Prevalence and Characteristics of Subjective Cognitive Decline Among Unpaid Caregivers Aged ≥45 Years — 22 States, 2015–2019

Jeffers, Eva M; Bouldin, Erin D.; McGuire, Lisa C.; Knapp, Kenneth; Patel, Roshni; Guglielmo, Dana; Taylor, Christopher A.; Croft, Janet B.

doi:10.15585/mmwr.mm7046a1

Cited by 8 publications

(9 citation statements)

References 8 publications

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“…We assert that dementia exposure can encompass many relationships with people with dementia. However, the vast majority of studies used a familial definition of dementia exposure, such that only two studies (i.e., Jeffers et al, 2021 and Vitaliano et al, 2017 ) did not include a familial definition of dementia exposure. Vitaliano et al (2017) exclusively used spouses of persons with AD as their sample (another type of familial exposure), while Jeffers et al (2021) compared caregivers with and without SCD, but did not specify the relationship to the care recipient, thus it cannot be ruled out that the care providers are also relatives.…”

Section: Discussionmentioning

confidence: 99%

“…However, the vast majority of studies used a familial definition of dementia exposure, such that only two studies (i.e., Jeffers et al, 2021 and Vitaliano et al, 2017 ) did not include a familial definition of dementia exposure. Vitaliano et al (2017) exclusively used spouses of persons with AD as their sample (another type of familial exposure), while Jeffers et al (2021) compared caregivers with and without SCD, but did not specify the relationship to the care recipient, thus it cannot be ruled out that the care providers are also relatives. Furthermore, almost half of the studies (15 of 32 reviewed) specified that dementia exposure was categorized as a first-degree family (i.e., parent, sibling, and child) only, which potentially limits the types of conclusions that can be drawn.…”

Section: Discussionmentioning

confidence: 99%

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How Does Exposure to Dementia Relate to Subjective Cognition? A Systematic Review

Turner

Hill

Brautigam

et al. 2023

Innovation in Aging

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Background and Objectives Subjective cognitive decline (SCD) may be indicative of future objective cognitive decline. However, factors other than objective cognitive performance may influence SCD. This review addresses whether family history or close, non-familial exposure to dementia is associated with self-reported SCD. Research Design and Methods Searches were conducted in PubMed, PsycINFO, Web of Science and the Dissertations and Theses Database. Eligible articles included measures of self-reported cognition for community-dwelling middle-aged or older adults (40+ years) not diagnosed with dementia, and who had either a family history of dementia, a family member, spouse, or close friend with dementia. Quality of evidence was evaluated using the LEGEND Appraisal Tool. Evidence was synthesized narratively. Results Thirty-two articles were included, with 28 rated as good quality. Across studies, the relationship between dementia exposure and SCD was inconsistent. A significant association between exposure and SCD was found in six studies, however seventeen reviewed studies found no evidence of a relationship. The remaining nine studies found mixed associations. Modifying factors that could potentially influence these associations were exploratorily identified among studies to provide context to our results. These factors included dementia worry, emotional closeness, and measurement sensitivity. Discussion and Implications Findings of this review suggest that both first-degree relatives and spouses of persons with dementia may have an increased likelihood of reporting SCD, although the current heterogeneity in definitions of exposure to dementia and SCD may influence these findings. In addition to the relationship between dementia exposure and SCD, future research should examine potential modifiers, including meaning attributed to exposure, as identifying how these perceptions impact cognition may promote early intervention.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

How Does Exposure to Dementia Relate to Subjective Cognition? A Systematic Review

Turner

Hill

Brautigam

et al. 2023

Innovation in Aging

View full text Add to dashboard Cite

show abstract

“…As Baby Boomers continue to age, there will be an increased prevalence of ageing persons with cognitive decline (PWCD) who require support from informal caregivers, as our current social and healthcare systems cannot meet the needs of patients with dementia through formal means 2 . Caregivers of PWCD are at increased risk of subjective cognitive decline, 3 dementia, 4 depression, 5 anxiety, 5 and adverse physical health outcomes 6,7 . Cognitive, physical, and mental health outcomes in general have been associated with various aspects of sleep quantity and quality in large, population‐based studies 8,9 .…”

Section: Introductionmentioning

confidence: 99%

Factors associated with reduced sleep among spouses and caregivers of older adults with varying levels of cognitive decline

Gallagher,

Reilly,

Rossetti

et al. 2023

Psychogeriatrics

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BackgroundCaregivers of persons with cognitive decline (PWCD) are at increased risk of poor sleep quantity and quality. It is unclear whether this is due to factors in the caregiver versus in the PWCD.MethodsThis secondary data analysis using Aging, Demographics, and Memory Study data from the Health Retirement Study examined factors contributing to reduced sleep/rest among spouses and caregivers of older adults with varying levels of cognitive decline (cognitively normal (CN), cognitive impairment but not dementia (CIND), or dementia).ResultsIn our preliminary analysis, among N = 218 spouses (not necessarily caregivers) (mean age (SD) = 73.77 (7.30); 70.64% female) of older adults with varying levels of cognitive decline, regression revealed that frequency of sleep complaints was lowest among spouses with CN partners, second highest with CIND partners, and highest with dementia‐partners, X2 = 26.810, P = 0.002. Primary aim: among n = 136 caregivers of PWCD (mean age (SD) = 59.27 (13.97); 74.26% female; 22.79% spouses), we analyzed whether caregiver reduced sleep/rest was predicted by PWCD factors (i.e., frequent nighttime waking, dementia severity) and/or caregiver factors (i.e., depression symptoms, caregiver role overload). Regression revealed that caregiver depression symptoms (d = 0.62) and role overload (d = 0.88), but not PWCD factors, were associated with reduced caregiver sleep/rest after adjusting for demographic factors, caregiving frequency, and shared‐dwelling status (overall model: X2 = 31.876, P = 0.002). Exploratory analyses revealed that a caregiver was 7.901 times more likely (95% CI: 0.99–63.15) to endorse experiencing reduced sleep/rest if back‐up care was not available (P = 0.023).ConclusionFindings highlight that the frequency of reported sleep problems among spouses increases in a stepwise fashion when partners have dementia versus CIND versus CN. The results also emphasise that caregiver mental health and burden are strongly associated with caregiver sleep disturbances and thus may be targets of intervention for caregiver sleep problems.

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“…In the US, in 2014 about 5 million people were living with Alzheimer's disease or a dementia-related disease, which is projected to double by 2060 [1]. Cognitive decline, an early warning sign for dementia, becomes apparent in one's inability to manage typical daily activities, household chores, and social interactions [2][3][4][5][6][7]. Overall, the national impact of cognitive decline on daily functioning prompted calls for enhanced surveillance and data collection [8,9].…”

Section: Introductionmentioning

confidence: 99%

A latent class analysis of cognitive decline in US adults, BRFSS 2015-2020

2022

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Background Cognitive decline can be an early indicator for dementia. Using quantitative methods and national representative survey data, we can monitor the potential burden of disease at the population-level. Methods BRFSS is an annual, nationally representative questionnaire in the United States. The optional cognitive decline module is a six-item self-reported scale pertaining to challenges in daily life due to memory loss and growing confusion over the past twelve months. Respondents are 45+, pooled from 2015-2020. Latent class analysis was used to determine unobserved subgroups of subjective cognitive decline (SCD) based on item response patterns. Multinomial logistic regression predicted latent class membership from socio-demographic covariates. Results A total of 54,771 reported experiencing SCD. The optimal number of latent classes was three, labeled as Mild, Moderate, and Severe SCD. Thirty-five percent of the sample belonged to the Severe group. Members of this subgroup were significantly less likely to be older (65+ vs. 45-54 OR = 0.29, 95% CI: 0.23-0.35) and more likely to be non-Hispanic Black (OR = 1.80, 95% CI: 1.53-2.11), have not graduated high school (OR = 1.60, 95% CI: 1.34-1.91), or earned <$15K a year (OR = 3.03, 95% CI: 2.43-3.77). Conclusions This study determined three latent subgroups indicating severity of SCD and identified socio-demographic predictors. Using a single categorical indicator of SCD severity instead of six separate items improves the versatility of population-level surveillance.

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Prevalence and Characteristics of Subjective Cognitive Decline Among Unpaid Caregivers Aged ≥45 Years — 22 States, 2015–2019

Cited by 8 publications

References 8 publications

How Does Exposure to Dementia Relate to Subjective Cognition? A Systematic Review

How Does Exposure to Dementia Relate to Subjective Cognition? A Systematic Review

Factors associated with reduced sleep among spouses and caregivers of older adults with varying levels of cognitive decline

A latent class analysis of cognitive decline in US adults, BRFSS 2015-2020

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