Cognitive performance, burden and stress in aged caregivers of older adults with and without cognitive impairment

There is an increasing number of aged people who provide care for other older people. Commonly existing burden and stress can change the forms of cognitive performance depending on the context of the aged caregivers.

Objective

To compare the cognitive performance, burden and stress of aged caregivers of older adults with and without signs of cognitive impairment.

Methods

A cross-sectional and quantitative study conducted with 205 aged caregivers of older adults with signs of cognitive impairment and 113 aged caregivers of older adults without signs of cognitive impairment treated in Primary Health Care. They were evaluated for sociodemographic characteristics, cognition, burden, and stress. Descriptive (Kolmogorov-Smirnov test) and comparative (Student's t-test and Pearson's χ² test) analyses were performed.

Results

Aged caregivers of older adults with signs of cognitive impairment were older, had lower schooling levels, and a higher percentage of daily care hours compared to the aged caregivers of older adults without signs of cognitive impairment. Regarding cognitive performance, the means were lower for all domains. In addition, this same group had higher scores, with a statistically significant difference for perceived stress and burden.

Conclusion

Aged caregivers of older adults with signs of cognitive impairment showed lower cognitive performance, as well as higher burden and stress levels. These findings guide the planning of interventions with aged caregivers in the Primary Health Care.

Sociodemographic, clinical, and psychosocial factors associated with burden in older caregivers: a cross-sectional study

The task of caring can negatively affect the physical and mental health; therefore, it is important to understand which factors are associated with burden in older caregivers of older adults.

Objective

This study aimed to explore sociodemographic, clinical, and psychosocial factors associated with burden in older caregivers of older adults.

Methods

This is a cross-sectional study developed with 349 older caregivers who were registered at a Family Health Unit of a city in the state of São Paulo, Brazil. Household interviews were conducted and data were collected on the sociodemographic (profile, family income), clinical (self-reported pain, sleep, frailty), and psychosocial (burden, family functioning, depressive symptoms, stress) characteristics of the caregivers as well as dependence on activities of daily living and cognition in the care recipients.

Results

Women predominated in the sample (76.5%) and mean age was 69.5 years. The mean burden score was 18.06 points, with 47.9% above the cutoff of 16 points, denoting excessive burden. The bivariate model revealed associations between burden and financial insufficiency, family dysfunction, difficulty sleeping, pain, perceived stress, depressive symptoms, frailty, and multimorbidity among the caregivers as well as worse functional and cognitive performance in the care recipients. The controlled model revealed an association between burden and depressive symptoms (β=16.75; 95%CI 1.80-31.68).

Conclusions

We identified an association between burden and depressive symptoms, underscoring the need for the planning and implementation of specific actions directed at caregivers in order to minimize the impact on health and to improve the quality of life.

The association between language and recognition of facial emotional expressions in elderly individuals

PURPOSE

To check the association between a good performance of language and the recognition of facial emotional expressions in elderly individuals.

METHODS

Transversal study performed with 118 elderly individuals from the primary care services of health of a city in the state of São Paulo. Sociodemographic data were collected, regarding the performance of language through the domain of Addenbrooke Cognitive Examination - Revised and Recognition of Facial Emotional Expressions. The sample was divided in thirds according to the performance of language: T1 = the best, T2 = average, and T3 = the worst. The groups T1xT3 were compared regarding the performance of recognition of facial expressions of anger, disgust, fear, happiness, sadness, and surprise, and for the intensities of 40%, 60%, 80%, and 100%. The association of independent variables over the performance of language was analyzed through logistic regression. The multivariate model was built from the results of the univariate analyses and has included the continuous variables by emotion and by intensity. Age and schooling associated to the performance of language in the univariate model were included in the multivariate model in order to adjust association analyses.

RESULTS

The sample was mainly female (84.7%), with an average age of 70.5 years old, and 3.5 schooling years. The variables associated to the best performance of language in comparative analysis of T1 and T3 were: surprise (OR = 1.485, IC 95% 1.194 - 1.846), and disgust (OR = 1.143, IC 95% 1.005 - 1.300).

CONCLUSION

The recognition of facial emotional expressions of surprise and disgust were shown as important factors associated to the good performance of language.

The association between language and recognition of facial emotional expressions in elderly individuals

ABSTRACT Purpose To check the association between a good performance of language and the recognition of facial emotional expressions in elderly individuals. Methods Transversal study performed with 118 elderly individuals from the primary care services of health of a city in the state of São Paulo. Sociodemographic data were collected, regarding the performance of language through the domain of Addenbrooke Cognitive Examination – Revised and Recognition of Facial Emotional Expressions. The sample was divided in thirds according to the performance of language: T1 = the best, T2 = average, and T3 = the worst. The groups T1xT3 were compared regarding the performance of recognition of facial expressions of anger, disgust, fear, happiness, sadness, and surprise, and for the intensities of 40%, 60%, 80%, and 100%. The association of independent variables over the performance of language was analyzed through logistic regression. The multivariate model was built from the results of the univariate analyses and has included the continuous variables by emotion and by intensity. Age and schooling associated to the performance of language in the univariate model were included in the multivariate model in order to adjust association analyses. Results The sample was mainly female (84.7%), with an average age of 70.5 years old, and 3.5 schooling years. The variables associated to the best performance of language in comparative analysis of T1 and T3 were: surprise (OR = 1.485, IC 95% 1.194 – 1.846), and disgust (OR = 1.143, IC 95% 1.005 – 1.300). Conclusion The recognition of facial emotional expressions of surprise and disgust were shown as important factors associated to the good performance of language.

Accumulated cognitive impairment, frailty, burden, and perceived stress and the risk of hospitalization and mortality in older caregivers

Combination of cognitive impairment, frailty, perceived stress, and excessive burden poses a risk to the health of caregivers.

Neuropsychiatric Symptoms in Behavioral Variant Frontotemporal Dementia and Alzheimer's Disease: A 12-Month Follow-Up Study

Introduction: Neuropsychiatric symptoms in patients with frontotemporal dementia (FTD) are highly prevalent and may complicate clinical managements.

Objective: To test whether the Neuropsychiatry Inventory (NPI) could detect change in neuropsychiatric symptoms and caregiver's distress in patients diagnosed with behavioral variant frontotemporal dementia (bvFTD) and Alzheimer's disease (AD) from baseline to a 12-month follow-up and to investigate possible predictors of change in NPI scores.

Methods: The sample consisted of 31 patients diagnosed with bvFTD and 28 patients with AD and their caregivers. The Mini-Mental State Examination (MMSE), Addenbrooke's Cognitive Examination Revised (ACE-R), the INECO Frontal Screening (IFS), the Frontal Assessment Battery (FAB), the Executive Interview (EXIT-25) and the NPI were applied. Descriptive statistics, Mann-Whitney U test, Wilcoxon test, Chi square (χ²) test and Linear Regression Analysis were used.

Results: NPI total and caregiver distress scores were statistically higher among bvFTD patients at both assessment points. MMSE, ACE-R scores significantly declined and NPI Total and Distress scores significantly increased in both groups. In the bvFTD group, age was the only independent predictor variable for the NPI total score at follow up. In the AD group, ACE-R and EXIT-25, conjunctively, were associated with the NPI total score at follow up.

Conclusions: In 12 months, cognition declined and neuropsychiatric symptoms increased in bvFTD and AD groups. In the AD group only, cognitive impairment was a significant predictor of change in neuropsychiatric symptoms.

Demographics and stress as risk factors associated with mortality in older adults who provide daily support and who receive daily support

ABSTRACT Objective: Despite the greater vulnerability of care providers, the literature shows that their mortality rate is considerably lower compared to care recipients. The aim of the present study was to analyze the mortality rates of community-dwelling older adults who provided support in activities of daily living (ADL) (group PC) and older adults who received in activities of daily living (group RC) in a four-year period considering the effects of age, sex and schooling in both groups and stress in in group PC. Methods: 261 older adults PC and 279 older adults RC participated in the study. In 2014, we collected data on demographic characteristics and functioning. In 2018, the participants were contacted a second time and information on deaths was obtained. The mortality rate was calculated for each group. Results: Death cases in four years were considerably higher among the group who were receiving support. The mortality rate was 12.6% in the PC group and 31.2% in the RC group. In deceased PC, 69% presented with high-perceived stress in baseline. About half of the PC were independent, whereas the RC group exhibited some functional dependence in 2014. There was no association between risk factors in the group PC, however the female sex was marginally associated with the risk of mortality among the RC (HR: 1.7 [95% CI: 0.9-3.0]). Conclusion: Some demographic characteristics have been considered risk factors for the mortality of the old age population, however these were not confirmed in this study among the older adults who provided and received care.

Association between perceived social support and better cognitive performance among caregivers and non-caregivers

OBJECTIVE

to identify the association between the characteristics of the support network and cognitive performance of older caregivers and compare characteristics between caregivers and non-caregivers.

METHODS

we evaluated 85 older caregivers and 84 older non-caregivers registered with primary care units regarding sociodemographic characteristics, cognition, and social support. Multiple linear regression analysis was performed.

RESULTS

among non-caregivers, significant associations were found between a better cognitive performance and receiving emotional/affectionate support; each one-point increase in the emotional support score and affectionate support score was related to a 0.43-point and 0.39-point increase in cognitive assessment, respectively. Among older caregivers, each one-point increase in the emotional support score was related to a 0.55-point increase in cognitive assessment.

CONCLUSION

strengthening the support networks of older caregivers and encouraging satisfactory exchanges of social support can assist in improving cognitive performance, which can have a positive impact on caregivers' health.

Social and health-related predictors of family function in older spousal caregivers: a cross-sectional study

Given the benefits of adequate family function for the health and well-being of older adults, it is important to understand what factors predict adequate family function in older people who care for their spouses.

Comparison of cognitive performance and aspects of the care context in elderly caregivers in Brazil: A follow-up study

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.