Recent theories have suggested that burden and distress among dementia caregivers may be higher in American culture, which emphasizes individualism, and lower in cultures with higher levels of familism. However, immigrants may experience higher levels of burden because of acculturation with attendant values, conflicts and stresses. Forty-four Korean caregivers and 32 Korean American caregivers were compared with 54 White American caregivers on sociodemographic variables, familism, burden, anxiety, and depression. Familism was highest in Korean caregivers and lowest in Whites, with Korean Americans in the middle. Koreans and Korean Americans reported higher levels of burden. Koreans showed higher levels of depression and of anxiety than White American caregivers, with Koreans and Korean Americans higher than Whites on anxiety. These results suggest a need for greater specificity in theories about familism values, with attention to the specific meaning of familism in different cultures.

Few data are available on the response of the human immune system to acute psychological stressors under controlled laboratory conditions. Young female subjects (21-41 years) showed increases in natural killer (NK) cell activity, and in the numbers of circulating CD8 suppressor/cytotoxic T cells, and natural killer lymphocytes following a brief (12 minute) stressful mental arithmetic examination. Older female subjects (65-85 years) failed to show the stress-related increase in NK activity. The psychological stress did lead to increases in the numbers of circulating CD8 suppressor/cytotoxic T cells and NK lymphocytes in old subjects to a similar degree as that seen in the young group. No changes in the numbers of helper/inducer T cells (CD4), total T cells (CD3), or B cells (CD20) were found following the stressor for either group. Cardiovascular, catecholamine, and subjective stress responses were similar for the two age groups. These results demonstrate that brief psychological stress is associated with some rapid immune cell changes, including release of CD8 suppressor/cytotoxic T cells and NK cells into circulation, and in young subjects, increases in NK activity. The absence of an NK activity increase in the older subjects indicates that NK cell mobilization and cell lysis induced by NK cells may be differentially affected by stress. The results also suggest the possibility of an age-related deficit in the up-regulation of NK activity under some environmental demands.

Alterations in immune function have been commonly reported in elderly persons. We have examined the effect of age on the responsiveness of natural killer (NK) cells to in vitro stimulation with recombinant interleukin-2 (rIL-2) and in vivo stimulation with exercise in 17 healthy subjects (8 young and 9 old). The old subjects were found to have NK cell numbers and function that were not significantly different from the young subjects at baseline. They also responded as well as the young subjects to rIL-2 stimulation of NK cells in vitro. In response to maximal bicycle ergometry exercise, there was a marked rise in NK activity in the old (7.52 +/- 1.71 LU/10(6) pre-exercise vs 15.20 +/- 3.27 LU/10(6) post-exercise, p less than .03) and the young (6.29 +/- .48 LU 10(6) vs 14.56 +/- 1.86 LU 10(6), p less than .005) subjects. Lymphocytes bearing the NK marker Leu 11a also rose significantly post-exercise in both old and young subjects. We conclude that healthy elderly subjects increase their NK activity in response to the acute stressor, exercise, at least as effectively as do young subjects.

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