Author(s):
Gonçalves-Pereira, M. ; Marques, Maria J. ; Alves, Regina F. ; Jelley, Hannah ; Wolfs, Claire ; Meyer, Gabriele ; Bieber, Anja ; Irving, Kate ; Hopper, Louise ; Zanetti, Orazio ; Portolani, Daniel M. ; Selbaek, Geir ; Røsvik, Janne ; Sköldunger, Anders ; Sjölund, Britt Marie ; de Vugt, Marjolein ; Verhey, Frans ; Woods, Bob
Date: 2025
Persistent ID: http://hdl.handle.net/10362/177009
Origin: Repositório Institucional da UNL
Subject(s): Alzheimer's disease; Cross-lagged analysis; Distress; Family; Longitudinal study; Salutogenesis; Clinical Psychology; Psychiatry and Mental health; SDG 3 - Good Health and Well-being
Description
Funding Information: Actifcare was an EU Joint Programme - Neurodegenerative Disease Research (JPND/2013/2) project. The project was supported through the following funding organizations under the aegis of JPND\u2014www.jpnd.eu: Germany, Bundesministerium fur Bildung und Forschung (BMBF); Ireland, Health Research Board (HRB); Italy, Italian Ministry of Health; Netherlands, The Netherlands Organisation for Health, Research and Development (ZonMw), and Alzheimer Netherlands; Norway, The Research Council of Norway; Sweden, Swedish Research Council (SRC); United Kingdom, Economic and Social Research Council (ESRC).The Actifcare project in Portugal had support from Funda\u00E7\u00E3o para a Ci\u00EAncia e a Tecnologia (FCT-JPND-HC-0001/2012), under the same JPND/2013/2 initiative. Maria J. Marques was supported by POPH/ESF funding (FCT-PD/BD/128011/2016). This secondary analysis was funded by Funda\u00E7\u00E3o para a Ci\u00EAncia e Tecnologia, I.P. national support through CHRC (UIDP/04923/2020). Funding Information: The Actifcare project in Portugal had support from Funda\u00E7\u00E3o para a Ci\u00EAncia e a Tecnologia ( FCT-JPND-HC-0001/2012 ), under the same JPND/2013/2 initiative. Maria J. Marques was supported by POPH/ESF funding ( FCT-PD/BD/128011/2016 ). This secondary analysis was funded by Funda\u00E7\u00E3o para a Ci\u00EAncia e Tecnologia , I.P. national support through CHRC ( UIDP/04923/2020 ). Publisher Copyright: © 2024 The Authors
Background: Sense of coherence (SOC) is a disposition to perceive things as comprehensible, manageable and meaningful. Lower SOC is associated with subjective burden and psychological morbidity in family caregivers, including in dementia. However, the evidence-base mainly comprises small-scale or cross-sectional studies. More should be known about SOC stability, causal relationships, and international contexts. We aimed to study longitudinal links between dementia caregivers' SOC, subjective burden, and anxiety and depression symptoms in a multinational sample. Methods: We analyzed the EU-Actifcare cohort (451 dyads of community-dwelling people with mild-moderate dementia and their caregivers). Caregivers' assessments included: SOC scale, Relatives' Stress Scale, Hospital Anxiety and Depression Scale. A cross-lagged panel model was used to investigate associations between these measures at baseline, 6 and 12-month follow-ups, controlling for covariates. Results: Caregivers' subjective burden, anxiety and depression symptoms increased over time, SOC remaining overall stable. Considering the first six-month follow-up, we found bidirectional relationships between SOC and subjective burden, and SOC and anxiety symptoms, while lower SOC predicted depression symptoms but not vice versa. For the remaining follow-up period, both anxiety and depression symptoms predicted lower SOC but not vice versa. Limitations: Convenience sampling precludes full generalizability. Conclusions: This large longitudinal study shed more light on interplays between SOC, subjective burden and mental health outcomes in dementia caregivers. Findings were consistent with SOC potential protective role against burden and psychological morbidity. However, they also supported reverse causality regarding part of the associations. Caregivers' SOC levels may be directly influenced by subjective burden and psychological morbidity.
