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. 2025 Jul;21(7):e70518.
doi: 10.1002/alz.70518.

Relationship between cellular aging, perceived stress, and cardiometabolic disease risk in Black family caregivers of persons with dementia

Jordan Watson  1 , Emily Buchi  1 , Melinda K Higgins  1 , Glenna S Brewster Glasgow  1 , Antoine R Trammell  2 , Christopher Herring  1 , Whitney Wharton  1 , Rebecca A Gary  1 , Kenneth Hepburn  1 , Sandra B Dunbar  1 , Brittany Butts  1
Affiliations

Relationship between cellular aging, perceived stress, and cardiometabolic disease risk in Black family caregivers of persons with dementia

Jordan Watson et al. Alzheimers Dement. 2025 Jul.

Abstract

Background: Informal caregivers of individuals with Alzheimer's disease and related dementias (ADRD) face significant physical and psychological demands. Chronic caregiving is linked to mental health challenges, poor cardiovascular health, and accelerated cellular aging, reflected in telomere shortening, with Black caregivers disproportionately affected.

Methods: This secondary analysis used data from Black caregivers from a randomized control trial. Telomere length was measured by qPCR. Questionnaires assessed perceived stress, sleep, depression, anxiety, and coping strategies. Salivary cortisol, inflammatory, and cardiometabolic biomarkers were measured. Pearson correlations and linear regression analyses controlled for demographic and health factors.

Results: Shorter telomeres were linked to stress, poor sleep, inflammation, and cardiometabolic markers. Perceived stress was associated with negative coping strategies, anxiety, and depressive symptoms.

Discussion: More research is needed to uncover mechanisms linking caregiver stress to cardiovascular health, guiding tailored interventions to reduce stress and improve cardiovascular health in Black caregivers of persons with ADRD.

Highlights: Chronic stress in Black caregivers: Chronic caregiving stress was linked to accelerated cellular aging, inflammation, and poor cardiometabolic health. Perceived stress associations: Higher perceived stress was associated with negative coping strategies, poor sleep quality, anxiety, depression, and reduced telomere length. Telomere length and cardiometabolic risk: Shorter telomere length was significantly associated with elevated cardiometabolic risk markers, including insulin resistance and increased blood pressure. Need for interventions: Findings emphasize the importance of culturally tailored interventions aimed at reducing stress and mitigating health risks in Black caregivers of persons living with Alzheimer's disease.

Keywords: Alzheimer's disease; caregiving; inflammation; race; stress; telomere.

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Conflict of interest statement

The authors declare no conflicts of interest. Author disclosures are available in the supporting information.

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