Skip to main content
Search
Search
    Quick Search anywhere
    Quick search in Citations
Advanced Search
Skip main navigationClose Drawer MenuOpen Drawer Menu
Previous article
Full-Length Research Report

Bouncing Back from the Burden of Dementia

Predictors of Resilience from the Perspective of the Patient, the Spousal Caregiver, and the Dyad – An Exploratory Study

Published Online:July 30, 2020https://doi.org/10.1024/1662-9647/a000238

Abstract

Abstract.Background: Although there is mounting evidence of dyadic interdependencies between patients with dementia (PWD) and their caregivers, predictors of resilience among PWD and their caregivers are generally regarded in isolation. We therefore investigated how dyadic interdependencies regarding common resilience factors predict subjective notions of individual resilience. Methods: A total of 29 dyads (caregivers: 23 female, 73 ± 7 years; PWD: 6 female, 76 ± 6 years, Mini-Mental State Examination (MMSE) score: 18 ± 6) drawn from two studies answered questions about resilience (Brief Resilience Scale; BRS), partnership quality (Marital Quality Questionnaire; PFB), and depression (Geriatric Depression Scale; GDS-15). Using linear regression models, we predicted BRS scores by linearly combining individual characteristics (intraindividual level), characteristics of the partner (interindividual level), and their dyadic similarity (dyadic level). Results: Intraindividually, higher resilience in caregivers was associated with female sex; interindividually, it was associated with lower MMSE scores and higher PFB scores in PWD. On a dyadic level, the more different the GDS-15 scores were, the higher the resilience of caregivers. For PWD, higher resilience was significantly related to individual lower GDS-15 scores and higher PFB scores, while the characteristics of caregivers did not explain any variance. However, similarity in GDS-15 scores predicted higher resilience in PWD. Discussion: Resilience is affected differently in PWD and caregivers, potentially pointing to different strategies in coping with disease-related changes. Future studies are necessary to examine the mechanisms underlying resilience in PWD and their respective caregiver in order to tailor interventions that address the needs of both parties, from the individual, interindividual, and dyadic perspectives.

References

  • Braun, M., Scholz, U., Bailey, B., Perren, S., Hornung, R., & Martin, M. (2009). Dementia caregiving in spousal relationships: A dyadic perspective. Aging & Mental Health, 13, 426–436. First citation in articleCrossref, Google Scholar

  • Brodaty, H., & Donkin, M. (2009). Family caregivers of people with dementia. Dialogues in Clinical Neuroscience, 11, 217–228. First citation in articleCrossref, Google Scholar

  • Chmitorz, A., Wenzel, M., Stieglitz, R.-D., Kunzler, A., Bagusat, C., Helmreich, I., … Tüscher, O. (2018). Population-based validation of a German version of the Brief Resilience Scale. PLoS One, 13(2), e0192761. First citation in articleCrossref, Google Scholar

  • Clare, L., Nelis, S. M., Whitaker, C. J., Martyr, A., Markova, I. S., Roth, I., … Morris, R. G. (2012). Marital relationship quality in early-stage dementia: Perspectives from people with dementia and their spouses. Alzheimer Disease & Associated Disorders, 26, 148–158. First citation in articleCrossref, Google Scholar

  • Conradsson, M., Rosendahl, E., Littbrand, H., Gustafson, Y., Olofsson, B., & Lövheim, H. (2013). Usefulness of the Geriatric Depression Scale 15-item version among very old people with and without cognitive impairment. Aging & Mental Health, 17, 638–645. First citation in articleCrossref, Google Scholar

  • Covinsky, K. E., Newcomer, R., Fox, P., Wood, J., Sands, L., Dane, K., & Yaffe, K. (2003). Patient and caregiver characteristics associated with depression in caregivers of patients with dementia. Journal of General Internal Medicine, 18, 1006–1014. First citation in articleCrossref, Google Scholar

  • Cuijpers, P. (2005). Depressive disorders in caregivers of dementia patients: A systematic review. Aging & Mental Health, 9, 325–330. First citation in articleCrossref, Google Scholar

  • Cummings, J. L., Mega, M., Gray, K., Rosenberg-Thompson, S., Carusi, D. A., & Gornbein, J. (1994). The Neuropsychiatric Inventory: Comprehensive assessment of psychopathology in dementia. Neurology, 44, 2308–2314. First citation in articleCrossref, Google Scholar

  • D’Ath, P., Katona, P., Mullan, E., Evans, S., & Katona, C. (1994). Screening, detection and management of depression in elderly primary care attenders. I: The acceptability and performance of the 15 item Geriatric Depression Scale (GDS15) and the development of short versions. Family Practice, 11, 260–266. First citation in articleCrossref, Google Scholar

  • de Vugt, M. E., Stevens, F., Aalten, P., Lousberg, R., Jaspers, N., Winkens, I., … Verhey, F. R. (2003). Behavioural disturbances in dementia patients and quality of the marital relationship. International Journal of Geriatric Psychiatry, 18, 149–154. First citation in articleCrossref, Google Scholar

  • Dias, R., Santos, R. L., de Sousa, M. F. B., Nogueira, M. M. L., Torres, B., Belfort, T., & Dourado, M. C. N. (2015). Resilience of caregivers of people with dementia: A systematic review of biological and psychosocial determinants. Trends in Psychiatry and Psychotherapy, 37, 12–19. First citation in articleCrossref, Google Scholar

  • Dias, R., Simões-Neto, J. P., Santos, R. L., de Sousa, M. F. B., Baptista, M. A. T., Lacerda, I. B., … Dourado, M. C. N. (2016). Caregivers resilience is independent from the clinical symptoms of dementia. Arquivos de Neuro-Psiquiatria, 74, 967–973. First citation in articleCrossref, Google Scholar

  • Dias, R., Simões-Neto, J. P., Santos, R. L., Torres, B., Baptista, M. A. T., Santos Kimura, N. R., & Dourado, M. C. N. (2020). Caregivers’ resilience in mild and moderate Alzheimer’s disease. Aging & Mental Health, 24, 250–258. First citation in articleCrossref, Google Scholar

  • Gaugler, J. E., Yu, F., Krichbaum, K., & Wyman, J. F. (2009). Predictors of nursing home admission for persons with dementia. Medical Care, 47, 191–198. First citation in articleCrossref, Google Scholar

  • Hahlweg, K. (1996). Fragebogen zur Partnerschaftsdiagnostik (FPD). Göttingen: Hogrefe. First citation in articleGoogle Scholar

  • Hinz, A., Stöbel-Richter, Y., & Brähler, E. (2001). Der Partnerschaftsfragebogen (PFB) [The “Partnerschaftsfragebogen” (Marital Quality Questionnaire)]. Diagnostica, 47, 132–141. First citation in articleLink, Google Scholar

  • Holley, C. K., & Mast, B. T. (2009). The impact of anticipatory grief on caregiver burden in dementia caregivers. Gerontologist, 49, 388–396. First citation in articleCrossref, Google Scholar

  • Joling, K. J., Windle, G., Dröes, R.-M., Huisman, M., Hertogh, C. M. P. M., & Woods, R. T. (2017). What are the essential features of resilience for informal caregivers of people living with dementia? A Delphi consensus examination. Aging & Mental Health, 21, 509–517. First citation in articleCrossref, Google Scholar

  • Joling, K. J., Windle, G., Dröes, R. M., Meiland, F., van Hout, H. P. J., MacNeil Vroomen, J., … Woods, B. (2016). Factors of resilience in informal caregivers of people with dementia from integrative international data analysis. Dementia and Geriatric Cognitive Disorders, 42, 198–214. First citation in articleCrossref, Google Scholar

  • Kaufer, D. I., Cummings, J. L., Christine, D., Bray, T., Castellon, S., Masterman, D., … DeKosky, S. T. (1998). Assessing the impact of neuropsychiatric symptoms in Alzheimer’s disease: The Neuropsychiatric Inventory Caregiver Distress Scale. American Geriatrics Society, 46, 210–215. First citation in articleCrossref, Google Scholar

  • Kliem, S., Job, A.-K., Kröger, C., Bodenmann, G., Stöbel-Richter, Y., Hahlweg, K., & Brähler, E. (2012). Entwicklung und Normierung einer Kurzform des Partnerschaftsfragebogens (PFB-K) an einer repräsentativen deutschen Stichprobe [Development and standardization of a short form of the Partnership Questionnaire (PFB-K) on a representative German sample]. Zeitschrift für Klinische Psychologie und Psychotherapie, 41, 81–89. First citation in articleLink, Google Scholar

  • Kunzler, A., Skoluda, N., & Nater, U. (2018). Die Bedeutung von Resilienzfaktoren für pflegende Angehörige von Demenzpatienten – eine Übersicht zu ausgewählten Faktoren [The role of resilience factors in informal caregivers of dementia patients – A review on selected factors]. Psychotherapie Psychosomatik Medizinische Psychologie, 68, 10–21. First citation in articleCrossref, Google Scholar

  • Lyketsos, C. G., & Lee, H. B. (2004). Diagnosis and treatment of depression in Alzheimer’s disease: A practical update for the clinician. Dementia and Geriatric Cognitive Disorders, 17, 55–64. First citation in articleCrossref, Google Scholar

  • Mitchell, A. J., Bird, V., Rizzo, M., & Meader, N. (2010). Diagnostic validity and added value of the geriatric depression scale for depression in primary care: A meta-analysis of GDS30 and GDS15. Journal of Affective Disorders, 125, 10–17. First citation in articleCrossref, Google Scholar

  • Nordheim, J., Hausler, A., Yasar, S., Suhr, R., Kuhlmey, A., Rapp, M., & Gellert, P. (2019). Psychosocial intervention in couples coping with dementia led by a psychotherapist and a social worker: The DYADEM trial. Journal of Alzheimer’s Disease, 68, 745–755. First citation in articleCrossref, Google Scholar

  • O’Rourke, N., Kupferschmidt, A. L., Claxton, A., Smith, J. Z., Chappell, N., & Beattie, B. L. (2010). Psychological resilience predicts depressive symptoms among spouses of persons with Alzheimer disease over time. Aging & Mental Health, 14, 984–993. First citation in articleCrossref, Google Scholar

  • Quinn, C., Clare, L., & Woods, B. (2009). The impact of the quality of relationship on the experiences and wellbeing of caregivers of people with dementia: A systematic review. Aging & Mental Health, 13, 143–154. First citation in articleCrossref, Google Scholar

  • Rapp, M. A., Schnaider-Beeri, M., Wysocki, M., Guerrero-Berroa, E., Grossman, H. T., Heinz, A., & Haroutunian, V. (2011). Cognitive decline in patients with dementia as a function of depression. The American Journal of Geriatric Psychiatry, 19, 357–363. First citation in articleCrossref, Google Scholar

  • Samus, Q. M., Rosenblatt, A., Steele, C., Baker, A., Harper, M., Brandt, J., … Lyketsos, C. G. (2005). The association of neuropsychiatric symptoms and environment with quality of life in assisted living residents with dementia. The Gerontologist, 45(suppl 1), 19–26. First citation in articleCrossref, Google Scholar

  • Sands, L. P., Ferreira, P., Stewart, A. L., Brod, M., & Yaffe, K. (2004). What explains differences between dementia patients’ and their caregivers’ ratings of patients’ quality of life? The American Journal of Geriatric Psychiatry, 12, 272–280. First citation in articleCrossref, Google Scholar

  • Savundranayagam, M. Y., Hummert, M. L., & Montgomery, R. J. (2005). Investigating the effects of communication problems on caregiver burden. Journals of Gerontology. Series B: Psychological Sciences and Social Sciences, 60(1), S48–S55. First citation in articleCrossref, Google Scholar

  • Sheikh, J., & Yesavage, J. (1986). Geriatric Depression Scale (GDS): Recent evidence and development of a shorter version. In T. L. BrinkEd., Clinical gerontology: A guide to assessment and intervention (pp. 165–173). New York: Haworth. First citation in articleGoogle Scholar

  • Smith, B. W., Dalen, J., Wiggins, K., Tooley, E., Christopher, P., & Bernard, J. (2008). The brief resilience scale: Assessing the ability to bounce back. International Journal of Behavioral Medicine, 15, 194–200. First citation in articleCrossref, Google Scholar

  • Teahan, A., Lafferty, A., McAuliffe, E., Phelan, A., O’Sullivan, L., O’Shea, D., & Fealy, G. (2018). Resilience in family caregiving for people with dementia: A systematic review. International Journal of Geriatric Psychiatry, 33, 1582–1595. First citation in articleCrossref, Google Scholar

  • Tsuno, N., & Homma, A. (2009). What is the association between depression and Alzheimer’s disease? Expert Review of Neurotherapeutics, 9, 1667–1676. First citation in articleCrossref, Google Scholar

  • Van’t Leven, N., Prick, A. E., Groenewoud, J. G., Roelofs, P. D., de Lange, J., & Pot, A. M. (2013). Dyadic interventions for community-dwelling people with dementia and their family caregivers: A systematic review. International Psychogeriatrics, 25, 1581–1603. First citation in articleCrossref, Google Scholar

  • Wilks, S. E., & Croom, B. (2008). Perceived stress and resilience in Alzheimer’s disease caregivers: Testing moderation and mediation models of social support. Aging & Mental Health, 12, 357–365. First citation in articleCrossref, Google Scholar

  • Wuttke-Linnemann, A., Baake, R., & Fellgiebel, A. (2019). Dyadic wind of change: New approaches to improve biopsychological stress regulation in patients with dementia and their spousal caregivers. Journal of Alzheimer’s Disease, 68, 1325–1337. First citation in articleCrossref, Google Scholar

  • Yesavage, J. A., Brink, T. L., Rose, T. L., Lum, O., Huang, V., Adey, M., & Leirer, V. O. (1982). Development and validation of a geriatric depression screening scale: A preliminary report. Journal of Psychiatric Research, 17, 37–49. First citation in articleCrossref, Google Scholar