Association of physical functioning of persons with dementia with caregiver burden and depression in dementia caregivers: an integrative data analysis

ABSTRACT

Objectives: To determine whether caregiver relationship and race modify associations between physical functioning of persons with dementia (PWD) and their caregiver's burden and general depressive symptoms.

Method: We pooled data from four behavioral intervention trials (N = 1,211). Using latent growth modeling, we evaluated associations of PWD physical functioning with the level and rate of change in caregiver burden and caregivers' general depressive symptoms and stratified these associations by caregiver relationship and race.

Results: PWD were, on average, 81 years old (68% female) with mean follow-up of 0.5 years. More baseline PWD physical impairment was associated with less worsening in caregiver burden over time (β = −0.23, 95% CI: −0.29, −0.14), but this relationship was not modified by caregiver characteristics. More impaired baseline PWD physical functioning was not associated with changes in depressive symptoms (β = −0.08, 95% CI: −0.17, 0.00), but was associated with less worsening in depressive symptoms among spousal (β = −0.08, 95% CI: −0.17, 0.00) and non-white (β = −0.08, 95% CI: −0.17, 0.00) caregivers.

Conclusions: Dementia caregivers may experience reduced caregiver-related burden because of adjustment to PWD functional status, while spousal and non-white caregivers may experience less depressive symptoms resultant of adjustment to functional status.

KEYWORDS:

• Physical functioning
• harmonization
• caregiver burden
• dementia
• depression

Acknowledgements

We would like to thank the participants and their caregivers from the following four behavioral intervention trials: Advancing Caregiver Training, Care of Persons with Dementia in their Environments, Resources for Enhancing Alzheimer's Caregiver Health II, and the Tailored Activity Program.

Disclosure statement

The authors report no conflicts of interest.

Additional information

Funding

This work was supported by a Pilot Award from the Johns Hopkins Center for Innovative Care in Aging, School of Nursing (PI: Gross) and T32AG000247 (Epidemiology and Biostatistics of Aging Training Program, Johns Hopkins Center on Aging and Health) (Armstrong). ACT was funded by the National Institute on Aging and the National Institute on Nursing Research [grant number R01AG22254]. COPE was funded by the Pennsylvania Department of Health and Tobacco Funds [grant number SAP#41000 272]. REACH II was funded by the National Institute on Aging and the National Institute on Nursing Research [grant number AG13305], [grant number AG13289], [grant number AG13313], [grant number AG20277], [grant number AG13265, NR004261]. TAP was funded by the National Institute of Mental Health [grant number R21MH069425]; National Institute on Nursing Research; National Institute on Aging . The contents do not necessarily represent views of the funding entities. Funders had no deciding roles in the design and conduct of the study.