Acculturation level and caregiver outcomes from a randomized intervention trial to enhance caregivers' health: evidence from REACH II

ABSTRACT

Objective: Latinos comprise a growing segment of the caregiver population and vary widely in acculturation, yet little is known regarding how acculturation might affect caregiver stress or intervention outcomes. This study examined the relationship between acculturation and burden, bother, and depression in Latino dementia caregivers at baseline and following an intervention.

Methods: This was a secondary data analysis of 211 Latino caregivers of older adults with dementia from Resources for Enhancing Alzheimer's Caregiver Health (REACH) II, a multisite randomized trial of caregiver interventions. Baseline and follow-up data were used to run mixed-effects models examining the main and moderating effect of acculturation on caregiver stress.

Results: No significant main effect of acculturation was found for any of the outcome measures, controlling for demographic covariates. Acculturation moderated the effect of the intervention on caregiver burden: those who were more acculturated benefited more from the intervention.

Conclusion: Differential acculturation for Latino caregivers was not directly associated with caregiver burden, bother, or depression, but was associated with reducing burden from the intervention. Future research should explore by what mechanism acculturation influences caregiver burden following an intervention.

KEYWORDS:

• Caregiving
• depression
• burden
• Latino
• dementia

Acknowledgments

We are grateful to the many participants of the REACH II trial.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1. Site was another variable in REACH II, but given that it was highly correlated with country of birth (e.g. the majority of Latinos in California were from Mexico, the majority in Florida were from Cuba), we believe that country of birth as a variable would be more informative than site.

2. In addition to the acculturation proxy reported in this manuscript (years in the US), we also tested age of arrival in the US as a proxy of acculturation (arrived in the US before or at the age of 12 years old versus after 12 years old); similar results emerged.

Additional information

Funding

This research was supported in part by the National Center for Advancing Translational Sciences [UL1 TR 000002]; the National Institute on Aging [P30AG010129], [P30AG043097], [K01AG052646]; and Alzheimer's Association grant [2016-MNIRGD-391433].