Moderate exercise program benefits health of older women caregivers

Older women caregivers slept better and lowered their blood pressure reactivity in response to stress tests after participating in a moderate exercise program compared to a group of women who only received nutrition counseling. Results of the study were published in the Journal of Gerontology: Medical Sciences' November issue.
Caregivers who exercised 4 times a week showed significant improvements to their health, according to the results of a randomized study headed by Abby C. King, Ph.D. at the Stanford University School of Medicine. * This is the first investigation of the effectiveness of a physical activity intervention tailored specifically to the needs of caregivers. It is another in a series of studies on the importance of exercise funded by the National Institute on Aging (NIA).

One hundred women ages 49 to 82 volunteered to participate in either a moderate exercise or a nutrition counseling program. Each received a 30- to 40-minute face-to-face introductory counseling session, with the remainder of contacts delivered by telephone. The women averaged 72 hours a week caring for demented family members, 63 percent of whom had Alzheimer's disease. Participants lived with their care recipients either all the time (92 percent) or most of the time (8 percent) and had spent an average of 4 years caring for their impaired relative.

Each week, 51 women in the exercise group engaged in four 30- to 40-minute sessions of aerobic exercise, such as brisk walking. Exercisers completed brief daily logs including activity type, intensity and duration that were mailed monthly to project staff. The 49 members of the nutrition group learned about nutrition topics, discussed benefits of good nutrition and kept daily diet logs. Telephone calls of 15- to 20-minutes were used to monitor progress of both groups, answer questions and provide individualized feedback.

At the end of the study, the exercise group showed significant improvements in stress-induced blood pressure levels and sleep quality compared to the women who received nutrition

counseling. Exercisers spent 5 hours a week in physical activity by the study's end compared to the nutrition group who spent less than 3 hours per week in all forms of physical activity. The exercising caregivers showed significantly lower 12-month systolic and diastolic blood pressure levels in response to an emotional stress test compared to the nutrition group. Reduced blood pressure reactivity in response to stress is associated with fewer heart and blood pressure problems. Conversely, the nutrition participants' diet improved but the group showed no changes in either resting or reactive blood pressure.

The home-based exercise program was particularly important to the 12 participants who could not leave or find coverage for their care recipients for 30 minutes during the day. A health educator worked with them to develop an indoor exercise program based on their preferences. Other participants also received an individualized physical activity plan based on their preferences.

"This is a an important study given that many U.S. households eventually will provide care to ill or disabled relatives," said Dr. Sidney M. Stahl, Chief of Behavioral Medicine within the NIA's Behavioral and Social Research Program. "Studies show that family caregiving accompanied by emotional strain is an independent risk factor for mortality among older adults. The study gives us some evidence that a self-directed exercise program can reduce stress reactions and perhaps improve the health of caregivers. This pilot intervention trial provides encouraging results and hope for a low-cost, effective means to combat caregiver stress." Future studies may confirm these findings and define the mechanisms and degree of benefit moderate exercise provides caregivers.

*In addition to Dr. King who is at Stanford's Division of Epidemiology, Department of Health Research & Policy, study authors included Kellie Baumann, B.A., Stanford University School of Medicine's Center for Research on Women's Health and Reproductive Medicine in the Department of Obstetrics and Gynecology; Paula O' Sullivan, Ph.D. and Cynthia Castro, Stanford University School of Medicine's Center for Research in Disease Prevention, Department of Medicine, and Sara Wilcox, Ph.D., University of South Carolina's Department of Exercise Science, School of Public Health.

The NIA, part of the National Institutes of Health, leads the Federal effort supporting basic, clinical, epidemiological and social research on aging and the special needs of older people