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Zhang Y, Yuan Y, Roche-Dean M, Vega I, Gonzalez R. A Visualization Tool to Study Dyadic Caregiving Health Profiles. J Aging Health 2024; 36:583-596. [PMID: 38768641 DOI: 10.1177/08982643241255739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
OBJECTIVES Guided by a life course perspective and fundamental cause theory, this study aims to visualize co-trajectories of health between partners and examine how changes in one spouse's cognitive status can cohesively impact the health of the other spouse along three dimensions (functional, mental, and cognitive). METHODS Drawing longitudinal data from the Health and Retirement Study 2000-2016 (N = 3582), we measure women's health profiles by functional limitation (physical health), depression (mental health), and cognitive function (cognitive health). We use multivariate linear mixed models to summarize these paths in the same visual representation. RESULTS The approach provides a visualization tool that depicts data and model in the same spatial representation allowing assessment of model fit and comparison. This study advances the traditional life course studies by representing underlying processes as a multidimensional time vector of health outcomes. DISCUSSION The described approach provides a blueprint for studying complex health profiles or trajectories.
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Affiliation(s)
- Yan Zhang
- Department of Sociology, East Carolina University, Greenville, NC, USA
| | - Yiyang Yuan
- Department of Clinical and Population Health Sciences, UMass Chan Medical School, Worcester, MA, USA
| | - Maria Roche-Dean
- Bronson School of Nursing, Western Michigan University, Kalamazoo, MI, USA
| | - Irving Vega
- Department of Translational Neuroscience, College of Human Medicine, Michigan State University, East Lansing, MI, USA
| | - Richard Gonzalez
- Department of Psychology and the Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
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Porricelli D, Tecilla M, Pucci V, Di Rosa E, Mondini S, Cappelletti M. Cognitive reserve modulates mental health in adulthood. Aging Clin Exp Res 2024; 36:139. [PMID: 38954168 PMCID: PMC11219466 DOI: 10.1007/s40520-024-02776-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 05/13/2024] [Indexed: 07/04/2024]
Abstract
Cognitive Reserve (CR) reflects acquired knowledge, skills, and abilities throughout life, and it is known for modulating cognitive efficiency in healthy and clinical populations. CR, which was initially proposed to explain individual differences in the clinical presentation of dementia, has subsequently been extended to healthy ageing, showing its role in cognitive efficiency also during middle age. Recently, CR has been linked to affective processes in psychiatric conditions such as schizophrenia, major depressive and anxiety symptoms, and psychological distress, suggesting its potential role in emotional expression and regulation. Whether the role of CR in mental health extends to non-pathological adults, and whether this is only relevant in older age is not yet clear. The aim of this work was therefore to explore the relationship between CR and mental health in healthy adults, with a focus on middle adulthood (40-60). In a sample of 96 participants, we found a positive association between CR and mental health outcomes, such that a higher cognitive reserve index corresponded to fewer mental health reported symptoms. Specifically, a higher CR reflecting professional activities was associated with lower stress levels, especially in middle agers. Taken together, these data therefore suggest that engaging occupations may help maintain a robust mental health, especially by reducing stress symptoms during middle age. These results broaden previous findings suggesting that CR relates to affective components of mental health in middle aged and older adults.
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Affiliation(s)
| | | | - Veronica Pucci
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padua, Padua, Italy
- Human Inspired Technology Centre (HIT), University of Padua, Padua, Italy
| | - Elisa Di Rosa
- Department of General Psychology, University of Padua, Padua, Italy
| | - Sara Mondini
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padua, Padua, Italy
- Human Inspired Technology Centre (HIT), University of Padua, Padua, Italy
- Department of Developmental Psychology and Socialization (DPSS), University of Padua, Padua, Italy
- IRCCS San Camillo Hospital, Venice, Italy
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Shin JH, Kim JH. Family Caregivers of People with Dementia Associate with Poor Health-Related Quality of Life: A Nationwide Population-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16252. [PMID: 36498333 PMCID: PMC9737807 DOI: 10.3390/ijerph192316252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 11/28/2022] [Accepted: 12/01/2022] [Indexed: 06/17/2023]
Abstract
Despite the growing awareness of poor health-related quality of life (HRQoL) in family caregivers of people with dementia (PWD), their relationship has rarely been explored with population-based samples. The current cross-sectional study aimed to determine the detrimental impact of informal dementia caregiving on HRQoL by using nationally representative population-based samples from the Korean Community Health Survey. Demographics, socioeconomic, and physical and mental health-related characteristics as well as HRQoL measured by the Korean version of the European Quality of Life Questionnaire Five Dimension (EQ-5D) were compared between 9563 family caregivers of PWD and 186,165 noncaregivers. Caregivers had lower index scores and higher frequency of some/extreme problems in all five dimensions of the EQ-5D compared with noncaregivers. Logistic regression adjusting for potential confounding factors found that caregivers had a higher frequency of poor HRQoL (lowest quartile of EQ-5D index) than noncaregivers (adjusted odds ratio [95% confidence interval] = 1.46 [1.39-1.53]). Compared to noncaregivers, caregivers had a higher frequency of some/extreme problems in each dimension of the EQ-5D: mobility (1.30 [1.21-1.40]), self-care (1.62 [1.46-1.80]), usual activity (1.39 [1.29-1.51]), pain/discomfort (1.37 [1.31-1.45]), and anxiety/depression (1.51 [1.42-1.61]). A one-to-one propensity score matching analysis confirmed that poor HRQoL was more frequently found in caregivers compared to noncaregivers (1.38 [1.29-1.48]). Our results indicated that family caregivers of PWD are significantly associated with overall poor HRQoL, underscoring the detrimental impact of informal dementia caregiving on HRQoL. Given the high frequency of poor HRQoL in dementia caregivers and the important recognition of its serious consequences on physical and mental health, clinicians should take into consideration efficient interventions to improve health and HRQoL for family caregivers of PWD.
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Song MJ, Kim JH. Family Caregivers of People with Dementia Have Poor Sleep Quality: A Nationwide Population-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:13079. [PMID: 34948685 PMCID: PMC8702002 DOI: 10.3390/ijerph182413079] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 12/02/2021] [Accepted: 12/07/2021] [Indexed: 11/16/2022]
Abstract
Previous studies have documented cognitive impairments, psychological stress, and depressive symptoms in family caregivers of people with dementia (PWD), which could be attributed to their sleep disturbances. Notwithstanding the increasing recognition of poor sleep quality and sleep disturbances in family caregivers of PWD, their association has not been tested yet using population-representative samples. We conducted a retrospective, cross-sectional study using population-based data from the 2018 Korean Community Health Survey. Sociodemographic, mental health-related, and physical health-related variables as well as sleep quality evaluated by the Pittsburgh Sleep Quality Index (PSQI) were compared between 2537 cohabitating caregivers of PWD, 8864 noncohabitating caregivers of PWD, and 190,278 non-caregivers. Two sets of multivariable logistic regressions were conducted to examine the associations between dementia caregiving and poor sleep quality in cohabitating and noncohabitating caregivers versus noncaregivers. Both cohabitating and noncohabitating caregivers had higher global PSQI scores and higher prevalence of poor sleep quality (PSQI score > 5) than did noncaregivers. Multivariable logistic regressions adjusted for potential confounders revealed that cohabitating caregivers (odds ratio (OR) 1.26, 95% confidence interval (CI) 1.15-1.38) and noncohabitating caregivers (OR 1.15, CI 1.10-1.21) were significantly associated with poor sleep quality. Our results showed that both cohabitating and noncohabitating caregivers of PWD experienced overall poorer sleep quality compared to noncaregivers, indicating the deleterious effect of dementia caregiving on sleep quality, regardless of living arrangements. Given the high prevalence of poor sleep quality in family caregivers of PWD and the increasing awareness of the serious health consequences of poor-quality sleep, physicians should consider active sleep interventions to promote health and wellbeing not only for the dementia patients but also for family caregivers.
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Affiliation(s)
- Min Ji Song
- Department of Neurology, Korea University Anam Hospital, Korea University College of Medicine, Seoul 02841, Korea;
| | - Ji Hyun Kim
- Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul 08308, Korea
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Yang HW, Bae JB, Oh DJ, Moon DG, Lim E, Shin J, Kim BJ, Lee DW, Kim JL, Jhoo JH, Park JH, Lee JJ, Kwak KP, Lee SB, Moon SW, Ryu SH, Kim SG, Han JW, Kim KW. Exploration of Cognitive Outcomes and Risk Factors for Cognitive Decline Shared by Couples. JAMA Netw Open 2021; 4:e2139765. [PMID: 34928355 PMCID: PMC8689387 DOI: 10.1001/jamanetworkopen.2021.39765] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 10/20/2021] [Indexed: 11/14/2022] Open
Abstract
Importance Although couples could share many risk factors of cognitive disorders in their lifetime, whether shared risk factors mediate the shared risk of cognitive disorders has rarely been investigated. Objective To identify the risk factors of cognitive decline shared within couples and investigate their mediating roles in the shared risk of cognitive disorders and cognitive functions within couples. Design, Setting, and Participants A prospective cohort study was launched in November 1, 2010, and 784 participants were followed up every 2 years until December 31, 2020. This nationwide, multicenter, community-based study included older couples from the Korean Longitudinal Study on Cognitive Aging and Dementia (KLOSCAD) and a cohort of their spouses (KLOSCAD-S). Exposures The cognitive disorder of a spouse was defined as mild cognitive impairment or dementia. Main Outcomes and Measures The mediating roles of factors shared within couples on the association between one spouse's cognitive disorder and the other's risk of cognitive disorders was examined with structural equation modeling. Results Included were 784 KLOSCAD participants (307 women [39.2%] and 477 men [60.8%]; mean [SD] age, 74.8 [4.8] years) and their spouses (477 women [60.8%] and 307 men [39.2%]; mean [SD] age, 73.6 [6.2] years). The cognitive disorder of the KLOSCAD participants was associated with almost double the risk of cognitive disorder of their spouses in the KLOSCAD-S cohort (odds ratio, 1.74; 95% CI, 1.12-2.69; P = .01). History of head injury (β = 0.50; 95% CI, 0.09-0.90; P = .02) and age (β = 2.57; 95% CI, 1.37-3.76; P < .001) mediated the association between cognitive disorder in the KLOSCAD participants and their spouses' risk of cognitive disorder. Physical inactivity mediated the association through major depressive disorder (β = 0.33, 95% CI, 0.09-0.57, P = .006 for physical inactivity; β = 0.28, 95% CI, 0.13-0.44, P < .001 for major depressive disorder). These factors similarly mediated the association between spousal cognitive disorder and cognitive functions such as memory and executive function. Conclusions and Relevance These findings suggest that the risk factors shared within couples may mediate approximately three-quarters of the spousal risk of cognitive disorders. Identification of and intervention in the shared risk factors of dementia within couples may reduce the risk of cognitive disorders in the spouses of people with dementia.
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Affiliation(s)
- Hee Won Yang
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Jong Bin Bae
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
- Department of Psychiatry, Seoul National University, College of Medicine, Seoul, South Korea
| | - Dae Jong Oh
- Department of Psychiatry, Seoul National University, College of Medicine, Seoul, South Korea
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul, South Korea
| | - Dong Gyu Moon
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Eunji Lim
- Department of Psychiatry, Gyeongsang National University Changwon Hospital, Changwon, South Korea
| | - Jin Shin
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Bong Jo Kim
- Department of Psychiatry, Gyeongsang National University, School of Medicine, Jinju, South Korea
| | - Dong Woo Lee
- Department of Neuropsychiatry, Inje University Sanggye Paik Hospital, Seoul, South Korea
| | - Jeong Lan Kim
- Department of Psychiatry, School of Medicine, Chungnam National University, Daejeon, South Korea
| | - Jin Hyeong Jhoo
- Department of Neuropsychiatry, Kangwon National University Hospital, Chuncheon, South Korea
| | - Joon Hyuk Park
- Department of Neuropsychiatry, Jeju National University Hospital, Jeju, South Korea
| | - Jung Jae Lee
- Department of Psychiatry, Dankook University Hospital, Cheonan, South Korea
| | - Kyung Phil Kwak
- Department of Psychiatry, Dongguk University Gyeongju Hospital, Gyeongju, South Korea
| | - Seok Bum Lee
- Department of Psychiatry, Dankook University Hospital, Cheonan, South Korea
| | - Seok Woo Moon
- Department of Psychiatry, School of Medicine, Konkuk University, Konkuk University Chungju Hospital, Chungju, South Korea
| | - Seung-Ho Ryu
- Department of Psychiatry, School of Medicine, Konkuk University, Konkuk University Medical Center, Seoul, South Korea
| | - Shin Gyeom Kim
- Department of Neuropsychiatry, Soonchunhyang University Bucheon Hospital, Bucheon, South Korea
| | - Ji Won Han
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
- Department of Psychiatry, Seoul National University, College of Medicine, Seoul, South Korea
| | - Ki Woong Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
- Department of Psychiatry, Seoul National University, College of Medicine, Seoul, South Korea
- Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, Seoul, South Korea
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Delgado-Gallén S, Soler MD, Albu S, Pachón-García C, Alviárez-Schulze V, Solana-Sánchez J, Bartrés-Faz D, Tormos JM, Pascual-Leone A, Cattaneo G. Cognitive Reserve as a Protective Factor of Mental Health in Middle-Aged Adults Affected by Chronic Pain. Front Psychol 2021; 12:752623. [PMID: 34759872 PMCID: PMC8573249 DOI: 10.3389/fpsyg.2021.752623] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 09/16/2021] [Indexed: 12/25/2022] Open
Abstract
Chronic pain is associated with worse mental health and cognitive impairment, which can be a cause or a consequence of brain structure and function alterations, e.g., maladaptive plasticity, antinociceptive system dysregulation. Cognitive reserve reflects the effectiveness of the internal connections of the brain and it has been shown to be a protective factor in brain damage, slowing cognitive aging or reducing the risk of mental health disorders. The current study explored the impact of chronic pain on psychosocial factors, mental health, and cognition. Furthermore, we aimed to examine the role of cognitive reserve in the relationship between mental health and chronic pain clinical characteristics in middle-aged adults. The study group consisted of 477 volunteers from the Barcelona Brain Health Initiative who completed online surveys on pain, mental health, cognitive reserve, and psychosocial factors (sleep and quality of life). We described the differences in sociodemographic data, psychosocial factors, mental health, and self-perceived cognitive impairment, and neuropsychological assessment, between participants reporting pain compared with those without pain, as well as the main characteristics of the chronic pain group. Finally, to study the role of cognitive reserve in the modulation of the relationship between chronic pain and mental health, we compared variables between subgroups of participants with high/low pain intensity and cognitive reserve. The results showed that chronic pain was reported by 45.5% of middle-aged adults. Our results revealed that participants with chronic pain were older and had worse health status than people without pain. The presence of chronic pain affected working memory, mental health, and daily life activities. Moreover, cognitive reserve moderated the influence of pain intensity on mental health, resulting in less mental health affection in people suffering from high pain intensity with high cognitive reserve. In conclusion, the construct of the cognitive reserve could explain differential susceptibility between chronic pain and its mental health association and be a powerful tool in chronic pain assessment and treatment, principally due to its modifiable nature.
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Affiliation(s)
- Selma Delgado-Gallén
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la Universitat Autònoma de Barcelona (UAB), Badalona, Spain
- Departament de Medicina, Facultat de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
| | - M. Dolors Soler
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la Universitat Autònoma de Barcelona (UAB), Badalona, Spain
- Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Sergiu Albu
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la Universitat Autònoma de Barcelona (UAB), Badalona, Spain
- Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Catherine Pachón-García
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la Universitat Autònoma de Barcelona (UAB), Badalona, Spain
- Departament de Medicina, Facultat de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
| | - Vanessa Alviárez-Schulze
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la Universitat Autònoma de Barcelona (UAB), Badalona, Spain
- Departament de Medicina, Facultat de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
| | - Javier Solana-Sánchez
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la Universitat Autònoma de Barcelona (UAB), Badalona, Spain
- Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - David Bartrés-Faz
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la Universitat Autònoma de Barcelona (UAB), Badalona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
| | - Josep M. Tormos
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la Universitat Autònoma de Barcelona (UAB), Badalona, Spain
- Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Alvaro Pascual-Leone
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la Universitat Autònoma de Barcelona (UAB), Badalona, Spain
- Hinda and Arthur Marcus Institute for Aging Research and Center for Memory Health, Hebrew SeniorLife, Boston, MA, United States
- Department of Neurology, Harvard Medical School, Boston, MA, United States
| | - Gabriele Cattaneo
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la Universitat Autònoma de Barcelona (UAB), Badalona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Spain
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Sato H, Nakaaki S, Sato J, Shikimoto R, Furukawa TA, Mimura M, Akechi T. Caregiver self-efficacy and associated factors among caregivers of patients with dementia with Lewy bodies and caregivers of patients with Alzheimer's disease. Psychogeriatrics 2021; 21:783-794. [PMID: 34216184 DOI: 10.1111/psyg.12740] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 05/24/2021] [Accepted: 06/20/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Dementia with Lewy bodies (DLB) is characterized by neuropsychiatric symptoms, which can be distressing to caregivers. However, little is known about their subjective distress in terms of caregiver self-efficacy. Thus, we examined the differences in caregiver self-efficacy and their associated factors between DLB and Alzheimer's disease (AD) caregivers. METHODS We conducted a comprehensive questionnaire for DLB and AD caregivers. Caregiver self-efficacy was evaluated using three domains (Self-Efficacy for Obtaining Respite: SE-OR, Self-Efficacy for Responding to Disruptive Patient Behaviours: SE-RDPB, Self-Efficacy for Controlling Upsetting Thoughts about Caregiving: SE-CUT) of the Revised Scale for Caregiving Self-Efficacy (RSCSE). In addition, data on the following features of caregivers were assessed: depression, sleep disturbance, caregiver burden, executive function, loneliness, social support, and distress associated with neuropsychiatric symptoms. The patients were assessed for general cognitive tasks, executive function, and neuropsychiatric symptoms. RESULTS Compared with AD caregivers, DLB caregivers experienced a significantly higher burden in terms of not only various clinical factors, but also all three domains of caregiver self-efficacy. Among the caregiver-associated factors, different domains were predictors of self-efficacy in DLB and AD caregivers (distress due to sleep disturbances in DLB patients; distress due to delusions in AD patients). Among the patient-associated factors, different domains were also predictors of self-efficacy in DLB and AD caregivers (sleep disturbances in DLB patients; delusions in AD patients). Among both the caregivers and the patients, executive function was a significant predictor of one RSCSE domain (SE-CUT). CONCLUSIONS A reduction in caregiver self-efficacy may contribute to a severe subjective burden among DLB caregivers. Furthermore, two neuropsychiatric symptoms (delusions and sleep disturbances) affected caregiver self-efficacy differently depending on whether care was being provided to a DLB or AD patient. Understanding the association between specific neuropsychiatric symptoms and caregiver self-efficacy may be useful for conducting interventions for DLB patients.
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Affiliation(s)
- Hirofumi Sato
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Shutaro Nakaaki
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.,Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Junko Sato
- Speech Language Hearing Therapy, School of Rehabilitation Science Seirei Christopher University, Shizuoka, Japan
| | - Ryo Shikimoto
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Toshi A Furukawa
- Department of Health Promotion and Human Behavior (Cognitive-Behavioral Medicine), Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Tatsuo Akechi
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
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Walsh S, Pertl M, Gillespie P, Lawlor B, Brennan S, O'Shea E. Factors influencing the cost of care and admission to long-term care for people with dementia in Ireland. Aging Ment Health 2021; 25:512-520. [PMID: 31847539 DOI: 10.1080/13607863.2019.1699901] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To explore the factors associated with the cost of care and admission to long-term care (LTC) for people with dementia living at home in Ireland. METHODS Data on formal and informal resource use for people with dementia, and their LTC admission, were obtained from a national study of spousal dementia caregivers. Functional status was measured using the Bristol Activities of Daily Living Scale, while behavioural and psychiatric symptoms were evaluated using the Neuropsychiatric Inventory. Multivariable regression analysis was used to model costs and the predictors of LTC admission. RESULTS Physical and cognitive symptoms were significantly associated with costs. Severely impaired functional ability was associated with a €2,308 increase in mean total 30-day monthly costs. Psychosis was associated with a €335 increase in primary and community 30-day monthly care costs. These factors also make it more likely that a person with dementia is admitted to LTC. Having an older caregiver also increases the risk of admission to LTC, while living in a rural area and having a female caregiver reduce the likelihood of admission. CONCLUSIONS Dependency matters for the cost of care. Physical and cognitive symptoms, caregiver age and gender, and geographic location are significant predictors of admission to LTC.
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Affiliation(s)
- Sharon Walsh
- Centre for Economic and Social Research on Dementia, Discipline of Economics, National University of Ireland Galway, Galway, Ireland
| | - Maria Pertl
- Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Paddy Gillespie
- Health Economic and Policy Analysis Centre, Discipline of Economics, National University of Ireland Galway, Galway, Ireland
| | - Brian Lawlor
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin 2, Ireland
| | - Sabina Brennan
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin 2, Ireland
| | - Eamon O'Shea
- Centre for Economic and Social Research on Dementia, Discipline of Economics, National University of Ireland Galway, Galway, Ireland
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Jütten LH, Mark RE, Sitskoorn MM. Episodic memory and executive functioning in informal dementia caregivers. Aging Ment Health 2020; 24:1681-1689. [PMID: 31116020 DOI: 10.1080/13607863.2019.1617242] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Objectives: Informal dementia caregivers are thought to experience high levels of depression and burden, which can contribute to worse cognitive functioning. However, poorer cognitive functioning in caregivers is not always found. The current study explored whether caregivers perform better, worse, or similar to non-caregivers on tasks for executive functioning and memory. Whether sociodemographic and psychosocial characteristics are associated with caregivers' performance was also assessed.Methods: One hundred forty-five caregivers completed the Letter Fluency and Category Fluency, the Logical Memory test from the WMS-III, and five questionnaires assessing psychological characteristics. Standardized z-scores (based on age, education, and sex) were calculated using data from a matched control group (187 non-caregivers). One sample z-tests were executed to examine if the caregivers' standardized mean z-score significantly deviated from the population mean of z = 0. The z-scores were used as dependent variables in multivariable regression analyses.Results: The caregivers performed significantly better on Logical Memory - Immediate Recall than non-caregivers (z = 2.92, p = .004). The obtained z-scores on the other tasks did not deviate significantly from 0. Male sex and social reliance predicted higher scores on Category Fluency, but the F-test was non-significant, and the explained variance was low (adjusted R2 = .068).Conclusions: We found no evidence for poorer cognitive performance among informal caregivers compared to non-caregivers. Our results suggest that caregiving for a loved one with dementia does not impair the caregivers' episodic memory or executive functioning when measured cross-sectionally.
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Affiliation(s)
- Linda Helena Jütten
- Department of Cognitive Neuropsychology, Tilburg University, Tilburg, The Netherlands
| | - Ruth Elaine Mark
- Department of Cognitive Neuropsychology, Tilburg University, Tilburg, The Netherlands
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Formica C, Bonanno L, Todaro A, Marra A, Alagna A, Corallo F, Marino S, Bramanti A, De Salvo S. The role of mind theory in patients affected by neurodegenerative disorders and impact on caregiver burden. J Clin Neurosci 2020; 78:291-295. [DOI: 10.1016/j.jocn.2020.05.028] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 05/03/2020] [Indexed: 11/30/2022]
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Ottaviani AC, Bregola AG, Terassi M, Luchesi BM, Souza ÉN, de Oliveira NA, Fraga FJ, Pavarini SCI. Comparison of cognitive performance and aspects of the care context in elderly caregivers in Brazil: A follow-up study. Dement Neuropsychol 2020; 14:159-164. [PMID: 32595885 PMCID: PMC7304268 DOI: 10.1590/1980-57642020dn14-020009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Cognitive health is important for the quality of life and well-being of elderly caregivers. Cognitive impairments can negatively affect the ability to care for oneself and others.
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Affiliation(s)
| | | | | | - Bruna Moretti Luchesi
- Federal University of Mato Grosso do Sul, Três Lagoas Campus, Graduate Program in Nursing, Três Lagoas, MS, Brazil
| | - Érica Nestor Souza
- Federal University of São Carlos, Graduate Program in Nursing, São Carlos, SP, Brazil
| | | | - Francisco José Fraga
- Federal University of ABC (UFABC), Engineering, Modeling and Applied Social Sciences Center (CECS), Santo André, SP, Brazil
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12
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Formica C, La Face A, Lo Buono V, Di Cara M, Micchìa K, Bonanno L, Logiudice AL, Todaro A, Palmeri R, Bramanti P, Marino S, Corallo F. Factors related to cognitive reserve among caregivers of severe acquired brain injury. J Clin Neurosci 2020; 77:94-97. [PMID: 32402612 DOI: 10.1016/j.jocn.2020.05.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 05/03/2020] [Indexed: 11/29/2022]
Abstract
Stroke is one of the severe cause of motor and cognitive disabilities. These type of disabilities occurred a strong impact on whole family system. Caregiver burden may determine in relatives of patients with brain injury a decreasement of mental and physical health. The present study aims to better clarify the mechanism through which chronic stress influence caregivers' cognitive functioning and how the psychological and cognitive resources may represent as a predictive factor. Caregivers were submitted to neuropsychological tests that evaluated level of mental health ad level of burden. Our results showed a significant correlation between cognitive reserve and self-efficacy skills in health care of patients. Findings suggested that the caregiver burden and the level of general distress influenced the cognitive performance. An improvement of cognitive functions is associated with a reduction of self-efficacy skills, causing a caregiver burden improvement.
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Affiliation(s)
- Caterina Formica
- IRCCS Centro Neurolesi "Bonino Pulejo", S.S. 113 C.da Casazza, Messina, Italy; Biomedical Department of Internal Medicine and Medical Specialties, University of Palermo, Italy
| | - Annalisa La Face
- IRCCS Centro Neurolesi "Bonino Pulejo", S.S. 113 C.da Casazza, Messina, Italy
| | - Viviana Lo Buono
- IRCCS Centro Neurolesi "Bonino Pulejo", S.S. 113 C.da Casazza, Messina, Italy
| | - Marcella Di Cara
- IRCCS Centro Neurolesi "Bonino Pulejo", S.S. 113 C.da Casazza, Messina, Italy
| | - Katia Micchìa
- IRCCS Centro Neurolesi "Bonino Pulejo", S.S. 113 C.da Casazza, Messina, Italy
| | - Lilla Bonanno
- IRCCS Centro Neurolesi "Bonino Pulejo", S.S. 113 C.da Casazza, Messina, Italy.
| | - Anna Lisa Logiudice
- IRCCS Centro Neurolesi "Bonino Pulejo", S.S. 113 C.da Casazza, Messina, Italy
| | - Antonino Todaro
- IRCCS Centro Neurolesi "Bonino Pulejo", S.S. 113 C.da Casazza, Messina, Italy
| | - Rosanna Palmeri
- IRCCS Centro Neurolesi "Bonino Pulejo", S.S. 113 C.da Casazza, Messina, Italy
| | - Placido Bramanti
- IRCCS Centro Neurolesi "Bonino Pulejo", S.S. 113 C.da Casazza, Messina, Italy
| | - Silvia Marino
- IRCCS Centro Neurolesi "Bonino Pulejo", S.S. 113 C.da Casazza, Messina, Italy
| | - Francesco Corallo
- IRCCS Centro Neurolesi "Bonino Pulejo", S.S. 113 C.da Casazza, Messina, Italy
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13
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El-Jawahri A, Jacobs JM, Nelson AM, Traeger L, Greer JA, Nicholson S, Waldman LP, Fenech AL, Jagielo AD, D’Alotto J, Horick N, Spitzer T, DeFilipp Z, Chen YBA, Temel JS. Multimodal psychosocial intervention for family caregivers of patients undergoing hematopoietic stem cell transplantation: A randomized clinical trial. Cancer 2020; 126:1758-1765. [PMID: 31899552 PMCID: PMC7103553 DOI: 10.1002/cncr.32680] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 11/20/2019] [Accepted: 12/03/2019] [Indexed: 11/08/2022]
Abstract
BACKGROUND Caregivers of patients undergoing hematopoietic stem cell transplantation (HCT) experience an immense caregiving burden before, during, and after HCT. METHODS We conducted an unblinded, randomized trial of a psychosocial intervention (BMT-CARE) for caregivers of patients undergoing autologous and allogeneic HCT at Massachusetts General Hospital. Caregivers were randomly assigned to BMT-CARE or usual care. BMT-CARE was tailored to the HCT trajectory and integrated treatment-related education and self-care with cognitive-behavioral skills to promote coping. Caregivers assigned to BMT-CARE met with a trained interventionist (a psychologist or a social worker) in person, via telephone, or via videoconferencing for 6 sessions starting before HCT and continuing up to day +60 after HCT. The primary endpoint was feasibility, which was defined as at least 60% of eligible caregivers enrolling and completing 50% or more of the intervention sessions. We assesed caregiver quality of life (QOL; Caregiver Oncology Quality of Life Questionnaire), caregiving burden (Caregiver Reaction Assessment), psychological distress (Hospital Anxiety and Depression Scale), self-efficacy (Cancer Self-Efficacy Scale-Transplant), and coping (Measures of Current Status) at baseline and 30 and 60 days after HCT. We used mixed linear effect models to assess the effect of BMT-CARE on outcomes longitudinally. RESULTS We enrolled 72.5% of eligible caregivers (100 of 138), and 80% attended 50% or more of the intervention sessions. Caregivers randomized to BMT-CARE reported improved QOL (B = 6.11; 95% CI, 3.50-8.71; P < .001), reduced caregiving burden (B = -6.02; 95% CI, -8.49 to -3.55; P < .001), lower anxiety (B = -2.18; 95% CI, -3.07 to -1.28; P < .001) and depression symptoms (B = -1.23; 95% CI, -1.92 to -0.54; P < .001), and improved self-efficacy (B = 7.22; 95% CI, 2.40-12.03; P = .003) and coping skills (B = 4.83; 95% CI, 3.04-6.94; P < .001) in comparison with the usual-care group. CONCLUSIONS A brief multimodal psychosocial intervention tailored for caregivers of HCT recipients is feasible and may improve QOL, mood, coping, and self-efficacy while reducing the caregiving burden during the acute HCT period.
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Affiliation(s)
- Areej El-Jawahri
- Massachusetts General Hospital, 55 Fruit Street, Boston, Massachusetts, 02134
- Harvard Medical School, Boston, Massachusetts, 02114
| | - Jamie M. Jacobs
- Massachusetts General Hospital, 55 Fruit Street, Boston, Massachusetts, 02134
- Harvard Medical School, Boston, Massachusetts, 02114
| | - Ashley M. Nelson
- Massachusetts General Hospital, 55 Fruit Street, Boston, Massachusetts, 02134
- Harvard Medical School, Boston, Massachusetts, 02114
| | - Lara Traeger
- Massachusetts General Hospital, 55 Fruit Street, Boston, Massachusetts, 02134
- Harvard Medical School, Boston, Massachusetts, 02114
| | - Joseph A. Greer
- Massachusetts General Hospital, 55 Fruit Street, Boston, Massachusetts, 02134
- Harvard Medical School, Boston, Massachusetts, 02114
| | - Showly Nicholson
- Massachusetts General Hospital, 55 Fruit Street, Boston, Massachusetts, 02134
- Harvard Medical School, Boston, Massachusetts, 02114
| | - Lauren P. Waldman
- Massachusetts General Hospital, 55 Fruit Street, Boston, Massachusetts, 02134
- Harvard Medical School, Boston, Massachusetts, 02114
| | - Alyssa L. Fenech
- Massachusetts General Hospital, 55 Fruit Street, Boston, Massachusetts, 02134
- Harvard Medical School, Boston, Massachusetts, 02114
| | - Annemarie D. Jagielo
- Massachusetts General Hospital, 55 Fruit Street, Boston, Massachusetts, 02134
- Harvard Medical School, Boston, Massachusetts, 02114
| | - Jennifer D’Alotto
- Massachusetts General Hospital, 55 Fruit Street, Boston, Massachusetts, 02134
- Harvard Medical School, Boston, Massachusetts, 02114
| | - Nora Horick
- Massachusetts General Hospital, 55 Fruit Street, Boston, Massachusetts, 02134
- Harvard Medical School, Boston, Massachusetts, 02114
| | - Thomas Spitzer
- Massachusetts General Hospital, 55 Fruit Street, Boston, Massachusetts, 02134
- Harvard Medical School, Boston, Massachusetts, 02114
| | - Zachariah DeFilipp
- Massachusetts General Hospital, 55 Fruit Street, Boston, Massachusetts, 02134
- Harvard Medical School, Boston, Massachusetts, 02114
| | - Yi-Bin A. Chen
- Massachusetts General Hospital, 55 Fruit Street, Boston, Massachusetts, 02134
- Harvard Medical School, Boston, Massachusetts, 02114
| | - Jennifer S. Temel
- Massachusetts General Hospital, 55 Fruit Street, Boston, Massachusetts, 02134
- Harvard Medical School, Boston, Massachusetts, 02114
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14
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Romero-Martínez Á, Hidalgo-Moreno G, Moya-Albiol L. Neuropsychological consequences of chronic stress: the case of informal caregivers. Aging Ment Health 2020; 24:259-271. [PMID: 30450952 DOI: 10.1080/13607863.2018.1537360] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Introduction: Caring for a family member with a long-term illness is a significant source of chronic stress that might significantly accelerate the cognitive ageing of informal caregivers. Nevertheless, the absence of a defined theoretical body of literature on the neuropsychology of this population makes it difficult to understand what the characteristic neuropsychological deficits of these caregivers are.Aims: The main aim of this study is to carry out a systematic review of studies of cognitive deficits present in informal caregivers of people with several chronic pathologies, and analyse the effects of cognitive-behavioural interventions on caregivers' cognition.Methods: The scientific literature was reviewed following the PRISMA quality criteria for reviews using the following digital databases: PubMEd, PsycINFO, and Dialnet.Results: Identification of 2046 abstracts and retrieval of 211 full texts led to the inclusion of 38 papers. The studies showed heterogeneous results, but most of the cross-sectional studies reviewed that employed neuropsychological assessments concluded that informal caregivers reported a generalized cognitive deterioration, especially memory dysfunctions (i.e. learning verbal, visuospatial, and digit information). Moreover, they also presented low selective attention and capacity for inhibition, along with slow processing speed. Longitudinal studies confirmed that caregivers whose care situation was more prolonged showed a marked deterioration in their overall cognitive state, memory, processing speed, and vocabulary richness. However, although the patient's death does not seem to reverse the neuropsychological alterations in caregivers, cognitive-behavioural interventions that employ techniques to reduce stress levels, cognitive biases, and inadequate adaptation schemas seem to improve some of the aforementioned cognitive abilities.Conclusions: Results from this synthesis and critical analysis of neuropsychological deficits in informal caregivers offer guidelines for diagnosing caregivers' cognitive status by including a test battery covering all the domains considered relevant. Finally, given the ability of cognitive behavioural interventions to improve cognition in caregivers, further studies on their long-term effects on caregivers are warranted.Chronic stress entails an acceleration of the cognitive ageingCross-sectional studies concluded that informal caregivers reported a generalized cognitive deteriorationCognitive-behavioural interventions seem to improve cognitive abilities of caregivers.
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Pertl MM, Sooknarine-Rajpatty A, Brennan S, Robertson IH, Lawlor BA. Caregiver Choice and Caregiver Outcomes: A Longitudinal Study of Irish Spousal Dementia Caregivers. Front Psychol 2019; 10:1801. [PMID: 31456713 PMCID: PMC6700469 DOI: 10.3389/fpsyg.2019.01801] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Accepted: 07/19/2019] [Indexed: 11/17/2022] Open
Abstract
Background The perception of choice in becoming a caregiver may impact on caregiver psychological and physical health. We determined the proportion of spousal dementia caregivers who felt they had a choice, and examined whether lack of choice in taking up the caregiving role and the perceived degree of choice in caregiving predicted caregiver health and wellbeing and care-recipient placement in long-term care at 1-year follow-up. Methods We performed secondary analyses of data from DeStress, a longitudinal study of 251 spousal dementia caregivers in Ireland. We used multivariate logistic and linear regression analyses to examine whether lack of choice (a dichotomous item) and/or the perceived degree of choice (a 9-point scale) at baseline predicted caregiver health (number of chronic health conditions; self-reported health) and wellbeing (e.g., burden, anxiety, depression, stress, and positive aspects of caregiving) and care status (continued care at home or placement in long-term care) at follow-up. Results The vast majority of caregivers (82%) reported that they had no choice in taking up the caregiving role. Nevertheless, nearly three-quarters (74%) responded above the midpoint on the rating scale (Mean = 6.82, SD = 3.22; Median = 9; Mode = 9), indicating they provided care voluntarily. Caregivers who reported a greater degree of choice were more likely to still be providing care at home at follow-up and to identify benefits from providing care. Neither choice nor degree of choice predicted any other caregiver outcomes. Conclusion For the vast majority of spousal dementia caregivers, taking up the caregiving role is not perceived as a choice; yet, most report performing this role voluntarily. Thus, facilitating greater choice may not necessarily diminish the key contribution family caregivers make to the care system. Although we found no evidence that caregiver choice predicted more positive caregiver health and wellbeing, the perception of choice is important in and of itself, and may benefit caregivers by facilitating the identification of positive aspects of care and be a factor in delaying care-recipient placement in long-term care. Future research should be especially mindful of how caregiver choice is assessed and how this may affect the resulting prevalence of choice.
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Affiliation(s)
- Maria M Pertl
- Royal College of Surgeons in Ireland, Dublin, Ireland
| | | | - Sabina Brennan
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Ian H Robertson
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Brain A Lawlor
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
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16
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Ihle A, Rimmele U, Oris M, Maurer J, Kliegel M. The Longitudinal Relationship of Perceived Stress Predicting Subsequent Decline in Executive Functioning in Old Age Is Attenuated in Individuals with Greater Cognitive Reserve. Gerontology 2019; 66:65-73. [PMID: 31352460 DOI: 10.1159/000501293] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Accepted: 06/04/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Cognitively stimulating activities contribute to the accumulation of cognitive reserve that is proposed to be instrumental for maintaining cognitive functioning in aging. Adopting a novel, more general conceptual perspective including models of vulnerability, we argue that cognitive reserve may modify the longitudinal association between perceived stress and the rate of subsequent decline in executive functioning. OBJECTIVE The present study set out to investigate the longitudinal relationship between perceived stress and subsequent decline in executive functioning over 6 years as measured through performance changes in the Trail Making Test (TMT) and whether this longitudinal relationship differed by key markers of cognitive reserve (education, occupation, and leisure activities), taking into account age, sex, and chronic diseases as covariates. METHODS We used latent change score modeling based on longitudinal data from 897 older adults tested on TMT parts A and B in two waves 6 years apart. Mean age in the first wave was 74.33 years. Participants reported information on perceived stress, education, occupation, leisure activities, and chronic diseases. RESULTS The longitudinal relationship between greater perceived stress in the first wave of data collection and steeper subsequent decline in executive functioning over 6 years was significantly reduced in individuals who had pursued a higher frequency of leisure activities in the first wave. CONCLUSION The longitudinal relationship between perceived stress and subsequent decline in executive functioning may be attenuated in individuals who have accumulated greater cognitive reserve through an engaged lifestyle. Implications for current cognitive reserve and gerontological research are discussed.
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Affiliation(s)
- Andreas Ihle
- Department of Psychology, University of Geneva, Geneva, Switzerland, .,Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Geneva, Switzerland, .,Swiss National Centre of Competence in Research LIVES - Overcoming Vulnerability: Life Course Perspectives, Lausanne and Geneva, Switzerland,
| | - Ulrike Rimmele
- Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Geneva, Switzerland.,Department of Basic Neurosciences, University of Geneva, Geneva, Switzerland
| | - Michel Oris
- Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Geneva, Switzerland.,Swiss National Centre of Competence in Research LIVES - Overcoming Vulnerability: Life Course Perspectives, Lausanne and Geneva, Switzerland
| | - Jürgen Maurer
- Swiss National Centre of Competence in Research LIVES - Overcoming Vulnerability: Life Course Perspectives, Lausanne and Geneva, Switzerland.,Department of Economics, University of Lausanne, Lausanne, Switzerland
| | - Matthias Kliegel
- Department of Psychology, University of Geneva, Geneva, Switzerland.,Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Geneva, Switzerland.,Swiss National Centre of Competence in Research LIVES - Overcoming Vulnerability: Life Course Perspectives, Lausanne and Geneva, Switzerland
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Ihle A, Oris M, Sauter J, Rimmele U, Kliegel M. Cognitive Reserve and Social Capital Accrued in Early and Midlife Moderate the Relation of Psychological Stress to Cognitive Performance in Old Age. Dement Geriatr Cogn Disord 2018; 45:190-197. [PMID: 29870984 DOI: 10.1159/000488052] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 02/27/2018] [Indexed: 11/19/2022] Open
Abstract
AIMS The present study set out to investigate the relation of psychological stress to cognitive performance and its interplay with key life course markers of cognitive reserve and social capital in a large sample of older adults. METHODS We assessed cognitive performance (verbal abilities and processing speed) and psychological stress in 2,812 older adults. The Participants reported information on education, occupation, leisure activities, family, and close friends. RESULTS Greater psychological stress was significantly related to lower performance in verbal abilities and processing speed. Moderation analyses suggested that the relations of psychological stress to cognitive performance were reduced in individuals with higher education, a higher cognitive level of the first profession practiced after education, a larger number of midlife leisure activities, a larger number of significant family members, and a larger number of close friends. CONCLUSION Cognitive reserve and social capital accrued in early and midlife may reduce the detrimental influences of psychological stress on cognitive functioning in old age.
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Affiliation(s)
- Andreas Ihle
- Department of Psychology, University of Geneva, Geneva, Switzerland.,Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Geneva, Switzerland
| | - Michel Oris
- Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Geneva, Switzerland
| | - Julia Sauter
- Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Geneva, Switzerland
| | - Ulrike Rimmele
- Department of Basic Neurosciences, University of Geneva, Geneva, Switzerland
| | - Matthias Kliegel
- Department of Psychology, University of Geneva, Geneva, Switzerland.,Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Geneva, Switzerland
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Zwar L, König HH, Hajek A. The impact of different types of informal caregiving on cognitive functioning of older caregivers: Evidence from a longitudinal, population-based study in Germany. Soc Sci Med 2018; 214:12-19. [PMID: 30134218 DOI: 10.1016/j.socscimed.2018.07.048] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 07/09/2018] [Accepted: 07/27/2018] [Indexed: 12/23/2022]
Abstract
STUDY AIM This study's aim was to investigate the influence of different caregiving types on cognitive functioning of caregivers aged 65 years and older longitudinally and to look at potential gender differences in this association. METHOD Data from the German Ageing Survey, a longitudinal population-based study assessing community-dwelling people in Germany, was used. Our sample consisted of participants 65 years and older (waves 2008, 2011 and 2014; N = 6560). Informal caregiving was assessed in terms of three caregiving types (help around the house, looking after someone, performing nursing care services). An adaption of the widely used Digit Symbol Substitution Test was used to assess cognitive function. RESULTS Fixed-effects regressions demonstrated a positive association of looking after someone with cognitive functioning (β = 1.90, p < .01). There was no significant association of help around the house (β = 0.96, p = .22) or performing nursing care services (β = 2.12, p = .09) with cognitive function. Stratifying for gender, we found this effect of looking after someone on cognitive functioning only in women (β = 2.82, p < .01), but not in men (β = 1.00, p = .23). The other caregiving types showed no significant association with cognitive function, neither in men (helping around the house: β = 0.20, p = .85; performing nursing care services: β = 1.16, p = .52), nor in women (helping around the house: β = 1.67, p = .13; performing nursing care services: β = 2.88, p = .09). CONCLUSIONS Results indicate that informal caregiving, in terms of looking after someone, can be beneficial for cognitive function, at least for female caregivers. Thus, we recommend to consider caregiving types when investigating informal caregiving and cognitive function. Furthermore, we recommend to focus support more on other outcomes, particularly for female caregivers.
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Affiliation(s)
- Larissa Zwar
- University Medical Center Hamburg-Eppendorf, Department of Health Economics and Health Services Research, Martinistr. 52, 20246, Hamburg, Germany.
| | - Hans-Helmut König
- University Medical Center Hamburg-Eppendorf, Department of Health Economics and Health Services Research, Martinistr. 52, 20246, Hamburg, Germany.
| | - André Hajek
- University Medical Center Hamburg-Eppendorf, Department of Health Economics and Health Services Research, Martinistr. 52, 20246, Hamburg, Germany.
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