Cognitive functioning among cognitively intact dementia caregivers compared to matched self-selected and population controls

ABSTRACT

Purpose of the study: Caregiving for a person with dementia is frequently used to model the impact of chronic stress on health, including cognitive functioning. However, the prevalence of typically healthier, self-selecting non-caregiving control groups could contribute to a picture of poorer caregiver performance and overstate the negative effects of stress. We investigated differences in cognitive performance between dementia caregivers and two groups of non-caregivers recruited using different sampling methods.

Design and methods: We compared cognitive function and psychological wellbeing among 252 spousal dementia caregivers with demographically matched non-caregiving control groups drawn from (1) a population study and (2) a self-selecting sample. Comparable cognitive measures included immediate and delayed recall, processing speed reaction time and verbal fluency.

Results: Caregiver and non-caregiver performance was comparable on most cognitive domains. However, caregivers outperformed both control groups on processing speed (p ≤ .05) and reaction time (p ≤ .05), despite having higher levels of stress and depression (ps < .001). Furthermore, caregivers had significantly better free recall than self-selecting controls (p < .001).

Implications: Our results, overall, do not support the idea that caregiving is associated with stress-induced cognitive deficits. Rather, the trend toward better caregiver performance is consistent with the healthy caregiver hypothesis.

KEYWORDS:

• Cognition
• caregiving
• stress
• Alzheimer's
• sampling
• matching

Acknowledgments

The authors would like to thank Alan Galvin, Jennifer Rogers and Katie O'Donnell who collected the data for this study.

Researchers interested in using TILDA data may access the data for free from the following sites: Irish Social Science Data Archive (ISSDA) at University College Dublin http://www.ucd.ie/issda/data/tilda/; Interuniversity Consortium for Political and Social Research (ICPSR) at the University of Michigan http://www.icpsr.umich.edu/icpsrweb/ICPSR/studies/34315.

This work was carried out in the NEIL (NeuroEnhancement for Independent Lives) programme in the Trinity College Institute of Neuroscience, Dublin.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

Trinity College Institute of Neuroscience, Dublin; The NEIL programme is funded by The Atlantic Philanthropies; Dr Maria Pertl and Dr Michael O'Sullivan are funded by the Alzheimer Society of Ireland and the Health Research Board under the Medical Charities Research Scheme; Dr Caoimhe Hannigan is supported by an Irish Research Council Postgraduate Scholarship.