Cognitive reserve and self-efficacy as moderators of the relationship between stress exposure and executive functioning among spousal dementia caregivers

Pertl, Maria; Hannigan, Caoimhe; Brennan, Sabina; Robertson, Ian H.; Lawlor, Brian A.

doi:10.1017/s1041610216002337

Cited by 20 publications

(29 citation statements)

References 30 publications

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“…Specifically, the relations of psychological stress to cognitive performance were reduced in individuals with higher education, a higher cognitive level of the first profession practiced after education, a larger number of midlife leisure activities, a larger number of significant family members, and a larger number of close friends. This is in line with studies showing that cognitive reserve and social capital may offset the detrimental influences of physiological stress on cognitive functioning in old age [2, 12, 21, 36] and extends prior evidence suggesting that the relation of psychological stress to cognitive functioning is smaller in individuals with higher scores in a late-life proxy of cognitive reserve [37], with data based on a comprehensive set of key life course markers of cognitive reserve and social capital in a large sample of older adults in the present study.…”

Section: Discussionsupporting

confidence: 90%

“…Empirically, research comprehensively investigating these important issues is sparse so far. For example, Pertl et al [37] found in a sample of 273 adults aged 50 years and older that the relationship between greater psychological stress (assessed with the 4-item Perceived Stress Scale) and lower cognitive performance (executive functioning) was reduced among individuals with higher (compared to those with lower) cognitive reserve (i.e., premorbid intellectual capacity as late-life proxy for cognitive reserve). Yet, a thorough examination based on a comprehensive set of key life course markers of cognitive reserve and social capital is lacking so far.…”

Section: Introductionmentioning

confidence: 99%

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Cognitive Reserve and Social Capital Accrued in Early and Midlife Moderate the Relation of Psychological Stress to Cognitive Performance in Old Age

Ihle

Oris

Sauter

et al. 2018

Dement Geriatr Cogn Disord

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Aims: The present study set out to investigate the relation of psychological stress to cognitive performance and its interplay with key life course markers of cognitive reserve and social capital in a large sample of older adults. Methods: We assessed cognitive performance (verbal abilities and processing speed) and psychological stress in 2,812 older adults. The Participants reported information on education, occupation, leisure activities, family, and close friends. Results: Greater psychological stress was significantly related to lower performance in verbal abilities and processing speed. Moderation analyses suggested that the relations of psychological stress to cognitive performance were reduced in individuals with higher education, a higher cognitive level of the first profession practiced after education, a larger number of midlife leisure activities, a larger number of significant family members, and a larger number of close friends. Conclusion: Cognitive reserve and social capital accrued in early and midlife may reduce the detrimental influences of psychological stress on cognitive functioning in old age.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Cognitive Reserve and Social Capital Accrued in Early and Midlife Moderate the Relation of Psychological Stress to Cognitive Performance in Old Age

Ihle

Oris

Sauter

et al. 2018

Dement Geriatr Cogn Disord

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“…Participants were recruited for a longitudinal study (the DeStress study) on the relationship between caregiver stress and cognitive functioning (Pertl et al, 2017; see O’Sullivan et al, 2018). Caregivers over the age of 50, who were providing care at home for a spouse or common-law partner with a formal diagnosis of dementia of the Alzheimer’s type, Parkinson’s disease, or other primary degenerative dementia, were eligible to participate.…”

Section: Methodsmentioning

confidence: 99%

Caregiver Choice and Caregiver Outcomes: A Longitudinal Study of Irish Spousal Dementia Caregivers

et al. 2019

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Background The perception of choice in becoming a caregiver may impact on caregiver psychological and physical health. We determined the proportion of spousal dementia caregivers who felt they had a choice, and examined whether lack of choice in taking up the caregiving role and the perceived degree of choice in caregiving predicted caregiver health and wellbeing and care-recipient placement in long-term care at 1-year follow-up. Methods We performed secondary analyses of data from DeStress, a longitudinal study of 251 spousal dementia caregivers in Ireland. We used multivariate logistic and linear regression analyses to examine whether lack of choice (a dichotomous item) and/or the perceived degree of choice (a 9-point scale) at baseline predicted caregiver health (number of chronic health conditions; self-reported health) and wellbeing (e.g., burden, anxiety, depression, stress, and positive aspects of caregiving) and care status (continued care at home or placement in long-term care) at follow-up. Results The vast majority of caregivers (82%) reported that they had no choice in taking up the caregiving role. Nevertheless, nearly three-quarters (74%) responded above the midpoint on the rating scale (Mean = 6.82, SD = 3.22; Median = 9; Mode = 9), indicating they provided care voluntarily. Caregivers who reported a greater degree of choice were more likely to still be providing care at home at follow-up and to identify benefits from providing care. Neither choice nor degree of choice predicted any other caregiver outcomes. Conclusion For the vast majority of spousal dementia caregivers, taking up the caregiving role is not perceived as a choice; yet, most report performing this role voluntarily. Thus, facilitating greater choice may not necessarily diminish the key contribution family caregivers make to the care system. Although we found no evidence that caregiver choice predicted more positive caregiver health and wellbeing, the perception of choice is important in and of itself, and may benefit caregivers by facilitating the identification of positive aspects of care and be a factor in delaying care-recipient placement in long-term care. Future research should be especially mindful of how caregiver choice is assessed and how this may affect the resulting prevalence of choice.

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“…[16][17][18]38 Enhancing caregivers' self-efficacy and coping skills may be a key factor in reducing caregivers' psychological distress and their perceived caregiving burden. [40][41][42] In fact, caregiving preparedness and self-efficacy may also lead to improvements in patient health behaviors, such as adherence to complex post-HCT medical regimens. 43 Future studies to examine the effect of BMT-CARE on patient outcomes and to explore potential mediators of the intervention effects on caregivers' psychological distress and caregiving burden are warranted.…”

Section: Discussionmentioning

confidence: 87%

“…Prior studies of caregiver interventions have demonstrated reductions in caregivers' psychological distress . Enhancing caregivers' self‐efficacy and coping skills may be a key factor in reducing caregivers' psychological distress and their perceived caregiving burden . In fact, caregiving preparedness and self‐efficacy may also lead to improvements in patient health behaviors, such as adherence to complex post‐HCT medical regimens .…”

Section: Discussionmentioning

confidence: 99%

Multimodal psychosocial intervention for family caregivers of patients undergoing hematopoietic stem cell transplantation: A randomized clinical trial

El‐Jawahri

Jacobs

Nelson

et al. 2020

Cancer

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Background Caregivers of patients undergoing hematopoietic stem cell transplantation (HCT) experience an immense caregiving burden before, during, and after HCT. Methods We conducted an unblinded, randomized trial of a psychosocial intervention (BMT‐CARE) for caregivers of patients undergoing autologous and allogeneic HCT at Massachusetts General Hospital. Caregivers were randomly assigned to BMT‐CARE or usual care. BMT‐CARE was tailored to the HCT trajectory and integrated treatment‐related education and self‐care with cognitive‐behavioral skills to promote coping. Caregivers assigned to BMT‐CARE met with a trained interventionist (a psychologist or a social worker) in person, via telephone, or via videoconferencing for 6 sessions starting before HCT and continuing up to day +60 after HCT. The primary endpoint was feasibility, which was defined as at least 60% of eligible caregivers enrolling and completing 50% or more of the intervention sessions. We assesed caregiver quality of life (QOL; Caregiver Oncology Quality of Life Questionnaire), caregiving burden (Caregiver Reaction Assessment), psychological distress (Hospital Anxiety and Depression Scale), self‐efficacy (Cancer Self‐Efficacy Scale–Transplant), and coping (Measures of Current Status) at baseline and 30 and 60 days after HCT. We used mixed linear effect models to assess the effect of BMT‐CARE on outcomes longitudinally. Results We enrolled 72.5% of eligible caregivers (100 of 138), and 80% attended 50% or more of the intervention sessions. Caregivers randomized to BMT‐CARE reported improved QOL (B = 6.11; 95% CI, 3.50‐8.71; P < .001), reduced caregiving burden (B = –6.02; 95% CI, –8.49 to –3.55; P < .001), lower anxiety (B = –2.18; 95% CI, –3.07 to –1.28; P < .001) and depression symptoms (B = –1.23; 95% CI, –1.92 to –0.54; P < .001), and improved self‐efficacy (B = 7.22; 95% CI, 2.40‐12.03; P = .003) and coping skills (B = 4.83; 95% CI, 3.04‐6.94; P < .001) in comparison with the usual‐care group. Conclusions A brief multimodal psychosocial intervention tailored for caregivers of HCT recipients is feasible and may improve QOL, mood, coping, and self‐efficacy while reducing the caregiving burden during the acute HCT period.

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Cognitive reserve and self-efficacy as moderators of the relationship between stress exposure and executive functioning among spousal dementia caregivers

Cited by 20 publications

References 30 publications

Cognitive Reserve and Social Capital Accrued in Early and Midlife Moderate the Relation of Psychological Stress to Cognitive Performance in Old Age

Cognitive Reserve and Social Capital Accrued in Early and Midlife Moderate the Relation of Psychological Stress to Cognitive Performance in Old Age

Caregiver Choice and Caregiver Outcomes: A Longitudinal Study of Irish Spousal Dementia Caregivers

Multimodal psychosocial intervention for family caregivers of patients undergoing hematopoietic stem cell transplantation: A randomized clinical trial

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