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Cited by 61Grief, Bereavement, and Mental HealthDementia and Cognitive Impairment ResearchNursing care and research

Comparing the Effects of Grief and Burden on Caregiver Depression in Dementia Caregiving: A Longitudinal Path Analysis over 2.5 Years

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Liew, Tau Ming, Tai, Bee Choo, Yap, Philip, Koh, Gerald Choon-Huat·2019·Journal of the American Medical Directors Association
DOI 10.1016/j.jamda.2018.11.016
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Abstract

OBJECTIVES: Caregivers of persons with dementia can experience loss and grief long before the death of the person. Although the phenomenon of caregiver grief has been increasingly described, it is uncertain if caregiver grief has independent effects-separate from the well-studied construct of caregiver burden-on adverse outcomes such as caregiver depression. We sought to compare the effects of baseline grief and burden on caregiver depression at baseline and 2.5 years later. DESIGN AND SETTING: A cohort study with 2.5 years of follow-up. PARTICIPANTS: Family caregivers of community-dwelling persons with dementia (n = 183). MEASURES: Participants completed questionnaires with scales that assessed caregiver grief, burden, and depression. Baseline grief and burden scores were included in a path analysis to predict depression at baseline and at 2.5 years. RESULTS: At baseline, grief and burden had synergistic relationships with each other (P = .012), where the high levels of grief amplified the effect of burden on caregiver depression. Both grief and burden had longitudinal effects on caregiver depression at 2.5 years (P <.001 and P = .047, respectively), albeit with some differences in mechanism; both had effects which were indirectly mediated through baseline depression (P < .001 and P = .002, respectively), but only grief had a direct path toward depression at 2.5 years (P = .030), which was distinct from baseline depression. CONCLUSIONS AND IMPLICATIONS: The findings highlight the need to identify and address caregiver grief in dementia services. They present a window of opportunity to improve caregiving outcomes, especially during the "latent phase" when caregivers encounter loss and grief but have yet to fully experience the debilitating effects of depression.

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Authors
Liew, T. M., Tai, B. C., Yap, P., & Koh, G. C.-H.
Affiliations
  • National University of Singapore (SG)
  • Khoo Teck Puat Hospital (SG)
Corresponding author
Liew, Tau Ming
ORCID
Venue
Journal of the American Medical Directors Association
Publisher
Elsevier BV
Published
2019-08
Volume
20
Issue
8
Pages
977-983.e4
ISSN
1525-8610 (ISSN-L)
DOI
10.1016/j.jamda.2018.11.016
OpenAlex
W2911733105
Cited by
61
References
57
Citations by year
2026: 7 · 2025: 7 · 2024: 5 · 2023: 7 · 2022: 8 · 2021: 5 · 2020: 19 · 2019: 2 · 2018: 1
FWCI
9.94
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of the American Medical Directors Association (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
Funders
  • National Medical Research Council (NMRC/HNIG/0002/2017)
  • Ministry of Health -Singapore
  • Singapore Population Health Improvement Centre (NMRC/CG/C026/2017_NUHS)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Grief, Bereavement, and Mental Health
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Health Sciences › Health Professions › Pharmacy › Nursing care and research
Keywords
caregiver grief, caregiver burden, caregiver depression, dementia caregiving, family caregivers, longitudinal effects
MeSH terms
Dementia, Depression, Female, Grief, Humans, Longitudinal Studies, Male, Middle Aged, Surveys and Questionnaires, Caregivers

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