Clinical diagnoses and disability of cognitively impaired older persons as predictors of stress in their carers.
BACKGROUND
Aspects of the caring relationship are often promoted as more important than the clinical features of the care recipient in predicting caregiver wellbeing. However, studies of consequences of caring for cognitively impaired people seldom include detailed measures of the diagnostic profile and disability of the care recipient.


METHODS
Ninety community-living elderly persons with cognitive impairment were clinically assessed for severity on a range of illnesses. Their disability was examined via informant reports. Informants (88% of whom were primary carers) provided information on the behaviour and personality of the subject and reports of their own (informant) wellbeing. Using multiple regression, features of the subjects' clinical profile (severity of diseases, disability, behavioural problems and personality change) were examined as predictors of informant wellbeing. After controlling for subject clinical profile, we explored the additional associations between informant stress measures and other descriptors of the subject, caregiver and their relationship.


RESULTS
The subjects' clinical characteristics, in particular disability and disturbed behaviour, were strong predictors of caregiver wellbeing, accounting for most of the explained variance. After control for the subjects' clinical profile, few of the sociodemographic, caregiver or relationship variables examined had any influence on caregiver outcome measures. The exceptions were caregiver time demands, older subject age and self-identification as primary carer. Coresidence was not associated with caregiver distress.


CONCLUSIONS
Clinical characteristics of the care recipient are determinants of caregiver wellbeing, while socio-demographic, caregiver and relationship characteristics are less influential.
Cullen
J S
JS
Centre for Education and Research on Ageing, Concord Hospital, NSW, Australia.
Grayson
D A
DA
Jorm
A F
AF
D000203:Activities of Daily Living / Q000523:psychology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology*; D017281:Cost of Illness; D003704:Dementia / Q000523:psychology* / Q000628:therapy; D004185:Disability Evaluation; D005260:Female; D016330:Frail Elderly / Q000523:psychology*; D006701:Home Nursing / Q000523:psychology; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D013315:Stress, Psychological / Q000150:complications*