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Daily stressful experiences, depressive symptoms, and behavioral responses of ADRD family caregivers
Author(s) -
Puga Frank,
Wang Danny,
Pickering Carolyn E
Publication year - 2020
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1002/alz.044050
Subject(s) - stressor , mental health , depression (economics) , activities of daily living , social support , dementia , clinical psychology , psychology , coping (psychology) , odds , neglect , psychiatry , medicine , disease , gerontology , logistic regression , economics , macroeconomics , pathology , psychotherapist
Background Family caregivers of individuals living with Alzheimer’s disease or related dementias (ADRDs) are at a higher risk for serious mental illness, specifically depression. Caring for individuals living with ADRDs can be stressful due to the behavioral symptoms of dementia (BSD). Over time, stressors, such as BSDs, can contribute to the onset of depressive symptoms. Few studies have examined BSDs as contextual triggers contributing to variations in daily mental health symptom experiences of caregivers. Further, it is unclear how behavioral adaptations to caregiving‐specific stressors, such as engaging in elder abuse and neglect (EAN), impact caregiver mental health. In this study, we identified specific individual vulnerabilities, daily environmental stressors, and caregiver behaviors that increase the daily odds of experiencing depressive symptoms. Method Using a micro‐longitudinal design and ecological momentary assessment methods, we examined daily environmental stressors (BSDs), caregiver behaviors (i.e., EAN events), and individual vulnerabilities (i.e., demographics, early life adversity, social isolation, social support, and coping strategies) that impact daily odds of experiencing depressive symptoms. Data were collected from a national sample of family caregivers (N=50) who completed daily diaries over a 21‐day period (n=841). Multi‐level modeling was used to test a series of hypotheses on the relationship between daily environmental stressors, caregiver behaviors, individual vulnerabilities, and depression symptom experiences. Result Family caregivers were more likely to report depressive symptoms on a given day when a BSD was present and perceived as bothersome (OR = 1.22, 95% CI: 1.09‐1.43, p = 0.002). Additionally, when an EAN event occurred on a given day, caregivers were more likely to report depressive symptoms (OR = 1.27, 95% CI: 1.02‐1.58, p = 0.034) . Individual‐level factors also interacted with BSD, EAN events, and daily depressive symptoms. Conclusion The results from this study help elucidate factors that contribute to variations in the daily mental health symptom experiences of ADRD caregivers. The interactions between BSDs, EAN events, and depression identified in this study will inform interventions to better support family caregivers and improve mental health outcomes for an at‐risk population.