Loneliness predicts dementia-caregiver burden better than extent, nature and length of caregiving or support service-use

Abstract

Background: Caring for a spouse with dementia can lead to high levels of burden and stress, which may ultimately compromise caregivers’ psychological health and quality of life. We examined contributing factors to caregiver burden to inform the development of targeted caregiver interventions. Method: 226 spousal dementia caregivers completed standardised psychological (depression, anxiety, self-efficacy), social (loneliness, social isolation), caregiving (length and extent of caregiving, support service-use) and burden measures, as well as measures of care-recipient symptom severity and disability, as part of a longitudinal study on caregiver cognitive functioning. Results: Burden was not related to length, nature or extent of caregiving, or support service-use. Depression, self-efficacy for symptom management, and symptom-related distress significantly explained 55% of the variation in caregiver burden; however, emotional loneliness and social isolation made additional unique contributions (∆R2=.03). Discussion: Higher levels of burden are primarily related to caregivers’ psychological wellbeing, social isolation and loneliness, rather than level of disability, length or extent of caregiving. Interventions need to address the impact of dementia care on loneliness and social isolation to protect caregivers from the stresses associated with caring.