A Landscape of Subjective and Objective Stress in African-American Dementia Family Caregivers.

This was a secondary analysis of baseline data only, so it cannot show that stress caused sleep problems, depression, or health changes. The analysis used baseline data before the parent trial interventions, so it says nothing about psychoeducation or exercise. Cortisol was missing for 48 of 142 participants, although those with and without data were similar in age, education, and gender. Sleep data were available for 135 caregivers, and CES-D data for 98 caregivers. Cortisol was measured at only three daily time points at baseline, which may not capture the full day's pattern or changes over time. The sample was recruited from a clinical trial with proximity to an Alzheimer's Disease Research Center, and had homogeneity on factors such as education. Sleep was measured by self-report recall, not objective sleep measurement. Hours of caregiving and employment were not available. Caregivers were excluded if they already exercised regularly, so results may not apply to more active caregivers.

No author conflict-of-interest statement is provided in the supplied text; the article is listed as NIH extramural research support.

Do not conclude that stress caused sleep problems or depression, or that cortisol or allostatic load predict health outcomes. These were baseline associations in a secondary analysis, and allostatic load was not associated with stress or health outcomes.