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Wang S, Leung SHI, Xu X, Liu M, Wang P, Zhang W, Moyle W. Influences of Social Disengagement and Depressive Symptoms on Sleep Disturbance in Dementia Caregiving Dyads: A Nationally Representative Study. J Am Med Dir Assoc 2024:105197. [PMID: 39127457 DOI: 10.1016/j.jamda.2024.105197] [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: 08/23/2023] [Revised: 06/28/2024] [Accepted: 07/05/2024] [Indexed: 08/12/2024]
Abstract
OBJECTIVES To examine the influence of social disengagement and depressive symptoms on sleep disturbance among dementia caregiving dyads and the actor-partner interdependence nature of these influences. DESIGN Actor-partner interdependence model through structural equation modeling for dyadic analyses. SETTING AND PARTICIPANTS A total of 310 dyads of older adults with dementia and their care partners from 2 national representative studies in the United States, the National Health and Aging Trends Study (NHATS) and its companion study, the National Study of Caregiving (NSOC). METHODS Data from the NHATS Round 11 and NSOC IV were analyzed using descriptive statistics, Pearson correlation analysis, and the actor-partner interdependence model. Structural equation modeling was used to assess the mediation effects of depressive symptoms within the actor-partner interdependence models. RESULTS In the model of caregivers, social disengagement had a direct impact on sleep disturbance (β = 0.49, P < .001) and an indirect impact through depressive symptoms (β = 0.25, P < .001). In the model of older adults with dementia, social disengagement only had an indirect effect on sleep disturbance through depressive symptoms. In models examining partner effects, caregivers' social disengagement directly influenced their care partners' depressive symptoms (β = 0.20, P = .019), which subsequently affected caregivers' sleep disturbance (β = 0.17, P < .001). Social disengagement (β = 0.17, P = .001) and depressive symptoms (β = 0.17, P < .001) in older adults with dementia directly impacted their caregivers' sleep disturbance. Depressive symptoms of older adults with dementia served as multiple mediators linking one member's social disengagement to both their own and partner's sleep. CONCLUSIONS AND IMPLICATIONS This study represents one of the first attempts to investigate the influencing mechanism of sleep disturbances among older adults with dementia and their informal caregivers through a dyadic perspective. The sleep disturbance of caregivers may be directly influenced by the social disengagement and depressive symptoms exhibited by both members of the dyad, whereas the sleep disturbance experienced by older adults with dementia can only be indirectly influenced by the dyad's social disengagement via their own depressive symptoms. Dyadic social activities targeting depressive symptoms could be designed to address sleep disturbances in dementia caregiving dyads.
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Affiliation(s)
- Shanshan Wang
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China.
| | - Sze Him Isaac Leung
- Department of Statistics, The Chinese University of Hong Kong, Sha Tin, Hong Kong SAR, China
| | - Xinyi Xu
- School of Nursing, Hebei Medical University, Hebei, China
| | - Minhui Liu
- School of Nursing, Ningxia Medical University, Ningxia, China
| | - Peng Wang
- School of Nursing and Health, Zhengzhou University, Henan, China; School of Nursing, Xinxiang Medical University
| | - Weihong Zhang
- School of Nursing and Health, Zhengzhou University, Henan, China
| | - Wendy Moyle
- School of Nursing and Midwifery, Griffith University, Brisbane, Queensland, Australia
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Jiménez-Gonzalo L, Vara-García C, Romero-Moreno R, Márquez-González M, Olazarán J, von Känel R, Mausbach BT, Losada-Baltar A. An integrated model of psychosocial correlates of insomnia severity in family caregivers of people with dementia. Aging Ment Health 2024; 28:969-976. [PMID: 38100598 DOI: 10.1080/13607863.2023.2293052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 12/04/2023] [Indexed: 12/17/2023]
Abstract
OBJECTIVES Research has shown the relevance of stress and coping factors in explaining caregivers' insomnia symptoms. However, few attempts have been made to empirically test an integrative model for insomnia severity in family caregivers of people with dementia. The aim of this study was to test such a model, in which insomnia severity is proposed to be influenced by predisposing factors, precipitated by stressors, and perpetuated by behaviors to cope with these stressors. METHODS 311 family caregivers of people with dementia were assessed for variables categorized as predisposing (e.g. female gender), precipitating (e.g. care-recipient's behavioral and psychological symptoms of dementia [BPSD]), and perpetuating factors (e.g. sleep aids). A theoretical model was developed and then statistically tested using structural equation modelling, analyzing the direct and indirect effects of the assessed variables on caregivers' insomnia severity. RESULTS Distress, sleep aids, and experiential avoidance showed a direct association with insomnia severity. Female gender, younger age, cognitive fusion, leisure activities, dysfunctional thoughts, frequency and distress caused by care-recipient's BPSD showed indirect associations with insomnia severity. The model explained 22% of the variance of caregivers' insomnia severity. CONCLUSION The results provide additional empirical support for the importance of predisposing, precipitating and perpetuating factors associated with caregivers' insomnia severity. The integrative model we propose may also be useful for developing interventions targeting insomnia symptoms in family dementia caregivers.
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Affiliation(s)
| | | | | | - María Márquez-González
- Department of Biological and Health Psychology, Universidad Autónoma de Madrid, Madrid, Spain
| | - Javier Olazarán
- Department of Neurology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Fundación Maria Wolff, Madrid, Spain
| | - Roland von Känel
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University of Zürich and University Hospital Zurich, Switzerland
| | - Brent T Mausbach
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
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Gabb VG, Blackman J, Morrison HD, Biswas B, Li H, Turner N, Russell GM, Greenwood R, Jolly A, Trender W, Hampshire A, Whone A, Coulthard E. Remote Evaluation of Sleep and Circadian Rhythms in Older Adults With Mild Cognitive Impairment and Dementia: Protocol for a Feasibility and Acceptability Mixed Methods Study. JMIR Res Protoc 2024; 13:e52652. [PMID: 38517469 PMCID: PMC10998181 DOI: 10.2196/52652] [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: 09/19/2023] [Revised: 02/12/2024] [Accepted: 02/13/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND Sleep disturbances are a potentially modifiable risk factor for neurodegenerative dementia secondary to Alzheimer disease (AD) and Lewy body disease (LBD). Therefore, we need to identify the best methods to study sleep in this population. OBJECTIVE This study will assess the feasibility and acceptability of various wearable devices, smart devices, and remote study tasks in sleep and cognition research for people with AD and LBD. METHODS We will deliver a feasibility and acceptability study alongside a prospective observational cohort study assessing sleep and cognition longitudinally in the home environment. Adults aged older than 50 years who were diagnosed with mild to moderate dementia or mild cognitive impairment (MCI) due to probable AD or LBD and age-matched controls will be eligible. Exclusion criteria include lack of capacity to consent to research, other causes of MCI or dementia, and clinically significant sleep disorders. Participants will complete a cognitive assessment and questionnaires with a researcher and receive training and instructions for at-home study tasks across 8 weeks. At-home study tasks include remote sleep assessments using wearable devices (electroencephalography headband and actigraphy watch), app-based sleep diaries, online cognitive assessments, and saliva samples for melatonin- and cortisol-derived circadian markers. Feasibility outcomes will be assessed relating to recruitment and retention, data completeness, data quality, and support required. Feedback on acceptability and usability will be collected throughout the study period and end-of-study interviews will be analyzed using thematic analysis. RESULTS Recruitment started in February 2022. Data collection is ongoing, with final data expected in February 2024 and data analysis and publication of findings scheduled for the summer of 2024. CONCLUSIONS This study will allow us to assess if remote testing using smart devices and wearable technology is a viable alternative to traditional sleep measurements, such as polysomnography and questionnaires, in older adults with and without MCI or dementia due to AD or LBD. Understanding participant experience and the barriers and facilitators to technology use for research purposes and remote research in this population will assist with the development of, recruitment to, and retention within future research projects studying sleep and cognition outside of the clinic or laboratory. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/52652.
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Affiliation(s)
- Victoria Grace Gabb
- Bristol Medical School, University of Bristol, Bristol, United Kingdom
- Neurology Department, Bristol Brain Centre, North Bristol NHS Trust, Bristol, United Kingdom
| | - Jonathan Blackman
- Bristol Medical School, University of Bristol, Bristol, United Kingdom
- Neurology Department, Bristol Brain Centre, North Bristol NHS Trust, Bristol, United Kingdom
| | - Hamish Duncan Morrison
- Bristol Medical School, University of Bristol, Bristol, United Kingdom
- Neurology Department, Bristol Brain Centre, North Bristol NHS Trust, Bristol, United Kingdom
| | - Bijetri Biswas
- Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Haoxuan Li
- Bristol Medical School, University of Bristol, Bristol, United Kingdom
- Neurology Department, Bristol Brain Centre, North Bristol NHS Trust, Bristol, United Kingdom
- King's College Hospital, King's College Hospital NHS Foundation Trust, London, United Kingdom
- Bristol Royal Infirmary, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
| | - Nicholas Turner
- Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | | | - Rosemary Greenwood
- Bristol Medical School, University of Bristol, Bristol, United Kingdom
- Research & Innovation, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
| | - Amy Jolly
- Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
- UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, United Kingdom
| | - William Trender
- Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Adam Hampshire
- Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Alan Whone
- Bristol Medical School, University of Bristol, Bristol, United Kingdom
- Neurology Department, Bristol Brain Centre, North Bristol NHS Trust, Bristol, United Kingdom
| | - Elizabeth Coulthard
- Bristol Medical School, University of Bristol, Bristol, United Kingdom
- Neurology Department, Bristol Brain Centre, North Bristol NHS Trust, Bristol, United Kingdom
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Monteiro BCDC, dos Santos TTBA, Nogueira MML, Dourado MCN. The relationship between burden and caregiver's sleep disturbances in dementia: a systematic review. Dement Neuropsychol 2023; 17:e20230030. [PMID: 38111593 PMCID: PMC10727027 DOI: 10.1590/1980-5764-dn-2023-0030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 08/27/2023] [Accepted: 09/24/2023] [Indexed: 12/20/2023] Open
Abstract
Caregivers of people living with dementia (PLwD) have a high burden degree that leads to health issues, including sleep. Objective This study aimed to analyze the impacts of the caregiving burden on caregiver's sleep disturbances. Methods This systematic review involved a qualitative analysis of publications on Web of Science and Pubmed/Medline databases published between February 2018 and August 2022. Results A total of 27 studies were identified and analyzed. Caregiver's sleep presents impairments in sleep latency, sleep fragmentation, sleep duration, subjective sleep quality, daytime dysfunction, and insomnia. Caregiver's distress and depressive symptoms have a dual relationship with sleep problems. Conclusion Sleep disturbances presented by caregivers are correlated with higher burden levels and lead to more vulnerability to psychiatric symptoms and health issues.
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Affiliation(s)
| | | | - Marcela Moreira Lima Nogueira
- Universidade Federal do Rio de Janeiro, Instituto de Psiquiatria, Centro de Doença de Alzheimer, Rio de Janeiro RJ, Brazil
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Brewster GS, Higgins M, McPhillips MV, Bonds Johnson K, Epps F, Yeager KA, Bliwise DL, Hepburn K. The Effect of Tele-Savvy on Sleep Quality and Insomnia in Caregivers of Persons Living with Dementia. Clin Interv Aging 2023; 18:2117-2127. [PMID: 38111602 PMCID: PMC10726954 DOI: 10.2147/cia.s425741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 12/01/2023] [Indexed: 12/20/2023] Open
Abstract
Introduction Sleep disturbance is prevalent in caregivers of persons living with dementia (PLwD). Tele-Savvy, a 7-week virtual psychoeducational intervention, enhances caregivers' competence and self-care, and reduces depression. While not explicitly designed to do so, Tele-Savvy can potentially improve caregivers' disturbed sleep. The present study aimed to examine the longitudinal effects of Tele-Savvy on caregivers' sleep quality and insomnia. Methods This was a secondary data analysis of a 3-arm randomized control trial [Tele-Savvy (active treatment), Healthy Living (attention control), and usual care (waitlist control)]. Multilevel mixed modeling with intent-to-treat principles tested for group, time, and group-by-time effects. Effect sizes were estimated for all changes from baseline to the initial 6-month post-intervention point. Following completion of the 6-month post-randomization delay, we examined combined outcomes for Tele-Savvy. Results Participants (n=137; mean age 64.7 years) were predominantly female (68.6%) and White (68.6%). We found no initial group-by-time effects for the Pittsburgh Sleep Quality Index (PSQI) and the Insomnia Severity Index (ISI). For the combined Tele-Savvy group, there was a statistically significant improvement in ISI scores across time (p=0.050). The combined Tele-Savvy effect size for PSQI was d=0.126 and ISI was d=0.310. Discussion Tele-Savvy resulted in a significant long-term reduction in insomnia symptoms in this sample of caregivers of PLwD and demonstrated a positive trend for improvement in their sleep quality. Since sleep disturbance is so prevalent among caregivers of PLwD, the inclusion of sleep health education into psychoeducation caregiver interventions may yield even better outcomes for caregivers.
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Affiliation(s)
- Glenna S Brewster
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - Melinda Higgins
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | | | | | - Fayron Epps
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - Katherine A Yeager
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - Donald L Bliwise
- Division of Sleep Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Kenneth Hepburn
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
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Almutairi RR, Zauszniewski JA. Sleep Quality and Depressive Symptoms in Caregivers of Persons with Dementia: A Systematic Review. Issues Ment Health Nurs 2023:1-13. [PMID: 37224817 DOI: 10.1080/01612840.2023.2205535] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
A majority of the care provided to persons with dementia is provided by unpaid or informal caregivers (friends or family members), and most caregivers have limited care-related training, which increases their risks of developing depressive symptoms. Also, persons with dementia may experience sleep-related stressors at night. Disruptive behavior and sleep of the care recipients may produce stress in the caregivers, which has been considered a precipitating factor for sleep issues among caregivers. This systematic review aims to examine the available literature to investigate depressive symptoms and sleep quality among informal caregivers of persons with dementia. Using PRISMA guidelines, only eight articles fulfilled the inclusion criteria. Sleep quality and depressive symptoms should be investigated because they may influence caregivers' health and their involvement in caregiving.
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Affiliation(s)
- Rayhanah R Almutairi
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio, USA
- College of Nursing, Community Health Department, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Jaclene A Zauszniewski
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio, USA
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Ergenekon AP, Gümüş Z, Yegit CY, Cenk M, Gulieva A, Kalyoncu M, Selcuk M, Karabulut S, Ozturk G, Eralp EE, Unver O, Karadag B, Gokdemir Y. Depression, anxiety, and sleep quality of caregivers of children with spinal muscular atrophy. Pediatr Pulmonol 2023; 58:1697-1702. [PMID: 36856268 DOI: 10.1002/ppul.26379] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 02/03/2023] [Accepted: 02/26/2023] [Indexed: 03/02/2023]
Abstract
BACKGROUND The aim of this study was to evaluate the prevalence of anxiety, depression, sleep, and associated factors in caregivers of children with spinal muscular atrophy (SMA). MATERIALS AND METHODS Beck Depression Inventory (BDI), the State-Trait Anxiety Inventory-State (STAI-S), the State-Trait Anxiety Inventory-Trait (STAI-T), and Pittsburgh Sleep Quality Index (PSQI) were used to assess the anxiety, depression, and sleep quality of the caregivers of children with SMA. Higher scores indicated worse outcome for all three questionnaires. RESULTS Fifty-six caregivers of children with SMA were included in the study. Median age of children was 6 (3.2-10) years and mean age of the caregivers was 37.0 ± 6.5 years. Median scores of the BDI, STAI-S, STAI-T, and PSQI were 12 (7.2-17), 35.5 (31-44), 40.5 (35-48), and 7.0 (5.0-10.0), respectively. There was a positive correlation between BDI and PSQI scores (p < 0.05). There was a negative correlation between the age of the caregivers and PSQI, BDI, STAI-T scores (p = 0.01, r = -0.341; p = 0.006, r = -0.364; p = 0.003, r = -0.395, respectively). There was a negative correlation between the age of the patients and the PSQI scores of the caregivers (p = 0.01, r = -0.33). There was a negative correlation between BDI scores and household income (p = 0.01, r = -0.34). CONCLUSION Caregivers of children with SMA had elevated depression and anxiety levels and they also had decreased sleep quality. Economic and social support resources are needed to help caregivers of those children.
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Affiliation(s)
- Almala Pinar Ergenekon
- Division of Pediatric Pulmonology, Marmara University School of Medicine, Istanbul, Turkey
| | - Zeynep Gümüş
- Marmara University School of Medicine, Istanbul, Turkey
| | - Cansu Yilmaz Yegit
- Division of Pediatric Pulmonology, Marmara University School of Medicine, Istanbul, Turkey
| | - Muruvvet Cenk
- Division of Pediatric Pulmonology, Marmara University School of Medicine, Istanbul, Turkey
| | - Aynur Gulieva
- Division of Pediatric Pulmonology, Marmara University School of Medicine, Istanbul, Turkey
| | - Mine Kalyoncu
- Division of Pediatric Pulmonology, Marmara University School of Medicine, Istanbul, Turkey
| | - Merve Selcuk
- Division of Pediatric Pulmonology, Marmara University School of Medicine, Istanbul, Turkey
| | - Seyda Karabulut
- Division of Pediatric Pulmonology, Marmara University School of Medicine, Istanbul, Turkey
| | - Gulten Ozturk
- Division of Pediatric Neurology, Marmara University School of Medicine, Istanbul, Turkey
| | - Ela Erdem Eralp
- Division of Pediatric Pulmonology, Marmara University School of Medicine, Istanbul, Turkey
| | - Olcay Unver
- Division of Pediatric Neurology, Marmara University School of Medicine, Istanbul, Turkey
| | - Bulent Karadag
- Division of Pediatric Pulmonology, Marmara University School of Medicine, Istanbul, Turkey
| | - Yasemin Gokdemir
- Division of Pediatric Pulmonology, Marmara University School of Medicine, Istanbul, Turkey
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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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Mochón-Benguigui S, Carneiro-Barrera A, Dote-Montero M, Castillo MJ, Amaro-Gahete FJ. Sleep and Anabolic/Catabolic Hormonal Profile in Sedentary Middle-Aged Adults: The FIT-AGEING Study. Int J Mol Sci 2022; 23:ijms232314709. [PMID: 36499035 PMCID: PMC9739476 DOI: 10.3390/ijms232314709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/22/2022] [Accepted: 11/23/2022] [Indexed: 11/27/2022] Open
Abstract
Sleep quality plays an important role in the modulation of several aging markers. This influence could be explained by aging-induced hormonal changes. Indeed, poor sleep quality has been associated with the development of several endocrine-related health complications. This study examined the relationship of both subjective and objective sleep quantity and quality, with basal levels of selected plasma anabolic and catabolic hormones in sedentary middle-aged adults. A total of 74 volunteers (52.7% women; aged 53.7 ± 5.1) were recruited for this study. Subjective sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI; higher scores indicate worse sleep quality), and objective sleep quality parameters (total sleep time [TST], wake after sleep onset [WASO], and sleep efficiency [SE]) were measured using a wrist-worn accelerometer. Basal levels of plasma dehydroepiandrosterone sulphate (DHEAS), total testosterone, sex hormone binding globulin (SHBG), somatotropin, and cortisol levels, were determined. Free testosterone was calculated from the total testosterone and SHBG levels. No associations of global PSQI score, TST, WASO, and SE with DHEAS, free testosterone, and somatotropin plasma levels were found, neither in men nor in women (all p ≥ 0.05). Global PSQI score was inversely related to cortisol plasma levels in women (p = 0.043). WASO was positively associated with cortisol plasma levels, while SE was negatively associated with cortisol plasma levels in women (all p ≤ 0.027). Sleep quality is not related to levels of plasma anabolic hormones, but to levels of catabolic hormones, in sedentary middle-aged adults. Therefore, these results suggest that potential changes in aging biomarkers associated with sleep disturbances, could be mediated by age-related changes in the catabolic endocrine system.
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Affiliation(s)
- Sol Mochón-Benguigui
- EFFECTS-262 Research Group, Department of Medical Physiology, School of Medicine, University of Granada, 18016 Granada, Spain
| | - Almudena Carneiro-Barrera
- Department of Psychology, Universidad Loyola Andalucía, 41704 Seville, Spain
- Sleep and Health Promotion Laboratory, Mind, Brain and Behavior Research Centre, University of Granada, 18011 Granada, Spain
- PROmoting FITness and Health through Physical Activity Research Group (PROFITH), Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, 18071 Granada, Spain
| | - Manuel Dote-Montero
- EFFECTS-262 Research Group, Department of Medical Physiology, School of Medicine, University of Granada, 18016 Granada, Spain
- PROmoting FITness and Health through Physical Activity Research Group (PROFITH), Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, 18071 Granada, Spain
| | - Manuel J. Castillo
- EFFECTS-262 Research Group, Department of Medical Physiology, School of Medicine, University of Granada, 18016 Granada, Spain
| | - Francisco J. Amaro-Gahete
- EFFECTS-262 Research Group, Department of Medical Physiology, School of Medicine, University of Granada, 18016 Granada, Spain
- PROmoting FITness and Health through Physical Activity Research Group (PROFITH), Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, 18071 Granada, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Correspondence:
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Miyawaki CE, Tahija N, McClellan A, Chen NW. Feasibility Study of Caregiver-Provided Life Review: Implementation, Adaptation, and Effects on Care Recipients' Depressive Symptoms. Clin Gerontol 2022:1-12. [PMID: 36369922 DOI: 10.1080/07317115.2022.2144578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES This study aimed to examine the feasibility of unpaid, family/friend caregivers conducting life reviews with people with dementia in long-term care and community settings and reported on how we adapted the intervention modality under the COVID-19 pandemic. METHODS Twenty-one caregiver-care recipient dyads completed 6 weekly life review sessions. The intervention format was modified to accommodate COVID-19 restrictions. Primary and secondary outcome measures were analyzed based on repeated measures at baseline and post-intervention. RESULTS Due to the changing nature of the pandemic, we iterated the caregiver training intervention four times to accommodate caregivers' needs while having faced multiple recruitment challenges with care facility residents. Care recipients' depression appeared to have improved (p = .001). CONCLUSIONS Although the COVID-19 pandemic created unique recruitment challenges, all the care recipients seemed to enjoy the life review activities supported by the positive outcomes in gaining socialization opportunities. It may be beneficial to offer a more self-paced intervention modality to ease the burden on caregivers. CLINICAL IMPLICATIONS It appears that unpaid family/friend caregivers can provide life reviews to their loved ones with dementia. Training the caregivers on how to provide life reviews can be an easy, low-risk activity that might ameliorate depressive symptoms in the care recipients.
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Affiliation(s)
| | - Nina Tahija
- Graduate College of Social Work, University of Houston, Houston, Texas, USA
| | - Angela McClellan
- The Diana R. Garland School of Social Work, Baylor University, Waco, Texas, USA
| | - Nai-Wei Chen
- Beaumont Health System, Beaumont Research Institute, Royal Oak, Michigan, USA
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11
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Sanprakhon P, Chaimongkol N, Hengudomsub P. Relationships between caregiving stress and sleep quality among family caregivers of older adults with dementia in Thailand. BELITUNG NURSING JOURNAL 2022; 8:229-234. [PMID: 37547117 PMCID: PMC10401382 DOI: 10.33546/bnj.2106] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 04/28/2022] [Accepted: 05/16/2022] [Indexed: 08/08/2023] Open
Abstract
Background Providing care for older people with memory loss is a significantly stressful task. The caregiver experienced deterioration of the care recipients regarding their cognitive and functioning abilities, often resulting in the caregiver's feelings of distress, stress, and unsatisfactory sleep quality. Objective This cross-sectional study aimed to examine the relationships between caregiving stress and sleep quality among family caregivers of older adults with dementia. Methods A simple random sampling method was used to recruit participants of seventy-two family caregivers who received care from a community long-term care facility at two primary hospitals in Thailand. Research instruments included the Relative Stress Scale and the Pittsburgh Sleep Quality Index. The data were analyzed using descriptive statistics, means, standard deviation, and simple linear regression. Results The study revealed that caregivers had a high level of caregiving stress (M = 49.68, SD = 4.71), and poor sleep quality (M = 12.44, SD = 3.60). Caregiving stress was positively correlated with poor sleep quality (r = 0.54, p < 0.01) with a large relationship. Conclusion Thai family caregivers of people with dementia reported high stress level and had poor sleep quality. The findings suggest that nurses in primary health care should focus on assessing stress levels and sleep quality as well as improving sleep quality for family caregivers by developing interventions.
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Affiliation(s)
- Panawat Sanprakhon
- Faculty of Nursing, Burapha University, Chon Buri, 20131, Thailand
- Faculty of Nursing, Suan Dusit University, Bangkok, 10700, Thailand
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Johansson MF, McKee KJ, Dahlberg L, Summer Meranius M, Williams CL, Marmstål Hammar L. Negative Impact and Positive Value of Caregiving in Spouse Carers of Persons with Dementia in Sweden. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031788. [PMID: 35162811 PMCID: PMC8835239 DOI: 10.3390/ijerph19031788] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 02/01/2022] [Accepted: 02/02/2022] [Indexed: 12/04/2022]
Abstract
(1) Background: Spouse carers of persons with dementia (PwD) are particularly vulnerable to negative outcomes of care, yet research rarely focuses on their caregiving situation. This study explores factors associated with the positive value and negative impact of caregiving in spouse carers of PwD in Sweden. (2) Methods: The study was a cross-sectional questionnaire-based survey, with a convenience sample of spouse carers of PwD (n = 163). The questionnaire addressed: care situation, carer stress, health and social well-being, relationship quality and quality of support, and contained measures of positive value and negative impact of caregiving. (3) Results: Hierarchical regression models explained 63.4% variance in positive value and 63.2% variance in negative impact of caregiving. Three variables were significant in the model of positive value: mutuality, change in emotional closeness following dementia and quality of support. Six variables were significant in the model of negative impact: years in relationship, years as carer, behavioural stress, self-rated health, emotional loneliness and change in physical intimacy following dementia. (4) Conclusions: Support to spouse carers of PwD should address the carer–care-recipient relationship quality, although different aspects of the relationship should be addressed if both the positive value of caregiving is to be enhanced and the negative impact reduced.
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Affiliation(s)
- Marcus F. Johansson
- School of Health and Welfare, Dalarna University, 791 88 Falun, Sweden; (K.J.M.); (L.D.); (L.M.H.)
- Correspondence:
| | - Kevin J. McKee
- School of Health and Welfare, Dalarna University, 791 88 Falun, Sweden; (K.J.M.); (L.D.); (L.M.H.)
| | - Lena Dahlberg
- School of Health and Welfare, Dalarna University, 791 88 Falun, Sweden; (K.J.M.); (L.D.); (L.M.H.)
- Aging Research Center, Karolinska Institutet & Stockholm University, Tomtebodavägen 18A, 171 65 Solna, Sweden
| | | | - Christine L. Williams
- Christine E Lynn College of Nursing, Florida Atlantic University Boca Raton, FL 334 31, USA;
| | - Lena Marmstål Hammar
- School of Health and Welfare, Dalarna University, 791 88 Falun, Sweden; (K.J.M.); (L.D.); (L.M.H.)
- School of Health, Care and Social Welfare, Mälardalen University, 721 23 Västerås, Sweden;
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Alfred Nobels Allé 23, 141 52 Huddinge, Sweden
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