The Cognitive Effects of Caregiving for Patients with Alzheimer\u27s Disease

Background: Extensive literature exists documenting the relationship between stress and cognition. Caregiving for an individual with Alzheimer’s disease is characterized as a chronic stress experience due to the increasing dependency of the care-recipient as the disease progresses. Caregiving has been associated with depression, anxiety, and poorer physical health. Despite this, little is known about the relationship between caregiver stress and cognition. Therefore, using the Stress Process Model as a theoretical framework, this study aimed to examine the cognitive effects of serving as a caregiver for an individual with Alzheimer’s disease. Methods: The current study included 47 Alzheimer’s caregivers and 47 control participants matched on gender, age, and education. Participants completed questionnaires pertaining to stress, depression, coping, and social support, along with a series of cognitive tests measuring episodic memory, working memory, attention, visuospatial processing, implicit memory, processing speed, and executive functioning. Results: When comparing caregivers to control participants, caregivers significantly performed worse on cognitive measures, particularly in the episodic memory, executive functioning, and processing speed domains. When examining caregivers specifically, primary stressors, which are stressors derived directly from the care environment (e.g., problematic behaviors exhibited by the care-recipient and relational deprivation) consistently predicted impaired cognitive performance. Conclusion: This study examined the influence of caregiver stress on performance across seven domains of cognition. The findings suggest that caregiving is a unique stress experience and highlights the complex nature of serving a caregiver. Results showed that caregivers performed worse compared to control participants on multiple domains of cognition. When examining caregivers and the specific domains of stress outlined by Pearlin et al.’s (1990) Stress Process Model, results showed that stressors that emerge from the care-environment was the most consistent predictor of cognitive performance. The findings address a gap in the literature and is helpful in understanding the negative effects of caregiver stress. With the rising older adult population, and increases in age-related illnesses, the number of individuals providing care to a loved one will continue to increase. Thus, research examining the adverse effects of this role is pivotal in order to develop strategies and methods that can improve the well-being of caregivers