Maria J Marques1, Eva Y L Tan2,3, Bob Woods4, Hannah Jelley4, Liselot Kerpershoek2, Louise Hopper5, Kate Irving6, Anja Bieber7, Astrid Stephan7, Anders Sköldunger8, Britt-Marie Sjölund8, Geir Selbaek9, Janne Røsvik9, Orazio Zanetti10, Daniel M Portolani5, João Marôco11, Marjolein de Vugt2, Frans Verhey2, Manuel Gonçalves-Pereira1. 1. Comprehensive Health Research Center (CHRC), CEDOC, Nova Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal. 2. Department of Psychiatry and Neuropsychology and Alzheimer Centre Limburg, School for Mental Health and Neurosciences, Maastricht University, Maastricht, The Netherlands. 3. Reinier van Arkel Mental Health Institute, 's-Hertogenbosch, The Netherlands. 4. Dementia Services Development Centre (DSDC) Wales, School of Health Sciences, Bangor University, Bangor, UK. 5. School of Psychology, Dublin City University, Dublin, Ireland. 6. School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland. 7. Institute for Health and Nursing Science, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany. 8. Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden. 9. Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg; Department of Geriatric Medicine, Oslo University Hospital, Faculty of Medicine, University of Oslo, Oslo, Norway. 10. Alzheimer's Research Unit-Memory Clinic, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy. 11. William James Center for Research, Instituto Superior de Psicologia Aplicada - Instituto Universitário (ISPA-IU), Lisboa, Portugal.
Abstract
OBJECTIVES: Relationship quality (RQ) between a person with dementia and a family carer may influence their health and quality of life. However, evidence regarding its course and influencing factors is limited. We aimed to explore RQ trajectories in dementia, and identify predictors of change. METHODS: We analysed longitudinal data from a cohort of 350 community-dwelling people with dementia and their informal carers, participating in the Actifcare study in eight European countries. The Positive Affect Index, rated separately by both people with dementia and their carers, assessed RQ. Other measures included the Neuropsychiatric Inventory Questionnaire (regarding persons with dementia), and the Relative Stress Scale, Sense of Coherence Scale and Lubben Social Network Scale (for carers). Trajectories and influencing factors were explored applying a latent growth model (LGM). RESULTS: RQ in the group of carers declined over 1 year, but RQ scores for the persons with dementia did not change. Higher stress in carers negatively influenced their baseline RQ ratings. Carer sense of coherence and being a spouse were associated with more positive baseline RQ carer assessments. Higher levels of neuropsychiatric symptoms were linked to decline in carers' RQ, whereas social support was associated with more positive RQ trajectories. CONCLUSION: This study provides a valuable insight into the course of RQ. LGM proved useful to explore the factors that influence RQ trajectories and variability within- and between-persons. Our findings emphasise the importance of carer-perceived social support and sense of coherence, and of reducing neuropsychiatric symptoms, in maintaining a good RQ.
OBJECTIVES: Relationship quality (RQ) between a person with dementia and a family carer may influence their health and quality of life. However, evidence regarding its course and influencing factors is limited. We aimed to explore RQ trajectories in dementia, and identify predictors of change. METHODS: We analysed longitudinal data from a cohort of 350 community-dwelling people with dementia and their informal carers, participating in the Actifcare study in eight European countries. The Positive Affect Index, rated separately by both people with dementia and their carers, assessed RQ. Other measures included the Neuropsychiatric Inventory Questionnaire (regarding persons with dementia), and the Relative Stress Scale, Sense of Coherence Scale and Lubben Social Network Scale (for carers). Trajectories and influencing factors were explored applying a latent growth model (LGM). RESULTS: RQ in the group of carers declined over 1 year, but RQ scores for the persons with dementia did not change. Higher stress in carers negatively influenced their baseline RQ ratings. Carer sense of coherence and being a spouse were associated with more positive baseline RQ carer assessments. Higher levels of neuropsychiatric symptoms were linked to decline in carers' RQ, whereas social support was associated with more positive RQ trajectories. CONCLUSION: This study provides a valuable insight into the course of RQ. LGM proved useful to explore the factors that influence RQ trajectories and variability within- and between-persons. Our findings emphasise the importance of carer-perceived social support and sense of coherence, and of reducing neuropsychiatric symptoms, in maintaining a good RQ.
Entities:
Keywords:
Alzheimer’s disease; Sense of Coherence; family caregivers; longitudinal studies; neuropsychiatric symptoms; social support
Authors: Charlotte T M van Corven; Annemiek Bielderman; Peter L B J Lucassen; Hilde Verbeek; Ivonne Lesman-Leegte; Marja F I A Depla; Annerieke Stoop; Maud J L Graff; Debby L Gerritsen Journal: BMC Geriatr Date: 2022-03-16 Impact factor: 3.921