Quality of relationships as a predictor of psychosocial functioning in patients with dementia.

This prospective cohort study evaluated the quality of caregiver and care-recipient relationship, or mutuality, and its relationship to psychosocial functioning among patients with dementia. Patients older than 59 years of age with newly diagnosed dementia between 2001 and 2004 were identified from the Michael E. DeBakey Veterans Affairs Medical Center in Houston, Texas. Among these patients, we identified patients who were under the care of a caregiver in the community setting for at least 8 hours per week. A Mutuality Scale was used to measure the quality of relationships between family caregivers and care recipients. The effect of relationship quality on the following dependent variables was assessed: depression, psychosis, pain, caregiver burden, social stimulation, and aggression. Based on the sample of 171 patients, high mutuality scores predicted decreased patient depression and caregiver burden. Increased mutuality scores also correlated with increased number and frequency of pleasant events (social stimulation) 4 months later. There was no relationship between total mutuality scores and patients' pain levels, psychotic symptoms, or aggression. Improvement in mutuality over 4-month periods was associated with increased social stimulation, decreased caregiver burden, and decreased aggression over time.