Abstract
BACKGROUND: Spousal caregivers (SCGs) of patients with cognitive impairment are predisposed to an elevated risk of cardiovascular disease and cognitive decline. Homocysteine and folate levels are potential modifiable biomarkers for these risks, given their associations with cardiovascular and cognitive health. OBJECTIVE: This study aimed to examine the association of the caregiving burden with homocysteine and folate levels in SCGs. METHODS: This study included 107 SCGs and their care recipients who visited the Chungnam National University Hospital between May 2020 and May 2023. The caregiving burden was quantified using the Zarit Burden Interview, and blood assays were performed after overnight fasting. We adjusted for the age and sex of SCGs and the clinical diagnosis of care recipients as covariates. RESULTS: The caregiving burden of SCGs showed a significant positive correlation with their homocysteine level (β = 0.219, t = 2.165, p = 0.033). In contrast, caregiving burden and folate showed an inverse correlation (β = -0.207, t = -1.997, p = 0.049). Furthermore, the association between caregiving burden and homocysteine levels remained significant after including vascular risk score and physical activity level as covariates (p = 0.042). CONCLUSIONS: Our findings indicate that the caregiving burden of SCGs in individuals with cognitive impairment is associated with elevated homocysteine levels and low folate levels, potentially exacerbating the risk of cardiovascular disease and cognitive decline. These findings underscore the importance of monitoring homocysteine and folate as modifiable biomarkers to address and potentially mitigate health risks in SCGs.