Factors influencing quality of life in African-American dementia dyads

Abstract

Objective: Both caregivers and the older adults they care for can experience declines in quality of life (QOL) over the course of the dementia trajectory. Little research has examined QOL in African-American caregivers and even less in African-American persons with dementia (PWDs), making it difficult to identify associated factors.

Method: Guided by the Negro Family as a Social System framework, a secondary data analysis was used to examine the influence of family structure, instrumental and expressive role functions on QOL in a sample of 62 African-American dementia dyads (i.e. African-American PWDs and their African-American caregivers). Dyadic data were analyzed using multilevel modeling to control for the interdependent nature of the data.

Results: On average, African-American PWDs reported significantly worse QOL than African-American caregivers. Within African-American dementia dyads, QOL covaried. African-American PWDs experienced significantly worse QOL when their caregiver was a non-spouse and they themselves perceived less involvement in decision-making. In addition, African-American caregivers experienced significantly worse QOL when they reported greater dyadic strain with the African-American PWD and were non-spouses of African-American PWDs.

Conclusion: Findings suggest understanding the interpersonal characteristics (e.g., dyadic relationship, family structure and role functions) of dyads may hold promise for improving their QOL.

Keywords:

• Multilevel modeling
• caregiver
• decision-making involvement
• dyadic strain

Acknowledgments

Partially funded through the National Institutes of Health National Institute of Nursing Research grant number [2T32NR012715] (PI: S. Dunbar( for trainee Kalisha Bonds. This content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Disclosure statement

The authors report no conflict of interest.

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

This work was supported by the Jonas Veterans Healthcare Scholarship; Oregon Health & Science University (OHSU) School of Nursing Dean’s Alumni Scholarship; OHSU School of Nursing Pierce Scholarship and SAMSHA-ANA. Funding for this manuscript was made possible (in part) by Grant Number 1H79SM080386-01. The views expressed in written training materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. government (all K.B). This work was supported by grants from The Robert Wood Johnson Foundation, The AARP Andrus Foundation, The Retirement Research Foundation, The National Institute of Aging (P50AG08012), and The National Institute of Mental Health (R01070629) (all C.J.W).