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Caregiver personality predicts rate of cognitive decline in a community sample of persons with Alzheimer's disease. The Cache County Dementia Progression Study

Published online by Cambridge University Press:  05 July 2013

Maria C. Norton ,
Christine Clark ,
Elizabeth B. Fauth ,
Kathleen W. Piercy ,
Roxane Pfister ,
Robert C. Green ,
Christopher D. Corcoran ,
Peter V. Rabins ,
Constantine G. Lyketsos  and
JoAnn T. Tschanz
Maria C. Norton*
Affiliation:
Department of Family Consumer and Human Development, Utah State University, Logan, Utah, USA Department of Psychology, Utah State University, Logan, Utah, USA
Christine Clark
Affiliation:
Department of Family Consumer and Human Development, Utah State University, Logan, Utah, USA
Elizabeth B. Fauth
Affiliation:
Department of Family Consumer and Human Development, Utah State University, Logan, Utah, USA
Kathleen W. Piercy
Affiliation:
Department of Family Consumer and Human Development, Utah State University, Logan, Utah, USA
Roxane Pfister
Affiliation:
Department of Family Consumer and Human Development, Utah State University, Logan, Utah, USA
Robert C. Green
Affiliation:
Division of Genetics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
Christopher D. Corcoran
Affiliation:
Department of Mathematics and Statistics, Utah State University, Logan, Utah, USA
Peter V. Rabins
Affiliation:
Department of Psychiatry and Behavioral Sciences, Division of Geriatric Psychiatry and Neuropsychiatry, Johns Hopkins Bayview Medical Center and Johns Hopkins School of Medicine, Baltimore, Maryland, USA Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
Constantine G. Lyketsos
Affiliation:
Department of Psychiatry and Behavioral Sciences, Division of Geriatric Psychiatry and Neuropsychiatry, Johns Hopkins Bayview Medical Center and Johns Hopkins School of Medicine, Baltimore, Maryland, USA Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
JoAnn T. Tschanz
Affiliation:
Department of Psychology, Utah State University, Logan, Utah, USA
*
Correspondence should be addressed to: Dr. Maria C. Norton, Department of Family Consumer and Human Development, Utah State University, 2905 Old Main Hill, Logan, UT 84322-2905, USA. Phone: (435) 797-1599; Fax: (435) 797-3845. Email: [email protected].
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Abstract

Background:

Environmental influences on the rate of Alzheimer's disease (AD) progression have received little attention. Our objective was to test hypotheses concerning associations between caregiver personality traits and the rate of AD progression.

Methods:

Care receivers (CR) were 161 persons with AD from a population-based dementia progression study; 55 of their caregivers were spouses and 106 were adult children. Cognitive status of the CR was measured with the Mini-Mental State Examination every six months, over an average of 5.6 (range: 1–14) years. Linear mixed models tested rate of cognitive decline as a function of caregiver personality traits from the NEO Five-Factor Inventory.

Results:

Significantly faster cognitive decline was observed with higher caregiver Neuroticism overall; however, in stratified models, effects were significant for adult child but not spouse caregivers. Neuroticism facets of depression, anxiety, and vulnerability to stress were significantly associated with faster decline. Higher caregiver Extraversion was associated with slower decline in the CR when caregivers were adult children but not spouses.

Conclusions:

For adult child caregivers, caregiver personality traits are associated with rate of cognitive decline in CRs with AD regardless of co-residency. Results suggest that dementia caregiver interventions promoting positive care management strategies and ways to react to caregiving challenges may eventually become an important complement to pharmacologic and other approaches aimed at slower rate of decline in dementia.

Keywords

caregiverpersonalitydementiacognitivedecline
Type
Research Article
Information
International Psychogeriatrics , Volume 25 , Issue 10 , October 2013 , pp. 1629 - 1637
Copyright
Copyright © International Psychogeriatric Association 2013 

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References

Ablitt, A., Jones, G. and Muers, J. (2010). Awareness of carer distress in people with dementia. International Journal of Geriatric Psychiatry, 25, 1246–1252. doi:10.1002/gps.2461.CrossRefGoogle ScholarPubMed
Alzheimer's Association (2012). 2012 Alzheimer's disease facts and figures. Available at: http://www.alz.org/downloads/facts_figures_2012.pdf; last accessed 25 June 2013.Google Scholar
Behl, P., Stefurak, T. L. and Black, S. E. (2005). Progress in clinical neurosciences: cognitive markers of progression in Alzheimer's disease. Canadian Journal of Neurological Sciences, 32, 140–151.CrossRefGoogle ScholarPubMed
Bookwala, J. and Schulz, R. (1998). The role of neuroticism and mastery in spouse caregivers’ assessment of and response to a contextual stressor. Journals of Gerontology: Psychological Sciences and Social Sciences, 53, P155–164. doi:10.1093/geronb/53B.3.P155.CrossRefGoogle ScholarPubMed
Breitner, J. C. S.et al. (1999). APOE-epsilon4 count predicts age when prevalence of AD increases, then declines: the Cache County Study. Neurology, 53, 321–331. doi:10.1212/WNL.53.2.321.CrossRefGoogle ScholarPubMed
Chappell, N. L. and Dujela, C. (2009). Caregivers – who copes how? International Journal of Aging and Human Development, 69, 221–244. doi:10.2190/AG.69.3.d.CrossRefGoogle Scholar
Costa, P. T. and McCrae, R. R. (1992). Professional Manual: Revised NEO Five-Factor Inventory. Lutz, FL: Psychological Assessment Resources.Google Scholar
de Vugt, M. E.et al. (2004). Do caregiver management strategies influence patient behavior in dementia? International Journal of Geriatric Psychiatry, 19, 85–92. doi:10.1002/gps.1044.CrossRefGoogle ScholarPubMed
Hooker, K., Frazier, L. D. and Monahan, D. J. (1994). Personality and coping among caregivers of spouses with dementia. Gerontologist, 34, 386–392. doi:10.1093/geront/34.3.386.CrossRefGoogle ScholarPubMed
Jang, Y., Clay, O. J., Roth, D. L, Haley, W. E. and Mittelman, M. S. (2004). Neuroticism and longitudinal change in caregiver depression: impact of a spouse-caregiver intervention program. Gerontologist, 44, 311–317. doi:10.1093/geront/44.3.311.CrossRefGoogle ScholarPubMed
Kitwood, T. (1993). Toward a theory of dementia care: the interpersonal process. Ageing and Society, 13, 51–67. doi:org/10.1017/S0144686X00000647.CrossRefGoogle Scholar
Koerner, S. S., Kenyon, D. B. and Shirai, Y. (2009). Caregiving for elder relatives: which caregivers experience personal benefits/gains? Archives of Gerontology and Geriatrics, 48, 238–245. doi:10.1016/j.archger.2008.01.015.CrossRefGoogle ScholarPubMed
Melo, G., Maroco, J. and de Mendonca, A. (2011). Influence of personality on caregiver's burden, depression and distress related to the BPSD. International Journal of Geriatric Psychiatry, 26, 1275–1282. doi:10.1002/gps.2677.CrossRefGoogle Scholar
Morris, J. C.et al. (1993). The consortium to establish a registry for Alzheimer's disease (CERAD). Part IV. Rates of cognitive change in the longitudinal assessment of probable Alzheimer’ s disease. Neurology, 43, 2457–2465. doi:10.1212/WNL.43.12.2457.CrossRefGoogle Scholar
Norton, M. C.et al. (2009). Caregiver–recipient closeness and symptom progression in Alzheimer disease. The Cache County Dementia Progression Study. Journal of Gerontology: Psychological Sciences, 64B, 560–568. doi:10.1093/geronb/gbp052.CrossRefGoogle Scholar
Pot, A. M., Deeg, D. J. H. and Knipscheer, C. P. M. (2001). Institutionalization of demented elderly: the role of caregiver characteristics. International Journal of Geriatric Psychiatry, 16, 273–280. doi:10.1002/gps.331.CrossRefGoogle ScholarPubMed
Rabins, P. V., Fitting, M. D., Eastham, J. and Fetting, J. (1990). The emotional impact of caring for the chronically ill. Psychosomatic Medicine, 31, 331–336. doi:10.1016/S0033-3182(90)72171-8.CrossRefGoogle ScholarPubMed
Rapp, M.et al. (2011). Cognitive decline in patients with dementia as a function of depression. American Journal of Geriatric Psychiatry, 19, 357–363. doi:10.1097/JGP.0b013e3181e898d0.CrossRefGoogle ScholarPubMed
Reis, M. F., Gold, D. P., Andres, D., Markiewicz, D. and Gauthier, S. (1994). Personality traits as determinants of burden and health complaints in caregiving. International Journal of Aging and Human Development, 39, 257–271. doi:10.2190/6LYN-YFWQ-P87D-MKWX.CrossRefGoogle ScholarPubMed
Roberts, B. W. and DelVecchio, W. F. (2000). The rank-order consistency of personality traits from childhood to old age: a quantitative review of longitudinal studies. Psychological Bulletin, 126, 3–25. doi:10.1037/0033-2909.126.1.3.CrossRefGoogle ScholarPubMed
Ruiz, J. M., Matthews, K. A., Scheier, M. G. and Schulz, R. (2006). Does who you marry matter for your health? Influence of patients’ and spouses’ personality on their partners’ psychological well-being following coronary artery bypass surgery. Journal of Personality and Social Psychology, 91, 255–267. doi:10.1037/0022-3514.91.2.255.CrossRefGoogle ScholarPubMed
Scarmeas, N.et al. (2005). Delusions and hallucinations are associated with worse outcome in Alzheimer disease. Archives of Neurology, 62, 1601–1608. doi:10.1001/archneur.62.10.1601.CrossRefGoogle ScholarPubMed
Schulz, R. and Beach, S. R. (1999). Caregiving as a risk factor for mortality: the caregiver health effects study. JAMA, 282, 2215–2219. doi:10.1001/jama.282.23.2215.CrossRefGoogle ScholarPubMed
Shurgot, G. R. and Knight, B. G. (2005). Influence of neuroticism, ethnicity, familism, and social support on perceived burden in dementia caregivers: pilot test of the transactional stress and social support model. Journal of Gerontology: Psychological Sciences, 60, S331–334. doi:10.1093/geronb/60.6.P331.CrossRefGoogle ScholarPubMed
Teri, L., Logsdon, R. G., Uomoto, J. and McCurry, S. (1997). Behavioral treatment of depression in dementia patients: a controlled clinical trial. Journals of Gerontology: Psychological Sciences and Social Sciences, 52, P159–P166. doi:10.1093/geronb/52B.4.P159.CrossRefGoogle ScholarPubMed
Teri, L., McCurry, S. M., Edland, S. D., Kukull, W. A. and Larson, E. B. (1995). Cognitive decline in Alzheimer's disease: a longitudinal investigation of risk factors for accelerated decline. Journals of Gerontology: Biological Sciences and Medical Sciences, 50A, M49–55. doi:10.1093/gerona/50A.1.M49.Google ScholarPubMed
Treiber, K. A.et al. (2011). Cognitive stimulation and cognitive and functional decline in Alzheimer's disease: the Cache County Dementia Progression Study. Journals of Gerontology: Psychological Sciences and Social Sciences, 66, 416–425. doi:10.1093/geronb/gbr023.CrossRefGoogle ScholarPubMed
Tschanz, J. T.et al. (2011). Progression of cognitive, functional and neuropsychiatric symptom domains in a population cohort with Alzheimer's dementia. The Cache County Dementia Progression Study. American Journal of Geriatric Psychiatry, 19, 532–542. doi:10.1097/JGP.0b013e3181faec23.CrossRefGoogle Scholar
Tschanz, J. T.et al. (2013). Caregiver coping strategies predict rate of cognitive and functional decline in dementia. The Cache County Dementia Progression Study. American Journal of Geriatric Psychiatry, 21, 57–66. doi:10.1016/j.jagp.2012.10.005.CrossRefGoogle Scholar
Viatonou, S.et al. (2009). Predictors of rapid cognitive decline among demented subjects aged 75 or more: (“Sujet Age´ Fragile–Evaluation et Suivi” Cohort – SAFES). International Journal of Geriatric Psychiatry, 24, 709–715. doi:10.1002/gps.2183.CrossRefGoogle ScholarPubMed