Is carer management style associated with longitudinal functional decline in dementia?

Puthusseryppady, Vaisakh, Bregola, Allan, Camino, Julieta ORCID:, Backhouse, Tamara ORCID: and Mioshi, Eneida (2023) Is carer management style associated with longitudinal functional decline in dementia? Journal of Alzheimer's Disease, 96 (3). pp. 1139-1149. ISSN 1387-2877

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Background: Various intrinsic (related to dementia) and extrinsic (not related to dementia) factors have been suggested to contribute separately to disability in people living with dementia (PLwD). Objective: To investigate if the combination of specific intrinsic and extrinsic factors at baseline is associated with longitudinal declines in activities of daily living (ADL) performance of PLwD at 12-month follow-up. Methods: 141 community-dwelling PLwD-carer dyads were assessed on their global cognition (ACE-III), apathy (CBI-R), carer management styles (DMSS), medical comorbidities (CCI), and ADL performance (DAD) at baseline, and for a subset of participants (n = 53), at 12-month follow-up. Multiple linear regression models were run to assess: 1) the relationships between PLwD’s DAD scores and the remaining variables at baseline and 2) whether these variables’ scores at baseline were associated with longitudinal change in the PLwD’s DAD scores. Results: At baseline, having lower ACE-III (β = 0.354, p < 0.001), higher CBI-R (β = –0.284, p < 0.001), higher DMSS criticism (β = –0.367, p = 0.013), lower DMSS encouragement (β = 0.370, p = 0.014), and higher CCI scores (β = –2.475, p = 0.023) were significantly associated with having lower DAD scores. The PLwD’s DAD scores significantly declined from baseline to follow-up (p < 0.001, d = 1.15), however this decline was not associated with the baseline scores of any of the independent variables. Instead, it was associated with declines in the PLwD’s ACE-III scores from baseline to follow-up (β = 1.021, p = 0.001). Conclusions: In our limited sample, cognitive changes seem to be the main factor underlying longitudinal decline in ADL performance for PLwD. Carer management styles appear associated with current ADL performance but not with longitudinal ADL decline.

Item Type: Article
Additional Information: Funding Information: This work was supported by a project grant from the Alzheimer’s Society (grant number AS-SF-241). This work was also funded in part by the National Institute for Health and Care Research (NIHR) Applied Research Collaboration East of England (NIHR ARC EoE) at Cambridgeshire and Peterborough NHS Foundation Trust. The views expressed are those of the authors and not necessarily those of the NIHR or Department of Health and Social Care. Funding Information: This study was conducted as a part of the TASKed project, funded by the Alzheimer’s Society, sponsored by the University of East Anglia, and led by the senior author. Publisher Copyright: © 2023 – IOS Press. All rights reserved.
Uncontrolled Keywords: activities of daily living,alzheimer’s disease,dementia,disability studies,functional independence,longitudinal studies,risk factors,neuroscience(all),clinical psychology,geriatrics and gerontology,psychiatry and mental health,sdg 3 - good health and well-being ,/dk/atira/pure/subjectarea/asjc/2800
Faculty \ School: Faculty of Medicine and Health Sciences > School of Health Sciences
UEA Research Groups: Faculty of Medicine and Health Sciences > Research Groups > Dementia & Complexity in Later Life
Faculty of Medicine and Health Sciences > Research Centres > Norwich Institute for Healthy Aging
Faculty of Medicine and Health Sciences > Research Centres > Lifespan Health
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Depositing User: LivePure Connector
Date Deposited: 03 May 2024 14:31
Last Modified: 03 May 2024 14:31
DOI: 10.3233/JAD-230075


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