neoplasia: Replication. Psychother. Psychosom. 66: 208–213.

    Google Scholar 

  • Uchino, B. D., Kiecolt-Glaser, J. K., and Cacioppo, J. T. (1994). Construals of preillness relationship quality predict cardiovascular response in family caregivers of Alzheimer's disease victims. Psychol. Aging 9: 113–120.

    Google Scholar 

  • Venkatraman, J. T., and Fernandes, G. (1996). Exercise, immunity and aging. Aging Clin. Exp. Res. 9: 42–56.

    Google Scholar 

  • Vinick, B. H. (1984). Elderly men as caretakers of wives. J. Geriatr. Psychiatry 17: 61–68.

    Google Scholar 

  • Vitaliano, P. P. (2000). A meta-analysis or research on associations of caregiving with physical health. Paper presented at the Gerontological Society of America, Annual Meeting, Washington, DC.

  • Vitaliano, P. P., Maiuro, R. D., Bolton, P. A., and Armsden, G. C. (1987). A psychoepidemiological approach to the study of disaster. J. Commun. Psychol. 15: 99–122.

    Google Scholar 

  • Vitaliano, P. P., Russo, J., Bailey, S., Young, H., and McCann, B. (1993). Psychosocial factors associated with cardiovascular reactivity in older individuals. Psychosom. Med. 55: 164–177.

    Google Scholar 

  • Vitaliano, P. P., Russo, J., and Niaura, R. (1995). Plasma lipids and their relationship to psychosocial factors in older adults. J. Gerontol. Psychol. Sci. 50: 18–24.

    Google Scholar 

  • Vitaliano, P. P., Russo, J., Scanlan, J. M., and Greeno, K. (1996a). Weight changes in caregivers of Alzheimer's care-recipients: Psychobehavioral predictors. Psychol. Aging 11: 155–163.

    Google Scholar 

  • Vitaliano, P. P., Scanlan, J. M., Krenz, C., Schwartz, R. S., and Marcovina, S. M. (1996b). Psychological distress, caregiving, and metabolic variables. J. Gerontol. Psychol. Sci. 51: 290–297.

    Google Scholar 

  • Vitaliano, P. P., Scanlan, J. M., Krenz, C., and Fujimoto, W. (1996c). Insulin and glucose: Relationships with hassles, anger and hostility in non-diabetic older adults. Psychosom. Med. 58: 489–499.

    Google Scholar 

  • Vitaliano, P. P., Scanlan, J. M., Ochs, H. D., Syrjala, K., Siegler, I. C., and Snyder, E. A. (1998). Psychosocial stress moderate the relationship of cancer history with natural killer cell activity. Ann. Behav. Med. 20: 199–208.

    Google Scholar 

  • Vitaliano, P. P., Scanlan, J. M., and Zhang, J. (2001a). Chronic stress and physical health:Ametaanalysis of 1507 caregivers of dementia victims and 1394 non-caregiver controls. Paper presented at the Society of Behavioral Medicine, Annual Meeting, Seattle,WA.

  • Vitaliano, P. P., Scanlan, J. M., Zhang, J., Savage, M. V., Hirsch, I., and Siegler, I. C. (2001b). A path model of chronic stress, the metabolic syndrome, and coronary disease. Psychosom. Med. (in press).

  • Weintraub, S., Barataz, R., and Mesulam, M. (1982). Daily living activities in the assessment of dementia. In Corkin, S., Davis, K., Cravden, J., Usdin, E., and Wurtman, J. (eds.), Alzheimer's Disease:AReport of Progress in Research, Raven Press, NewYork. pp. 189–192.

    Google Scholar 

  • Williams, D. E., Vitiello, M. V., Ries, R. K., Bokan, J., and Prinz, P. N. (1988). Successful recruitment of elderly community-dwelling subjects for Alzheimer's disease research. J. Gerontol. 43: 69–74.

    Google Scholar 

  • Young, R. F., and Kahana, E. (1989). Specifying caregiver outcomes: Gender and relationship aspects of caregiver strain. Gerontologist 29: 660–666.

    Google Scholar 

  • Zubin, J., and Spring B. (1977). Vulnerability-A new view of schizophrenia. J. Abnorm. Psychol. 86: 103–126.

    Google Scholar 

Download references

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Scanlan, J.M., Vitaliano, P.P., Zhang, J. et al. Lymphocyte Proliferation Is Associated with Gender, Caregiving, and Psychosocial Variables in Older Adults. J Behav Med 24, 537–559 (2001). https://doi.org/10.1023/A:1012987226388

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1012987226388

Navigation