Dementia caregivers’ coping strategies and their relationship to health and well-being: the Cache County Study

Abstract

Objectives: Prior research identifies that psychological outcomes among dementia caregivers are associated with their use of coping strategies. Few studies have tested the association of coping and health longitudinally.

Method: This study examined factors associated with the use of coping strategies over time and their associations with physical and mental health outcomes in a population-based sample of 226 dementia caregivers in Cache County, Utah, USA. Caregivers annually completed the Ways of Coping Checklist-Revised, the Beck Anxiety Inventory, and a health interview. Care-recipient cognitive and functional abilities were obtained using the Mini-Mental State Exam and the Clinical Dementia Rating. Neuropsychiatric symptoms were assessed using the Neuropsychiatric Inventory.

Results: Caregivers most frequently identified providing care as a problem (37.6%). Linear mixed models of caregiver coping strategies found that the use of most strategies were stable except for increasing Avoidance among adult child caregivers (β = 0.14, p = 0.048). On average, increased Wishful Thinking (β = 2.48, p < 0.001) or Blames Self (β = 1.06, p = 0.002) was associated with higher anxiety scores. Increased use of Blames Others among males (interaction, β = 0.28, p = 0.02) and greater use of Wishful Thinking among younger caregivers (interaction, β = −0.01, p = 0.01) were associated with more caregiver health conditions. Coping strategies were not associated with change in anxiety or health conditions over time.

Conclusion: Our results emphasize the importance of caregiver coping strategies on caregiver health and well-being and may identify subgroups of persons at risk for worse outcomes.

Keywords:

• dementia
• caregiver coping
• problem-focused coping
• dementia caregiving
• caregiver medical conditions
• caregiver psychological outcomes

Acknowledgements

The authors are indebted to Dr Ronald Munger for his unqualified support of the DPS. We also acknowledge the contributions of the following individuals whose activities have helped to ensure the success of the project: John C.S. Breitner, MD, MPH; Cara Brewer, BA; Tony Calvert, RN, BA; Michelle Carlson, PhD; Kimberly Graham, BA; Robert C. Green, MD, MPH; Hochang Ben Lee, MD; Jeanne-Marie Leoutsakos, PhD; Carol Leslie, MS; Lawrence S. Mayer, PhD; Michelle M. Mielke, PhD; Chiadi U. Onyike, MD; Roxane Pfister, MS; Georgiann Sanborn, MS; Nancy Sassano, PhD; Sarah Schwartz, MS; Ingmar Skoog, MD; Martin Steinberg, MD; Katherine Treiber, PhD; Yorghos Tripodis, PhD; Kathleen A. Welsh-Bohmer, PhD; Heidi Wengreen, PhD, RD; James Wyatt, and Peter P. Zandi, PhD, MPH. Finally, we thank the participants and their families for their participation and support.

Additional information

Funding

This project was supported by the NIA [grant numbers R01AG21136 and R01AG11380].