Dementia caregivers' coping strategies and their relationship to health and well-being: the Cache County Study

Objectives: Prior research identifies that psychological outcomes among dementia caregivers are associated with their use of coping strategies. Few studies have tested the association of coping and health longitudinally. Method: This study examined factors associated with the use of coping strategies over time and their associations with physical and mental health outcomes in a population-based sample of 226 dementia caregivers in Cache County, Utah, USA. Caregivers annually completed the Ways of Coping Checklist-Revised, the Beck Anxiety Inventory, and a health interview. Care-recipient cognitive and functional abilities were obtained using the Mini-Mental State Exam and the Clinical Dementia Rating. Neuropsychiatric symptoms were assessed using the Neuropsychiatric Inventory. Results: Caregivers most frequently identified providing care as a problem (37.6%). Linear mixed models of caregiver coping strategies found that the use of most strategies were stable except for increasing Avoidance among adult child caregivers (beta = 0.14, p = 0.048). On average, increased Wishful Thinking (beta = 2.48, p < 0.001) or Blames Self (beta = 1.06, p = 0.002) was associated with higher anxiety scores. Increased use of Blames Others among males (interaction, beta = 0.28, p = 0.02) and greater use of Wishful Thinking among younger caregivers (interaction, beta = -0.01, p = 0.01) were associated with more caregiver health conditions. Coping strategies were not associated with change in anxiety or health conditions over time. Conclusion: Our results emphasize the importance of caregiver coping strategies on caregiver health and well-being and may identify subgroups of persons at risk for worse outcomes.