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UTHSC researchers work to boost immune function of caregivers who serve Alzheimer's patients

At 35, Yvette Ortiz was at the prime of her life. Yet she felt just the opposite — tired, achy, irritable and depressed. Last year, after the death of her mother, Ortiz became the primary caregiver for her 82-year-old grandmother who has Alzheimer's disease. Torn between her undying love for her grandmother and the difficulty of caring for an ill loved one, Ortiz's frustration soon turned into a deep depression.

Just when she was at the end of her rope, Ortiz learned about a program specifically aimed to help caregivers of people with Alzheimer's disease. The "Relaxation Therapy and Stress Management for Caregivers" study, funded by the National Institutes of Health, is directed by Sharon Lewis, R.N., Ph.D., F.A.A.N. The purpose of the study is to determine the effectiveness of relaxation therapy to improve the quality of life, enhance the immune function and promote the relaxation responses of caregivers who aid individuals with Alzheimer's disease. An estimated 39,000 people in Bexar County have Alzheimer's disease or related disorders. Dr. Lewis says the number will continue to grow. "Caregivers provide an amazing service for their loved ones. However, they do it at a high emotional and physical cost to themselves," Dr. Lewis said.

The field of psychoneuroimmunology plays a large role in the framework of Dr. Lewis' study. "Psychoneuroimmunology focuses on the study of the interactions between the brain and the immune system. Our moods and feelings determine the kinds of chemicals secreted by our brains," Dr. Lewis said. "Under stressful situations, more epinephrine, norepinephrine and cortisol are released. These chemicals can inhibit the immune system."

Ortiz is one of nearly 60 caregivers ranging in age from 35 to 87 who participate in the study. Their mental and physical parameters are monitored. Dr. Lewis' staff use state-of-the-art biofeedback equipment to measure subjects' heart rates, muscle tension, skin temperatures and sweat gland activity. Caregivers' blood samples are drawn to determine various immune functions. One test in particular investigates the ability of the caregivers' lymphocytes (a type of white blood cells also called "natural killer" cells) to destroy cancer cells.

"In patients whose stress levels were unusually high, we found their natural killer cells weak and unable to kill the cancer cells, indicating a compromised immune system," Dr. Lewis said.

After the testing period, patients are instructed on breathing techniques, muscle relaxation and other techniques to decrease stress and anxiety. Patients return for testing every four weeks for four months. Their progress is evaluated on an ongoing basis.

Dr. Lewis hopes to expand the program to include educational support groups for caregivers who aid individuals with chronic neurological diseases such as Parkinson's disease, stroke, multiple sclerosis and dementia. Because many caregivers are not able to leave their homes to attend support groups or therapy sessions, Dr. Lewis plans to create a home-based intervention program using the Web and telephone communication.

Ortiz says the program not only helped her to control her emotions and ease her anxiety, but it helped her gain a new perspective about Alzheimer's disease and her grandmother.

"The program came at a time when I felt I had no place to turn," Ortiz said. "It saved my life."

Ortiz continues her own self-therapy and wellness program at home. The strength of her natural killer cells has increased from 12 percent to 26 percent. For more information or to become a study participant, call Dr. Lewis at (210) 949-3696.

Dr. Lewis is professor of acute nursing care and the Castella Distinguished Professor at the Health Science Center. She also is a clinical nurse scientist at the Geriatric Research, Education and Clinical Center in the South Texas Veterans Health Care System.

Contact: Natalie Gutierrez or Aileen Salinas