Cognitive limitations in older adults receiving care reduces well-being among spouse caregivers

Abstract

A large number of older adults have physical and/or cognitive challenges and require help to manage everyday activities. Many older adults receive care from a spouse. Over the long term, this has adverse consequences for caregiver health and well-being. Less is known about the outcomes associated with the early transition to becoming a spousal caregiver. Nor is it clear how mild-cognitive decline worsens caregiver outcomes. The present study uses dyadic data from 588 couples in the National Social Life, Health, and Aging Project to compare mental and social well-being in marital partners who became a spousal caregiver versus those who remained noncaregivers or became caregivers for someone other than a spouse between 2010 and 2015. Cognitive ability was assessed using a validated version of the Montreal Cognitive Assessment. Moderated Actor-Partner Independence Models revealed that becoming a caregiver was associated with an increase in perceived stress in both men and women, and an increase in anxiety among men. Partners' cognitive limitations moderated, in a dose-dependent fashion, the association between becoming a caregiver and changes in well-being. Specifically, becoming a caregiver was associated with increased support from friends for wives at lower levels of husband's cognitive ability, and with increased anxiety for husbands at lower levels of wife's cognitive ability. Associations were independent of demographic characteristics and physical limitations. We discuss the value of using population-based samples to study the transition to caregiving and implications for interventions during the early transition to a caregiving role for even modestly cognitively impaired partners. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Figure 1:

Moderated Actor Partner Interdependence Model Notes. Variable definitions: H: Husband; W: Wife. CG: caregiving status change, Cog: Cognitive ability as measured by the MoCA-SA. CES-D: Depression, UCLA-R: Loneliness, HADs: Anxiety, PSS: Perceived stress, RSA: Religious service attendance, SE: social engagement, FamSp: Family support, and FrndSp: Friend support. Controls* include measures of functional limitations in Wave 3 and change from Wave 2, comorbidity index in Wave 3 and change from Wave 2, change in cognitive ability from Wave 2, and indicators for household income categories, race categories, education categories, and age categories.