Mental states in caregivers toward people with Alzheimer's disease at different stages

Bei Li; Haiqiang Jin; Guiying Yan; Chen Zhang; Siwei Chen; Yue Wang; Ting Wang; Qiaoqin Wan; Zhimin Wei; Yongan Sun

doi:10.3389/fneur.2023.1327487

Mental states in caregivers toward people with Alzheimer's disease at different stages

Front Neurol. 2024 Jan 11:14:1327487. doi: 10.3389/fneur.2023.1327487. eCollection 2023.

Authors

Bei Li^#¹, Haiqiang Jin^#¹, Guiying Yan^{2

3}, Chen Zhang¹, Siwei Chen¹, Yue Wang^{4

5}, Ting Wang¹, Qiaoqin Wan⁶, Zhimin Wei⁷, Yongan Sun¹

Affiliations

¹ Department of Neurology, Peking University First Hospital, Peking University, Beijing, China.
² Academy of Mathematics and Systems Science, Chinese Academy of Sciences, Beijing, China.
³ School of Mathematical Sciences, University of Chinese Academy of Sciences, Beijing, China.
⁴ The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.
⁵ Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
⁶ Nursing School of Peking University, Beijing, China.
⁷ Health Service Department of the Guard Bureau of the Joint Staff Department, Beijing, China.

^# Contributed equally.

Abstract

Introduction: Caring for people with Alzheimer's disease (AD) is burdensome, especially when family members act as caregivers. This multicenter survey first aimed to investigate caregivers' mental states as well as its influencing factors in caring for people with different severities of AD in China.

Methods: People with AD and their caregivers from 30 provincial regions in mainland China were enrolled from October 2020 to December 2020 to be surveyed for caregivers' mental states and living conditions, as well as caregivers' attitudes toward treatment and caring. Logistic regression was used to explore the factors that influence the positive and negative states of caregivers who care for people with different stages of AD.

Results: A total of 1,966 valid questionnaires were analyzed (mild AD: 795, moderate AD: 521, severe AD: 650). A total of 73.6% of caregivers maintained normal states (mild group: 71.9%, moderate group: 73.9%, severe group: 75.2%; X² = 2.023, p = 0.364), and the proportions of caregivers with positive and negative states were 26.3% (mild group: 38.4%, moderate group: 24.6%, severe group: 13.1%; X² = 119.000, p < 0.001) and 36.5% (mild group: 25.2%, moderate group: 36.9%, severe group: 50.2%; X² = 96.417, p < 0.001), respectively. The major factors that both influenced caregivers' positive and negative states were the severity of AD, perceived efficacy of treatment, safety issues after AD dementia diagnosis and perceived social support (p < 0.005), while neuropsychiatric symptoms causing stress in caregivers (p < 0.001) only affected the negative states of caregivers. The results of further analysis according to disease severity showed that safety issues after AD dementia diagnosis (p < 0.005) only made significant differences in the mild-to-moderate group.

Conclusion: To reduce negative states and promote positive states among caregivers, flexible and sensitive caregiving support could be built on caregivers' demands in caring for people with different stages of AD. The support of emotion, social functioning and nursing skills is one of the significant ways for health workers to enhance caregivers' competency.

Keywords: Alzheimer’s; caregivers; dementia; influencing factors; mental states; severity of disease.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was supported by the Chinese Academy of Engineering (Strategic research and consulting project), National Key Research and Development Program of China (SQ2018YFC130024), National Major Science and Technology Projects of China (2021ZD0201800 and 2021ZD0201805), National Natural Science Foundation of China (82071306).