Stress and Hypertension in Dementia Caregivers

No demographic group is more at risk for the double jeopardy of caregiving stress and hypertension (HTN) than African American women caring for a family member with Alzheimer's disease and related dementias (ADRD). Both situations lead to reduced quality of life and cardiovascular disease-a complication of uncontrolled hypertension. Maintaining the health of these caregivers is critical to support the well-being of the care recipients. Although some multi-component interventions have addressed ADRD caregiver's stress and quality of life, gaps remain in targeting interventions to address the complexity of chronic caregiving stress and hypertension self-care in African American women.This pilot study builds on our earlier work which showed that stress, blood pressure knowledge, and complex diet information deficits all interfered with older African American women's hypertension self-care. Lifestyle changes (stress management, reducing sodium, eating fruits/vegetables, and physical activity) are effective in managing hypertension. Our Stage I pilot study is based on the scientific rationale that we can promote these lifestyle changes by addressing stress reactivity/stress resilience, the psychological and physiological response of the body to stress, as the underlying mechanism to facilitate behavioral change. In this way we can improve health outcomes (caregiver stress, quality of life, cardiovascular disease risk).

Inclusion criteria:diagnosis of HTN treated with an antihypertensive medication;age 40 and oldera caregiver rating of the PLWD of 2 or greater on the Alzheimer's Dementia-8 scale;caregiver provides unpaid care to a PLWD at least 10 hours per week or assists with at least one instrumental activity of daily livingself-identifies as Black/African American;English speaking; andaccess to a telecommunications device such as the internet via desktop, laptop/tablet, smartphone, or telephone.Exclusion criteria:expect to move out of the area within 9 months;diagnosis of resistant HTN (blood pressure that remains above goal despite concurrent use of a diuretic/water pill and at least two other antihypertensive agents of different classes); oractive participation in mindfulness/yoga program. The NIA Common Data Screening and Enrollment forms will be used to track data.