Does expressed emotion in spouses predict subsequent problems among care recipients with Alzheimer's disease?

Researchers have observed that Expressed Emotion (i.e., criticism; EE) in caregivers is predictive of poorer functioning in psychiatric care recipients over time. Few studies have examined, however, whether EE has predictive validity for the decline of care recipients with a clearly defined organic illness such as Alzheimer's disease. This study evaluated whether Alzheimer's disease care recipient problems [in cognition, activities of daily living (ADLs), and negative behaviors] were predicted longitudinally by caregiver EE. As hypothesized, caregiver EE was not predictive of care recipient cognitive or ADL decline; however, data suggested that EE was predictive of increased negative behaviors over time. The specific predictions of negative care recipient behaviors, and not care recipient cognitive/ADL decline, suggest that the former outcomes may be determined by environmental factors as well as the organicity of the disease. These data may be important because researchers have reported that caregivers are more distressed by negative care recipient behaviors than by care recipient cognitive/ADL decline.