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Physical Disability Contributes to Caregiver Stress in Dementia Caregivers

¹ School of Medicine and Pharmacology, University of Western Australia, Perth.
² School of Nursing, Edith Cowan University, Perth, Australia.
³ Department of Environmental Science, Murdoch University, Perth, Australia.
⁴ Alzheimer's Association of Western Australia, Perth.

Address correspondence to D. G. Bruce, School of Medicine and Pharmacology, Fremantle Hospital, P. O. Box 480, Fremantle, Western Australia 6959, Australia. E-mail: dbruce{at}cyllene.uwa.edu.au

Background. Previous findings of studies on the impact of physical illness on caregiver health have been inconsistent. The authors wanted to determine whether physical disability, as determined by the SF-12 survey that provides information on both physical and mental health problems, contributes to caregiver stress.

Methods. The authors interviewed 91 primary caregivers (aged 38–85 years) of persons with dementia who had been referred by their family physicians for the first time for formal support services or memory evaluation. Caregivers completed the SF-12 version of the Medical Outcomes Study Short Form Health Survey that generates Mental Component Summary (MCS) and Physical Component Summary (PCS) scores and reported on caregiver stress and concurrent medical conditions and medications.

Results. Most caregivers reported stress (76.9%), having medical conditions (72.4%), or taking medications (67%). The MCS but not the PCS scores were significantly lower than community norms, indicating an excess of disability due to mental health problems. Nevertheless, 40.7% had PCS scores indicating some degree of physical disability. Using multiple logistic regression analysis, PCS scores but not the presence of medical problems were independently associated with caregiver stress.

Conclusions. Chronic disability as assessed by SF-12 PCS scores is independently associated with caregiver stress. These data suggest that caregivers of persons with dementia should be assessed for disabling physical conditions and mental health problems. In addition, reducing the impact of physical disability could ameliorate caregiver stress.