title: Modeling the Distress of Spousal Caregivers of People with Dementia.
abstract: The progressive mobilization of spouse caregivers who take care of a person with dementia (PWD) can lead to situations of distress.
  
  
  
  The current study sought to investigate the influence of the characteristics of the caregiving context on spousal caregiver distress.
  
  
  
  125 spousal caregivers participated in this study. The characteristics of the caregiving context were assessed using questionnaires. We examined a moderated-mediator model (Step 1) in which we hypothesized that PWD and caregiver characteristics and dyadic determinants contribute to spousal caregiver distress. This model was compared based on the age at onset of the disease and the gender of the caregiver (Step 2).
  
  
  
  The model revealed that poor self-rated health and a lack of family support accentuated spousal caregiver distress, whereas the feeling of being prepared and level of confidence decreased spousal caregiver distress. Moreover, the quality of couple adjustment affected spousal caregiver distress, and this effect was mediated by the severity of the PWD's symptoms. Regarding the age at onset of the disease, the path between Couple Adjustment and the Care recipient's impairments was more important for caregivers of person with early-onset dementia (PEOD). Female caregivers who reported poor self-rated health experienced greater distress.
  
  
  
  It would be interesting to create a support program that would incorporate these three areas of intervention regarding the progression of the disease: first, "preparedness modules"; second, "dyadic modules" (especially for caregivers of PEOD); and third, "family modules". Specific attention should be given to female caregivers who report poor self-rated health.
authors.affiliation: Laboratory SCALab, UMR CNRS 9193, University of Lille, Villeneuve d'Ascq, France.|Roubaix Hospital, Addiction Service, Roubaix, France.
authors.forename: Emilie
authors.initials: E
authors.lastname: Wawrziczny
authors.affiliation: Laboratory SCALab, UMR CNRS 9193, University of Lille, Villeneuve d'Ascq, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Berna
authors.affiliation: Institut Universitaire de Gériatrie de Montréal, Montréal, QC, Canada.|Université de Montréal, Montréal, QC, Canada.
authors.forename: Francine
authors.initials: F
authors.lastname: Ducharme
authors.affiliation: Institut Universitaire de Gériatrie de Montréal, Montréal, QC, Canada.|Université de Montréal, Montréal, QC, Canada.
authors.forename: Marie-Jeanne
authors.initials: MJ
authors.lastname: Kergoat
authors.affiliation: Department of Neurology, Memory Research and Resources Clinic at the University Hospital of Lille, Lille, France.
authors.forename: Florence
authors.initials: F
authors.lastname: Pasquier
authors.affiliation: Laboratory SCALab, UMR CNRS 9193, University of Lille, Villeneuve d'Ascq, France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Antoine
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology*; D003704:Dementia / Q000451:nursing* / Q000523:psychology; D005260:Female; D006801:Humans; D057187:Independent Living; D016015:Logistic Models; D008297:Male; D013315:Stress, Psychological / Q000209:etiology* / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: Caregivers; dementia; early onset Alzheimer disease; late onset Alzheimer disease; psychological model; spouses