Subjective stress plays a key role for caregivers of people with dementia

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Caregivers, mostly family members, facing physical, emotional, social and econom
Caregivers, mostly family members, facing physical, emotional, social and economic challenges for years / George Arthur via Unsplash

Family care of a person with dementia imposes an emotional burden that often leads to the joint appearance of symptoms of anxiety and depression in caregivers. A recent study by the CUIDEMOS team, formed by researchers from the Autonomous University of Madrid (UAM) and the Rey Juan Carlos University (URJC), highlights the relationship between the subjective stress of family caregivers and the appearance of anxious and depressive symptoms, highlighting the need for adaptive interventions to improve their well-being.

The increase in life expectancy, a remarkable health and social achievement, brings with it an aging population and thus an increase in the prevalence of dementia. This reality has placed a considerable burden on caregivers, mostly family members, who face physical, emotional, social and economic challenges for years. This has turned caring for a person with dementia into a prototypical situation of chronic stress.

The CUIDEMOS team, composed of researchers from the Universidad Autónoma de Madrid (UAM) and the Universidad Rey Juan Carlos (URJC), has conducted a study to analyze anxious-depressive comorbidity from the perspective of stress in family caregivers.

According to the paper, published in the journal Clinical Gerontologist, it is common for caregivers to experience symptoms of anxiety and depression, which often present comorbidly. This comorbidity not only intensifies the severity of symptoms, but also complicates the effectiveness of psychological interventions.

Diagram of results according to the study/ Cabrera I.

However, not all caregivers experience this comorbidity. What factors influence this emotional distress? Previous research suggests that stress stemming from problematic behaviors of the person with dementia, such as agitation or aggression, may play a role.

"It is crucial to understand that stress is not merely objective; it depends on how the caregiver perceives and manages the situation based on his or her resources and abilities," the researchers stress.

The role of subjective stress

The study categorized caregivers according to their stress response to problematic behaviors. The presence of comorbidity was explored using Network Analysis (NA), a novel methodology to examine symptom-to-symptom relationships.

Comorbidity, according to RA, appears when there is an interrelationship between anxiety and depressive symptoms, so that the presence of one symptom is related to the appearance of the other.

The findings revealed distinct patterns between the groups. Those with low stress showed no comorbidity, whereas in the high stress group multiple interrelationships between symptoms were identified, indicating comorbidity.

It was also confirmed that between groups there were no differences in objective stress, measured as hours per day spent on caregiving-related tasks and the amount of time spent caregiving.

Although the study is cross-sectional and does not allow causal relationships to be established, it suggests that subjective stress plays a crucial role in anxious-depressive comorbidity.

"This tells us that interventions should include components aimed at reducing caregivers’ stress related to problem behaviors, through, for example, their training in more adaptive coping resources and skills for coping with these situations," the authors conclude.

Bibliographic reference:

García-Batalloso, I., Cabrera, I., Losada-Baltar, A., Mérida-Herrera, L., Olazarán, J., Márquez-González, M. (2023). Network Analysis of comorbid depressive and anxiety symptoms in family caregivers of people with dementia . Clinical Gerontologist. doi: 10.1080/07317115.2023.2217162

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