Dealing with stress-caused sickness in family caregivers
This article was made possible thanks to the support of Yakult and produced independently by Scientific AmericanThe editorial board of.
My mother lived with Alzheimer’s disease for 12 years. Even with lots of help, the care cost me a lot. It was physically difficult to transfer her from bed to wheelchair, hard on my time when Mom couldn’t be left alone, and emotionally devastating as her decline took away the person I had known and loved. She died in 2024.
About one in five American adults now find themselves where I was: responsible for the care of a loved one with a chronic illness or disability. About half of them do this work with elderly parents. It is well known that family caregivers are at higher risk of depression than non-caregivers. But these helpers also have more than their share of diabetes, asthma, obesity and various painful conditions. And they tend to die sooner. In a U.S. Centers for Disease Control and Prevention study published in 2024, caregivers performed worse than non-caregivers on 13 of 19 health indicators. The root cause, according to research, is chronic stress. This not only leads to mental distress but also, by hampering the immune system, to physical ailments.
On supporting science journalism
If you enjoy this article, please consider supporting our award-winning journalism by subscription. By purchasing a subscription, you are helping to ensure the future of impactful stories about the discoveries and ideas shaping our world today.
But caregivers are finally receiving care. Scientists are using what they have learned about how stress affects mental and physical functions to develop approaches that can build resilience. “It’s important to understand that caregiving, even if it’s a compulsion, does not determine poorer mental and physical health,” says psychologist Elissa Epel, who directs the Center on Aging, Metabolism and Emotions at the University of California, San Francisco. “Many resilience factors can make a difference. »
Innovative programs providing support and resources are gradually being replicated across the country. And in 2024, the Centers for Medicaid and Medicare Services have adopted policies that will help doctors train people to provide direct care to loved ones and will support both doctors and families in this process.
Combined with depression, caregiving pressure increases inflammation that contributes to age-related damage to the body, an effect called inflammation.
The links between chronic stress, weakened immunity and physical problems were highlighted in the 1980s and 1990s in the pioneering work of psychoneuroimmunologist Janice Kiecolt-Glaser of Ohio State University. Among other things, she found that spouses who cared for their sick partner recovered more slowly from puncture wounds to the arms than those who did not provide care.
Caregivers also appear biologically older than people without caregiving burden. “We know that caregiving accelerates many areas of aging,” says social psychologist Kathi Heffner, deputy chief of research in the division of geriatrics and aging at the University of Rochester Medical Center. Combined with depression, caregiving pressure increases inflammation that contributes to age-related damage to the body, an effect called inflammation. Studies of caregivers show a decrease in enzyme activity that protects telomeres, caps on the ends of chromosomes that shorten as people age. These telomeres shrink more quickly in stressed people, including caregivers.
As we age, our bodies also produce fewer naive T cells, immune cells that the body keeps in reserve until faced with a new attacker, such as SARS-CoV-2, the virus that causes COVID. A person’s T cell profile, the ratio of naive to mature cells, can indicate the health of their immune system. Epel and colleagues showed in 2018 that parents caring for children with disabilities have T cell profiles that lean toward less naïve profiles, and this observation is consistent with accelerated immunological aging.
One obvious way to help caregivers is to ease their burden. In a program called Caring for Caregivers at Rush University Medical Center in Chicago, one of the goals is to raise awareness about the effects of caregiving and change the culture among health care providers. “We want primary care physicians to start asking, ‘Are you providing care to anyone?’ » says Diane Mariani, social worker and program manager of Caring for Caregivers. “Then you’d have to go further: ‘How do you think this might affect your health?’ » And go even further, the doctor proposing possible remedies.
Unfortunately, caregiver burden often increases over time, especially when caring for someone with cancer or dementia. “Stressors aren’t going to go away,” Heffner says. “In fact, the challenges will increase as the disease progresses. » That’s why Heffner, Epel and others seek to build resilience. They found that not all caregivers are affected in the same way. “People can find more meaning and purpose in being caregivers,” Epel says. Those who have social support seem to do better.
In a randomized trial conducted in 2025, Heffner tested cognitive training (such as brain games) as a strategy to build resilience. Previous studies have shown that such training and games can produce faster neural processing in people, and that this speed correlates with greater adaptability to stress. Ninety-six people caring for loved ones with dementia played games designed to improve their processing speed and attention for eight weeks; Another 96 watched educational videos. Players showed significantly improved processing speed and attention six months later. “A year later, they reported being less bothered by the memory and behavior problems of the person they were caring for,” Heffner says. She is currently examining blood tests from study participants to look for any improvements in immune responses and to see if cognitive training slowed the aging of T cell profiles.
“If we can increase the stress coping capacity of these caregivers, it will lead to better outcomes and better quality of life for caregivers,” Heffner says. This is an outcome we should all be concerned about.
It’s time to defend science
If you enjoyed this article, I would like to ask for your support. Scientific American has been defending science and industry for 180 years, and we are currently experiencing perhaps the most critical moment in these two centuries of history.
I was a Scientific American subscriber since the age of 12, and it helped shape the way I see the world. SciAm always educates and delights me, and inspires a sense of respect for our vast and beautiful universe. I hope this is the case for you too.
If you subscribe to Scientific Americanyou help ensure our coverage centers on meaningful research and discoveries; that we have the resources to account for decisions that threaten laboratories across the United States; and that we support budding and working scientists at a time when the value of science itself too often goes unrecognized.
In exchange, you receive essential information, captivating podcasts, brilliant infographics, newsletters not to be missed, unmissable videos, stimulating games and the best writings and reports from the scientific world. You can even offer a subscription to someone.
There has never been a more important time for us to stand up and show why science matters. I hope you will support us in this mission.
