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Enhancement of antibody responses to influenza vaccination in the elderly following a cognitive-behavioural stress management intervention.

Abstract

BACKGROUND

Previous research has demonstrated that the psychological morbidity experienced by informal caregivers is associated with increased vulnerability to infectious diseases, in particular influenza. A pragmatic trial was conducted to examine whether a stress management intervention (SMI) could reduce psychological morbidity and enhance the antibody response to influenza vaccination in the elderly, and whether changes in immune response of SMI participants were associated with hypothalamic-pituitary-adrenal (HPA) axis activity.

METHODS

Forty-three elderly spousal carers of dementia patients and 27 non-carer controls were recruited. Sixteen carers were allocated to an 8-week SMI or a non-intervention condition (n = 27). The non-carers formed a no treatment, 'normal' comparison group. At the end of the SMI or its equivalent time period, all participants received an influenza vaccination. IgG antibody titres to the vaccine were measured 0, 2, 4 and 6 weeks post-vaccine.

RESULTS

There was evidence of elevated distress in both carer groups compared with non-carer controls throughout the SMI period, but no between-group differences in salivary cortisol. Immune responses to the vaccine revealed that 50% of SMI carers, 7% of non-intervention carers and 29% of non-carer controls produced a four-fold increase in antibody titre.

CONCLUSIONS

The immune response to influenza vaccination appears amenable to improvement through stress management, although the mechanisms underlying this effect remain unclear.

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  • Authors

    , , , , , , , , , , , ,

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    MeSH

    Aged
    Antibodies, Viral
    Cognitive Therapy
    Female
    Humans
    Hydrocortisone
    Hypothalamo-Hypophyseal System
    Immunity, Active
    Influenza Vaccines
    Influenza, Human
    Male
    Pituitary-Adrenal System
    Saliva
    Stress, Psychological

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    12920328

    Citation

    TY - JOUR T1 - Enhancement of antibody responses to influenza vaccination in the elderly following a cognitive-behavioural stress management intervention. AU - Vedhara,Kav, AU - Bennett,Paul D, AU - Clark,Sian, AU - Lightman,Stafford L, AU - Shaw,Samantha, AU - Perks,Paula, AU - Hunt,Moira A, AU - Philip,Judith M D, AU - Tallon,Deborah, AU - Murphy,Peter J, AU - Jones,Roy W, AU - Wilcock,Gordon K, AU - Shanks,Nola M, PY - 2003/8/16/pubmed PY - 2004/1/30/medline PY - 2003/8/16/entrez SP - 245 EP - 52 JF - Psychotherapy and psychosomatics JO - Psychother Psychosom VL - 72 IS - 5 N2 - BACKGROUND: Previous research has demonstrated that the psychological morbidity experienced by informal caregivers is associated with increased vulnerability to infectious diseases, in particular influenza. A pragmatic trial was conducted to examine whether a stress management intervention (SMI) could reduce psychological morbidity and enhance the antibody response to influenza vaccination in the elderly, and whether changes in immune response of SMI participants were associated with hypothalamic-pituitary-adrenal (HPA) axis activity. METHODS: Forty-three elderly spousal carers of dementia patients and 27 non-carer controls were recruited. Sixteen carers were allocated to an 8-week SMI or a non-intervention condition (n = 27). The non-carers formed a no treatment, 'normal' comparison group. At the end of the SMI or its equivalent time period, all participants received an influenza vaccination. IgG antibody titres to the vaccine were measured 0, 2, 4 and 6 weeks post-vaccine. RESULTS: There was evidence of elevated distress in both carer groups compared with non-carer controls throughout the SMI period, but no between-group differences in salivary cortisol. Immune responses to the vaccine revealed that 50% of SMI carers, 7% of non-intervention carers and 29% of non-carer controls produced a four-fold increase in antibody titre. CONCLUSIONS: The immune response to influenza vaccination appears amenable to improvement through stress management, although the mechanisms underlying this effect remain unclear. SN - 0033-3190 UR - https://www.unboundmedicine.com/medline/citation/12920328/full_citation L2 - http://www.karger.com?DOI=71895 ER -