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Decreasing sense of coherence and its determinants in spousal caregivers of persons with mild Alzheimer's disease in three year follow-up: ALSOVA study

Published online by Cambridge University Press:  21 March 2014

Tarja Välimäki*
Affiliation:
Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
Janne Martikainen
Affiliation:
School of Pharmacy, University of Eastern Finland, Kuopio, Finland
Kristiina Hongisto
Affiliation:
School of Medicine, Institute of Clinical Medicine, Neurology, University of Eastern Finland, Kuopio, Finland
Mikael Fraunberg
Affiliation:
Neurosurgery of Neuro Centre, Kuopio University Hospital, Kuopio, Finland Neurology of Neuro Centre, Kuopio University Hospital, Finland
Ilona Hallikainen
Affiliation:
School of Medicine, Institute of Clinical Medicine, Neurology, University of Eastern Finland, Kuopio, Finland
Juhani Sivenius
Affiliation:
School of Medicine, Institute of Clinical Medicine, Neurology, University of Eastern Finland, Kuopio, Finland
Katri Vehviläinen-Julkunen
Affiliation:
Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
Anna-Maija Pietilä
Affiliation:
Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
Anne M. Koivisto
Affiliation:
School of Medicine, Institute of Clinical Medicine, Neurology, University of Eastern Finland, Kuopio, Finland Neurology of Neuro Centre, Kuopio University Hospital, Finland
*
Correspondence should be addressed to: Tarja Välimäki, University of Eastern Finland, Department of Nursing Science, P.O. Box 1627, 70211 Kuopio, Finland. Phone: +358 403552267; Fax: +358 17 162632. Email: tarja.valimaki@uef.fi.

Abstract

Background:

Sense of coherence (SOC) is associated with the capability to cope with caregiving. Our aims were (1) to describe the trajectory of SOC in aged spousal caregivers of persons with mild Alzheimer's disease (AD) in 3-year follow-up and (2) to identify baseline determinants influencing SOC change.

Methods:

Both AD (n = 170) (CDR-SOB, MMSE, NPI, ADCS-ADL) and caregiver- (n = 170) (BDI, SOC) related efficacy parameters were evaluated annually. Follow-up time was 3 years. The relationship of potential baseline factors with longitudinal SOC was analyzed using linear mixed models.

Results:

The mean drop-out-adjusted SOC score (148.5 at baseline) was decreased by 4.56 points (p = 0.002) during the follow-up. Caregivers’ depression at baseline predicted the significant decrease of SOC (every + 1 BDI point decreases 2.181 points in SOC, p = 0.0001). When caregiver's depression was not taken into account in the analysis, female gender, and higher age and AD patient's lower baseline MMSE were associated significantly (p < 0.05) with decreasing SOC score in the follow-up. Other studied covariates were not associated with SOC change.

Conclusions:

SOC is not as stable as expected, but decreases during long-lasting caregiving. Caregiver's depression at baseline predicts SOC decrease over time. In the future, caregiver dependent factors should be evaluated at the beginning of caregiving to target individualized support programmes to the vulnerable caregivers.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2014 

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Decreasing sense of coherence and its determinants in spousal caregivers of persons with mild Alzheimer's disease in three year follow-up: ALSOVA study
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