The Impact of Chronic Stress on the Psychological Well-Being and Cognitive Functioning of Older Dementia Caregivers

Degree awarded: Ph.D. Psychology. The Catholic University of AmericaOlder individuals caring for loved ones with memory problems, including dementia, are part of a dramatically expanding population in the United States. Caregivers are faced with the physically, emotionally, cognitively and financially daunting task of caring for those whose well-beings are expected to progressively decline over time. Currently, 9.9 million informal (i.e., unpaid) caregivers, typically spouses or adult children, care for individuals 50 and older who have dementia in the United States. This estimate will significantly increase as the number of individuals with Alzheimer's disease grows from 5.3 million to 16 million Americans in 2050.Not surprisingly, dementia caregivers frequently experience higher levels of stress than non-caregivers and other types of caregivers. Studies have shown that the added impact of chronic stress accelerates the aging process and precipitates subsequent impairments in psychological and cognitive health. We are particularly concerned with how cognition is influenced given the enormous cognitive responsibilities older caregivers undertake in providing care. If caregiver cognitive functions are compromised, this could adversely affect their abilities to take care of themselves as well as their patients.This study explored the impact of chronic stress on both psychological well-being and cognitive functioning in older dementia caregivers. Sixty-five caregivers and 64 non-caregivers participated in a two-part study which included a take-home packet of clinical measures and a cognitive battery administered over the telephone. As expected, we found that caregivers exhibited significantly higher levels of distress (e.g., stress, depression and anxiety) than non-caregivers. We also predicted that caregivers would be impaired in cognitive functions dependent on brain areas impacted by stress, including the prefrontal cortex and hippocampus. Caregivers did perform, as expected, worse compared to non-caregivers on four areas of executive functioning mediated by the frontal lobes: working memory, verbal fluency, attention-switching and processing speed. Contrary to our prediction, caregivers were not impaired relative to non-caregivers on hippocampally-dependant episodic verbal fluency. Finally, as hypothesized, caregivers demonstrated preserved implicit learning despite the double insult of stress and aging. The findings of this study alert us to the cognitive issues older dementia caregivers face and important implications are discussed.Made available in DSpace on 2011-02-24T20:46:49Z (GMT). No. of bitstreams: 1 Halpert_cua_0043A_10084display.pdf: 426085 bytes, checksum: 021208ee6a13fded13a42a6d0c00ad4c (MD5