Center on Aging and Health, Division of Geriatric Medicine and Gerontology, Johns Hopkins University, Baltimore, Maryland.
School of Aging Studies, University of South Florida, Tampa.
Gerontologist. 2021 Jul 13;61(5):670-679. doi: 10.1093/geront/gnaa108.
Few population-based studies have directly compared caregivers of persons with dementia to caregivers of persons with other disabilities (nondementia caregivers). We enrolled dementia and nondementia caregivers who were providing substantial and sustained care and compared these groups on measures of caregiver stressors, appraisals of burden, and well-being.
Caregivers (N = 251) who provided continuous care for at least 1 year and at least 5 h per week were recruited from the population-based REasons for Geographic And Racial Differences in Stroke (REGARDS) study. Caregivers reported on dementia caregiving status, stressors, burden, and well-being.
Forty-seven percent (n = 117) reported caring for a person with dementia. Dementia caregivers reported more stressors, providing more care for self-care and behavioral problems than nondementia caregivers. Dementia caregivers also reported higher appraisals of stress and burden, and more depressive symptoms, but did not differ from nondementia caregivers on mental and physical health quality of life. In multivariable-adjusted models, adjustment for the total number of care recipient problems attenuated differences between dementia and nondementia caregivers on burden and depression measures.
Dementia and nondementia caregivers showed relatively few differences in indicators of overall well-being in this population-based sample, perhaps because both groups of caregivers in this study were providing substantial care. Dementia caregivers may require special assistance with dementia-specific problems such as behavioral problems. Clinical interventions and policy changes targeting highly burdened caregivers are needed to support them in allowing their care recipients to age in place at home.
仅有少数基于人群的研究直接比较了痴呆症患者的照顾者和其他残疾(非痴呆症)患者的照顾者。我们招募了提供大量持续护理的痴呆症和非痴呆症照顾者,并在照顾者压力源、负担评估和幸福感方面对这些群体进行了比较。
从基于人群的 REasons for Geographic And Racial Differences in Stroke(REGARDS)研究中招募了为至少 1 名被照顾者提供持续护理至少 1 年且每周至少 5 小时的照顾者。照顾者报告了痴呆症照顾者的状况、压力源、负担和幸福感。
47%(n=117)报告照顾痴呆症患者。与非痴呆症照顾者相比,痴呆症照顾者报告了更多的压力源,为自理和行为问题提供了更多的照顾。痴呆症照顾者还报告了更高的压力和负担评估以及更多的抑郁症状,但在心理健康和身体健康生活质量方面与非痴呆症照顾者没有差异。在多变量调整模型中,调整照顾受助人问题的总数后,减轻了痴呆症和非痴呆症照顾者在负担和抑郁测量方面的差异。
在这个基于人群的样本中,痴呆症和非痴呆症照顾者在整体幸福感的指标上相对较少差异,这可能是因为研究中的两组照顾者都在提供大量的护理。痴呆症照顾者可能需要特别帮助处理与痴呆症相关的问题,如行为问题。需要针对负担过重的照顾者的临床干预和政策改变,以支持他们让其被照顾者在家中安享晚年。