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College of Nursing > Faculty Funded Research
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Dr. Meredeth RoweIMPROVING DEMENTIA CAREGIVER SLEEP AND THE EFFECT ON HEART DISEASE BIOMARKERSMaureen Groer
CHRONIC TOXOPLASMA GONDII, PREGNANCY REACTIVATION, AND PERINATAL DEPRESSION
Project Start Date: 1512-AUG-20112017
Project End Date: 31-JULMAY-2016
Informal caregivers provide the majority of care for chronically ill adults, including persons with dementia. While these individuals provide a great benefit to the chronically ill relative, being a caregiver is associated with deleterious health consequences, including premature mortality and higher rates of coronary heart disease (CHD). Another common complaint among dementia caregivers is poor sleep, which has been connected to premature mortality and higher rates of CHD in noncaregiving adults. Currently no sleep therapies are empirically validated as effective for caregivers of persons with dementia (PWD), and since PWD often arise at night, improving caregiver sleep could be potentially hazardous as a sleeping caregiver cannot provide supervision during night awakenings. Our primary purpose is thus to determine whether a combined intervention is effective in improving sleep in caregivers of PWD who arise at night. The intervention consists of a night home monitoring system that provides reliable alerts to caregivers when PWD leave the bed and move through the house. While this system improved home safety for PWD, it did not affect caregiver sleep, so a more traditional sleep therapy will be added-cognitive-behavioral therapy for insomnia (CBTi). In the proposed study, experimental participants will receive the night home monitoring system + CBTi; control participants will receive only the night home monitoring system. Participants will remain in the study for 24 weeks, with 4 data collection points. We hypothesize experimental participants will have less time awake after going to bed, and improved sleep efficiency (percent time asleep while in bed). Sleep data will be collected for multiple nights using actigraphy and sleep diary. Our secondary research questions focus on the relationship between poor sleep and CHD. Both in adults and in dementia caregivers, there appears to be a link between poor sleep and abnormal levels on coronary heart disease biomarkers, and likely an increase in CHD with poor sleep. We aim to further explore this relationship as well as determine whether levels of biomarkers improve with improved sleep from the intervention. We propose to draw blood samples at 3 data collection points and measure a set of biomarkers indicative of CHD. Our primary expected outcome is an effective, easy-to-use treatment that can improve sleep in dementia CGs with sleep problems. We will continue to build the science on the relationship between sleep and CHD, and to understand mechanisms that may underlie deleterious changes in CG health. Obtaining evidence of the relationship between sleep and CHD biomarkers, supported by preliminary data that improving sleep reverses changes in biomarker levels, would begin to fill a critically important gap in research aiming to reduce the trend of PWD caregiver mortality and CHD as well as PWD placement in nursing homes. A longer study would then be proposed to determine how to deliver effective sleep therapies to sustain normalization of CHD biomarkers, as well as to determine whether the actual disease process was affected.
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2022
Project Summary/Abstract Toxoplasma gondii is a ubiquitous parasite that infects one third of the world's population. It remains in a latent state, encapsulated in cysts in the brain and muscle tissue of infected hosts. Reactivation rarely occurs, and usually only when the host has become significantly immunosuppressed. However, emerging literature suggests that chronic, latent infection is not innocuous. There have been reports associating depression, schizophrenia, suicidality, unusual behaviors, and migraine headaches with T. gondii IgG titers in chronically infected individuals. In addition, a few reports suggest that T. gondii can reactivate in healthy, immunocompetent pregnant women. These relationships have not yet been studied systematically in perinatal women. This proposal will study the relationships between latent T.gondii infection and depression through pregnancy and the early postpartum in T. gondii positive Hispanic women. Hispanic women are at highest risk for the type 1 serotype and a new highly virulent strain. Studies of behavioral and mood effects of T. gondii infection in both rodent models and humans have been done, but not in perinatal women. The research team has reported a relationship between T. gondii IgG titers and depression in second trimester pregnant women. In the proposed study, the role of socioeconomics and country of origin, cytokines, and immunosuppression will be determined across pregnancy. The relationship between IgG titer and depression in the postpartum will also be studied. A T. gondii negative control group will provide comparison. The second goal is to determine the true incidence of T. gondii reactivation in pregnant women with latent T. gondii infection. Women with positive IgG titers will be followed through pregnancy for changes in titer, symptoms, and for those with retinal scars, evidence of reactivation of chorioretinitis. The third goal is to explore the possibility of live tachyzoites transiting across the placenta into the fetal blood stream in T. gondii positive women.
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