Cooper, C.; (2007) Coping, anxiety and depression in caregivers of people with Alzheimer's disease. Doctoral thesis , University of London.

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Abstract

Background: There have been few longitudinal studies investigating the impact of coping on psychological morbidity in caregivers of people with dementia (CG), and those have conflicting or unreplicated findings. About a quarter of caregivers of people with dementia (CG) experience clinically significant anxiety, but anxiety is relatively neglected in this group.;Main Hypothesis: The relationship between burden at baseline (T1) and anxiety a year later will be mediated by more dysfunctional coping strategies, and less emotion-focussed and problem-focussed coping strategies at T1.;Methods: 126 people with Alzheimer's disease and their family carers were recruited, of whom 93(73.8%) were re-interviewed a year later. Sampling was designed to ensure that the participants were representative of people living in the UK with Alzheimer's disease in terms of dementia severity, gender and care setting. I used the Hospital Anxiety and Depression Scale to measure carer anxiety, and the Brief COPE to measure coping strategies, to explore our hypothesis that the relationship between carer burden and anxiety and depression is mediated by coping style.;Results: Using relatively fewer emotion-focussed strategies and more problem-focussed strategies mediated the relationship between caregiver burden and anxiety a year later, after controlling for potential confounders. Using fewer emotion focussed strategies also predicted higher psychological morbidity in general. More use of dysfunctional coping strategies mediated this relationship cross-sectionally but not on longitudinal analysis.;Conclusion: Carers who used more emotion-focussed coping strategies in response to carer burden were protected from having higher anxiety levels a year later, while those using problem-focussed strategies were not. Most current psychological interventions are based on problem-solving coping strategies, but our results suggest that a psychological intervention package to encourage emotion-focussed coping may be a rational approach to reduce anxiety in dementia carers. Studies are needed to test such interventions.

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