Refining caregiver vulnerability for clinical practice: determinants of self-rated health in spousal dementia caregivers
Abstract Background Caregivers of a family member with a chronic disability or illness such as dementia are at increased risk for chronic disease. There are many factors that contribute to dementia caregiver vulnerability and these factors can be challenging to assess in clinical settings. Self-rate...
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| Format: | Article |
| Language: | English |
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BMC
2019-01-01
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| Series: | BMC Geriatrics |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12877-019-1033-2 |
| _version_ | 1819038112362266624 |
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| author | Roland von Känel Brent T. Mausbach Joel E. Dimsdale Michael G. Ziegler Paul J. Mills Matthew A. Allison Thomas L. Patterson Sonia Ancoli-Israel Igor Grant |
| author_facet | Roland von Känel Brent T. Mausbach Joel E. Dimsdale Michael G. Ziegler Paul J. Mills Matthew A. Allison Thomas L. Patterson Sonia Ancoli-Israel Igor Grant |
| author_sort | Roland von Känel |
| collection | DOAJ |
| description | Abstract Background Caregivers of a family member with a chronic disability or illness such as dementia are at increased risk for chronic disease. There are many factors that contribute to dementia caregiver vulnerability and these factors can be challenging to assess in clinical settings. Self-rated health (SRH) is an independent measure of survival and physical health in the elderly. As an inclusive measure of health, SRH has been proposed as a reliable way to assess a patient’s general health in primary care. Therefore, we sought to identify determinants of poor/fair SRH versus categories of at least good SRH in informal caregivers. Methods In a cross-sectional study, we examined 134 elderly (≥55 years) providing in-home care for a spouse with dementia who rated their own health with a single-item question: “In general, would you say your health is excellent, very good, good, fair or poor?”. In a multivariable model, we compared caregivers with poor/fair SRH to those with good, very good, or excellent SRH on demographics, health characteristics (health behaviors, physical health indicators, psychosocial factors) and caregiving-specific stress (a composite index/total of four caregiving-specific stressors: years of caregiving, dementia severity, care recipient functional impairment and perceived caregiver burden). Results Compared with caregivers who rated their own health as either good (31.3%), very good (38.8%) or excellent (14.2%), caregivers with poor/fair SRH (15.7%) were more likely to have lower physical function and total greater caregiving-specific stress. More years of caregiving, severe dementia and care recipient functional impairment, but not perceived caregiver burden, were also more likely among caregivers with poor/fair SRH. Additionally, high negative affect and low positive affect were more likely in caregivers with poor/fair vs. good or excellent and very good or excellent SRH, respectively. Conclusions Caregivers with poor/fair SRH were characterized by higher levels of medical comorbidity, low physical function, high negative, but low positive affect and longer duration of caregiving, as well as more severe dementia and greater functional impairment of the care recipient. These findings suggest that caregivers need to be more closely evaluated and targeted for preventive interventions in clinical practice. Trial Registration ClinicalTrials.gov registration number: NCT02317523. |
| first_indexed | 2024-12-21T08:32:08Z |
| format | Article |
| id | doaj.art-826729a63d2c42c38860704d20ff1545 |
| institution | Directory Open Access Journal |
| issn | 1471-2318 |
| language | English |
| last_indexed | 2024-12-21T08:32:08Z |
| publishDate | 2019-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj.art-826729a63d2c42c38860704d20ff15452022-12-21T19:10:11ZengBMCBMC Geriatrics1471-23182019-01-0119111110.1186/s12877-019-1033-2Refining caregiver vulnerability for clinical practice: determinants of self-rated health in spousal dementia caregiversRoland von Känel0Brent T. Mausbach1Joel E. Dimsdale2Michael G. Ziegler3Paul J. Mills4Matthew A. Allison5Thomas L. Patterson6Sonia Ancoli-Israel7Igor Grant8Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of ZurichDepartment of Psychiatry, University of California San DiegoDepartment of Psychiatry, University of California San DiegoDepartment of Medicine, University of California San DiegoDepartment of Psychiatry, University of California San DiegoDepartment of Family Medicine and Public Health, University of California San DiegoDepartment of Psychiatry, University of California San DiegoDepartment of Psychiatry, University of California San DiegoDepartment of Psychiatry, University of California San DiegoAbstract Background Caregivers of a family member with a chronic disability or illness such as dementia are at increased risk for chronic disease. There are many factors that contribute to dementia caregiver vulnerability and these factors can be challenging to assess in clinical settings. Self-rated health (SRH) is an independent measure of survival and physical health in the elderly. As an inclusive measure of health, SRH has been proposed as a reliable way to assess a patient’s general health in primary care. Therefore, we sought to identify determinants of poor/fair SRH versus categories of at least good SRH in informal caregivers. Methods In a cross-sectional study, we examined 134 elderly (≥55 years) providing in-home care for a spouse with dementia who rated their own health with a single-item question: “In general, would you say your health is excellent, very good, good, fair or poor?”. In a multivariable model, we compared caregivers with poor/fair SRH to those with good, very good, or excellent SRH on demographics, health characteristics (health behaviors, physical health indicators, psychosocial factors) and caregiving-specific stress (a composite index/total of four caregiving-specific stressors: years of caregiving, dementia severity, care recipient functional impairment and perceived caregiver burden). Results Compared with caregivers who rated their own health as either good (31.3%), very good (38.8%) or excellent (14.2%), caregivers with poor/fair SRH (15.7%) were more likely to have lower physical function and total greater caregiving-specific stress. More years of caregiving, severe dementia and care recipient functional impairment, but not perceived caregiver burden, were also more likely among caregivers with poor/fair SRH. Additionally, high negative affect and low positive affect were more likely in caregivers with poor/fair vs. good or excellent and very good or excellent SRH, respectively. Conclusions Caregivers with poor/fair SRH were characterized by higher levels of medical comorbidity, low physical function, high negative, but low positive affect and longer duration of caregiving, as well as more severe dementia and greater functional impairment of the care recipient. These findings suggest that caregivers need to be more closely evaluated and targeted for preventive interventions in clinical practice. Trial Registration ClinicalTrials.gov registration number: NCT02317523.http://link.springer.com/article/10.1186/s12877-019-1033-2Clinical managementDementia caregiversElderly peopleHealth riskPsychological stressQuality of life |
| spellingShingle | Roland von Känel Brent T. Mausbach Joel E. Dimsdale Michael G. Ziegler Paul J. Mills Matthew A. Allison Thomas L. Patterson Sonia Ancoli-Israel Igor Grant Refining caregiver vulnerability for clinical practice: determinants of self-rated health in spousal dementia caregivers BMC Geriatrics Clinical management Dementia caregivers Elderly people Health risk Psychological stress Quality of life |
| title | Refining caregiver vulnerability for clinical practice: determinants of self-rated health in spousal dementia caregivers |
| title_full | Refining caregiver vulnerability for clinical practice: determinants of self-rated health in spousal dementia caregivers |
| title_fullStr | Refining caregiver vulnerability for clinical practice: determinants of self-rated health in spousal dementia caregivers |
| title_full_unstemmed | Refining caregiver vulnerability for clinical practice: determinants of self-rated health in spousal dementia caregivers |
| title_short | Refining caregiver vulnerability for clinical practice: determinants of self-rated health in spousal dementia caregivers |
| title_sort | refining caregiver vulnerability for clinical practice determinants of self rated health in spousal dementia caregivers |
| topic | Clinical management Dementia caregivers Elderly people Health risk Psychological stress Quality of life |
| url | http://link.springer.com/article/10.1186/s12877-019-1033-2 |
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