No abstract

People with HIV (PWH) are living longer and healthier lives; thanks to combination antiretroviral therapy. As many PWH age, they find themselves providing care to family members and friends, just as their counterparts without HIV. The literature indicates that becoming a caregiver creates conditions that compromise one's cognitive function. Additionally, nearly 45% of all PWH experience HIV-associated neurocognitive disorder and are already vulnerable to cognitive impairment due to HIV, aging, and accompanying health conditions, and lifestyle factors. Given what is known, we assert that caregivers with HIV, especially as they age, are at additional risk for developing cognitive impairments. The purpose of this commentary was to briefly examine the juxtaposition between cognitive vulnerability of caregiving and the cognitive vulnerability of aging with HIV. Potential factors contributing to impaired cognition include stress, lack of social support, stigma, lifestyle, and comorbidities. Implications for clinical practice and research are provided.

Family caregivers of individuals with dementia (IWDs) have an increased risk of developing depression and anxiety. Little is known about daily protective factors that mitigate this risk. The purpose of this study was to identify everyday coping strategies used by family caregivers that reduce the daily odds of experiencing depression and anxiety-related symptoms. Daily diaries were used to examine whether pleasant non-care activities with the IWD, social connection, and exercise were associated with a decrease in depression and anxiety-related symptoms. A national sample of ADRD caregivers (N=165) completed diaries over 21-days (n=2,841). Participants were asked about their daily experiences as caregivers, coping strategies, and mental health. Data were analyzed using mixed-level modeling. Depression and anxiety symptoms were endorsed by 141 (85.45%) and 155 (93.94%) participants, respectively. Social connection was associated with a decrease in the daily odds of depression (OR: 0.71, CI: 0.54 – 0.94, p=0.016) and anxiety symptoms (OR: 0.74, CI: 0.56 – 0.97, p=0.032). Caregivers were also less likely to endorse depression-related symptoms on days when engaging in a pleasant non-care activity with the IWD was reported (OR: 0.70, CI: 0.52 – 0.93, p=0.015). Finally, anxiety-related symptoms were less likely to be endorsed on days when caregivers reported engaging in exercise (OR: 0.65, CI: 0.49 – 0.86, p=0.003). The results from this study help elucidate coping strategies that may mitigate the risk of depression and anxiety associated with caregiving. These findings inform potential components for interventions to help support the health and well-being of family caregivers of IWDs.

Background: Family members providing informal care to individuals living with dementia have an increased risk of depression and anxiety. While risk and protective factors of poor mental health outcomes have previously been identified, little is known about the day-to-day circumstances in which depression and anxiety-related symptoms are more likely to appear among dementia caregivers. The purpose of this study was to identify contextual factors associated with daily depression and anxiety symptom experience among dementia family caregivers. Method:A national sample of family caregivers (N = 165) completed daily diary surveys over 21 days (n = 2,841). Mixed-level models were used to examine relationships between daily behavioral symptoms of dementia (BSDs), emotional and instrumental social support, and depression and anxiety-related symptoms.Result: Depression and anxiety symptoms were endorsed by 141 (85.45%) and 155 (93.94%) caregivers, respectively. Dementia caregivers were more likely to report depression (OR = 1.15, 95% CI: 1.11-1.18, p < 0.001) and anxiety (OR = 1.12, 95% CI:1.09-1.16, p < 0.001) on a given day when BSDs were present and perceived as more bothersome than usual. Specific BSDs, including restless behaviors and intense emotions, also increased the daily odds of experiencing depression and anxiety symptoms.Further, the daily odds of depression decreased on days when caregivers reported informal instrumental support (OR = 0.67, 95% CI: 0.4-0.92, p < 0.05), while the daily odds of anxiety increased on days when caregivers reported emotional support (OR = 1.46, 95% CI: 1.07-1.99, p < 0.05). Conclusion:The risk of experiencing depression and anxiety symptoms varies daily based on the presence of specific contextual factors. The results from this study demonstrate the dynamic nature of mental health in the context of dementia caregiving. These findings support the need for ecologically-valid interventions to improve the day-to-day well-being of dementia family caregivers.