TY  - GEN
A1  - Gellert, Paul
A1  - Häusler, Andreas
A1  - Suhr, Ralf
A1  - Gholami, Maryam
A1  - Rapp, Michael Armin
A1  - Kuhlmey, Adelheid
A1  - Nordheim, Johanna
T1  - Testing the stress-buffering hypothesis of social support in couples coping with early-stage dementia
T2  - Postprints der Universität Potsdam : Humanwissenschaftliche Reihe
N2  - Purpose

To test whether the negative relationship between perceived stress and quality of life (Hypothesis 1) can be buffered by perceived social support in patients with dementia as well as in caregivers individually (Hypothesis 2: actor effects) and across partners (Hypothesis 3: partner effects and actor-partner effects).

Method

A total of 108 couples (N = 216 individuals) comprised of one individual with early-stage dementia and one caregiving partner were assessed at baseline and one month apart. Moderation effects were investigated by applying linear mixed models and actor-partner interdependence models.

Results

Although the stress-quality of life association was more pronounced in caregivers (beta = -.63, p<.001) compared to patients (beta= -.31, p<.001), this association was equally moderated by social support in patients (beta = .14, p<.05) and in the caregivers (beta =.13, p<.05). From one partner to his or her counterpart, the partner buffering and actor-partner-buffering effect were not present.

Conclusion

The stress-buffering effect has been replicated in individuals with dementia and caregivers but not across partners. Interventions to improve quality of life through perceived social support should not only focus on caregivers, but should incorporate both partners.
T3  - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 657 
KW  - partner interdependence model
KW  - Quality-of-life
KW  - Alzheimers disease
KW  - depressive symptomatology
KW  - longitudinal cohort
KW  - caregivers
KW  - health
KW  - communication
KW  - metaanalysis
KW  - association
Y1  - 2020
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-446270
SN  - 1866-8364
IS  - 657
ER  - 
TY  - JOUR
A1  - Stachanow, Viktoria
A1  - Neumann, Uta
A1  - Blankenstein, Oliver
A1  - Bindellini, Davide
A1  - Melin, Johanna
A1  - Ross, Richard
A1  - Whitaker, Martin J. J.
A1  - Huisinga, Wilhelm
A1  - Michelet, Robin
A1  - Kloft, Charlotte
T1  - Exploring dried blood spot cortisol concentrations as an alternative for monitoring pediatric adrenal insufficiency patients
BT  - a model-based analysis
JF  - Frontiers in pharmacology
N2  - Congenital adrenal hyperplasia (CAH) is the most common form of adrenal insufficiency in childhood; it requires cortisol replacement therapy with hydrocortisone (HC, synthetic cortisol) from birth and therapy monitoring for successful treatment. In children, the less invasive dried blood spot (DBS) sampling with whole blood including red blood cells (RBCs) provides an advantageous alternative to plasma sampling. 

Potential differences in binding/association processes between plasma and DBS however need to be considered to correctly interpret DBS measurements for therapy monitoring. While capillary DBS samples would be used in clinical practice, venous cortisol DBS samples from children with adrenal insufficiency were analyzed due to data availability and to directly compare and thus understand potential differences between venous DBS and plasma. A previously published HC plasma pharmacokinetic (PK) model was extended by leveraging these DBS concentrations. 

In addition to previously characterized binding of cortisol to albumin (linear process) and corticosteroid-binding globulin (CBG; saturable process), DBS data enabled the characterization of a linear cortisol association with RBCs, and thereby providing a quantitative link between DBS and plasma cortisol concentrations. The ratio between the observed cortisol plasma and DBS concentrations varies highly from 2 to 8. Deterministic simulations of the different cortisol binding/association fractions demonstrated that with higher blood cortisol concentrations, saturation of cortisol binding to CBG was observed, leading to an increase in all other cortisol binding fractions. 

In conclusion, a mathematical PK model was developed which links DBS measurements to plasma exposure and thus allows for quantitative interpretation of measurements of DBS samples.
KW  - adrenal insufficiency
KW  - cortisol
KW  - dried blood spots
KW  - pediatrics
KW  - pharmacokinetics
KW  - binding
KW  - association
KW  - red blood cells
Y1  - 2022
U6  - https://doi.org/10.3389/fphar.2022.819590
SN  - 1663-9812
VL  - 13
PB  - Frontiers Media
CY  - Lausanne
ER  -