title: Caregiver coping strategies predict cognitive and functional decline in dementia: the Cache County Dementia Progression Study.
abstract: OBJECTIVE
  Few longitudinal studies have studied the influence of the care environment on the clinical progression of dementia. We examined whether caregiver coping strategies predict dementia progression in a population-based sample.
  
  
  METHODS
  Longitudinal, prospective cohort study.
  
  
  METHODS
  Cache County (Utah) population.
  
  
  METHODS
  A total of 226 persons with dementia, and their caregivers, were assessed semiannually for up to 6 years.
  
  
  METHODS
  Ways of Coping Checklist-Revised, Mini-Mental State Examination (MMSE), and Clinical Dementia Rating (CDR).
  
  
  RESULTS
  Mean (SD) age of dementia onset in persons with dementia was 82.11 (5.84) years and mean caregiver age was 67.41 (13.95) years. Mean (SD) follow-up was 1.65 (1.63) years from baseline. In univariate linear mixed-effects models, increasing use of problem-focused and counting blessings by caregivers was associated with slower patient worsening on the MMSE. Problem-focused coping, seeking social support, and wishful thinking were associated with slower Clinical Dementia Rating Scale sum of boxes (CDR-sb) worsening. Considering covariates, increasing use of problem-focused coping was associated with 0.70 points per year less worsening on the MMSE and 0.55 points per year less worsening on the CDR-sb. Compared with no use, the "regular" use of this strategy was associated with 2 points per year slower worsening on the MMSE and 1.65 points per year slower worsening on the CDR-sb.
  
  
  CONCLUSIONS
  Caregiver coping strategies are associated with slower dementia progression. Developing interventions that target these strategies may benefit dementia patients.
authors.affiliation: Department of Psychology, Utah State University, Logan, UT 84322, USA. Joann.tschanz@usu.edu
authors.forename: JoAnn T
authors.initials: JT
authors.lastname: Tschanz
authors.forename: Kathleen
authors.initials: K
authors.lastname: Piercy
authors.forename: Chris D
authors.initials: CD
authors.lastname: Corcoran
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Fauth
authors.forename: Maria C
authors.initials: MC
authors.lastname: Norton
authors.forename: Peter V
authors.initials: PV
authors.lastname: Rabins
authors.forename: Brian T
authors.initials: BT
authors.lastname: Tschanz
authors.forename: M Scott
authors.initials: MS
authors.lastname: Deberard
authors.forename: Christine
authors.initials: C
authors.lastname: Snyder
authors.forename: Courtney
authors.initials: C
authors.lastname: Smith
authors.forename: Lester
authors.initials: L
authors.lastname: Lee
authors.forename: Constantine G
authors.initials: CG
authors.lastname: Lyketsos
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology*; D003072:Cognition Disorders / Q000150:complications / Q000523:psychology*; D003704:Dementia / Q000150:complications / Q000451:nursing* / Q000523:psychology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012720:Severity of Illness Index