Mechanisms Underlying the Use of Abusive and Neglectful Behaviors in Dementia Caregiving: The Role of Caregiver Mental Health.
Wesley R Browning, Mustafa Yildiz, Jessica A Hernandez Chilatra and 5 others
PMID 39347758WHAT IT FOUND
Family dementia caregivers with depression or anxiety were more likely to report physically or psychologically aggressive or neglectful behavior on daily surveys.
Daily symptom spikes were also associated with this risk. These are caregiver-reported associations, not proof screening prevents harm.
Key findings
01Caregivers with baseline major depression had higher daily odds of physically aggressive (OR=2.47), psychologically aggressive (OR=2.59), and neglectful (OR=2.28) behaviors.
02Caregivers with baseline generalized anxiety disorder had higher daily odds of physically aggressive (OR=2.84), psychologically aggressive (OR=1.99), and neglectful (OR=1.73) behaviors.
03On days when a caregiver's depressive symptoms were worse than their average level, odds of physically aggressive (OR=1.73) and psychologically aggressive (OR=1.66) behavior were higher; on days when anxiety symptoms were worse than their average level, odds of psychologically aggressive (OR=1.39) and neglectful (OR=1.23) behavior were higher.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Abuse and neglect outcomes were self-reported by caregivers on daily surveys, so under-reporting or mis-reporting cannot be ruled out. The sample was highly female (394, 87.4%), limiting gender-specific conclusions. 22.22% of diary days were missing before imputation, and analysis used one randomly selected imputed dataset. Depression and anxiety were too strongly correlated to be modeled jointly, so their separate effects could not be fully separated. Financial exploitation and sexual aggression were excluded, and other relationship types were excluded because few participants met the co-residency requirement. The sample's generalizability is unknown because there is no nationally representative comparison group of dementia family caregivers.
Declared interests
The authors declare no conflicts of interest. The article is listed as supported by NIH extramural research.
The easy way to misread this
Do not conclude that screening or treating caregiver depression or anxiety will reduce elder abuse or neglect. This was an observational diary study of caregiver-reported associations, not a trial of screening or treatment.