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Cognitive reserve and self-efficacy as moderators of the relationship between stress exposure and executive functioning among spousal dementia caregivers

Published online by Cambridge University Press:  09 January 2017

M. M. Pertl Open the ORCID record for M. M. Pertl [Opens in a new window] ,
C. Hannigan ,
S. Brennan ,
I. H. Robertson  and
B. A. Lawlor
M. M. Pertl*
Affiliation:
Neuro-Enhancement for Independent Lives (NEIL) Programme, Trinity College Institute of Neuroscience (TCIN), Trinity College Dublin, Dublin 2, Ireland Royal College of Surgeons in Ireland, Dublin 2, Ireland
C. Hannigan
Affiliation:
Neuro-Enhancement for Independent Lives (NEIL) Programme, Trinity College Institute of Neuroscience (TCIN), Trinity College Dublin, Dublin 2, Ireland
S. Brennan
Affiliation:
Neuro-Enhancement for Independent Lives (NEIL) Programme, Trinity College Institute of Neuroscience (TCIN), Trinity College Dublin, Dublin 2, Ireland
I. H. Robertson
Affiliation:
Neuro-Enhancement for Independent Lives (NEIL) Programme, Trinity College Institute of Neuroscience (TCIN), Trinity College Dublin, Dublin 2, Ireland
B. A. Lawlor
Affiliation:
Neuro-Enhancement for Independent Lives (NEIL) Programme, Trinity College Institute of Neuroscience (TCIN), Trinity College Dublin, Dublin 2, Ireland
*
Correspondence should be addressed to: M. M. Pertl, Neuro-Enhancement for Independent Lives (NEIL) Programme, Trinity College Institute of Neuroscience (TCIN), Trinity College Dublin, Dublin 2, Ireland. Email: pertlm@tcd.ie.
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Abstract

Background:

A substantial literature has reported that stress negatively impacts on cognitive processes. As dementia caregiving can be stressful, it has been hypothesized that the challenges of dementia care may increase caregivers’ own vulnerability to cognitive decline. Prefrontal processes are thought to be most vulnerable to stress; however, few studies have examined whether greater caregiver stress predicts poorer executive dysfunction, and no previous research has considered potential moderators of this relationship. We examined (1) whether greater psychological stress mediated a relationship between caregiver stress exposure and executive functioning and (2) whether greater self-efficacy and cognitive reserve (CR) moderated this relationship.

Method:

Spousal dementia caregivers (n = 253) completed the Neuropsychiatric Inventory Questionnaire (stress exposure), the Perceived Stress Scale, the National Adult Reading Test (CR), the Fortinsky dementia-specific caregiver self-efficacy scale, and the Color Trails Test (executive functioning). Moderated mediation was tested using the PROCESS macro. Age, gender, and dementia risk factors were included as covariates.

Results:

Greater stress exposure indirectly predicted executive functioning through psychological stress. Stronger relationships between greater psychological stress and poorer executive functioning were observed among caregivers with lower CR; there was no evidence that self-efficacy moderated the relationship between stress exposure and psychological stress.

Conclusions:

Our findings are in line with the idea that greater psychological stress in response to challenges associated with dementia care predicts poorer caregiver executive functioning, particularly among caregivers with low CR. However, these findings are cross sectional; it is also possible that poorer executive functioning contributes to greater caregiver stress.

Keywords

carerscognitive impairmentrisk factorsdementia
Type
Research Article
Information
International Psychogeriatrics , Volume 29 , Issue 4 , April 2017 , pp. 615 - 625
Copyright
Copyright © International Psychogeriatric Association 2017 

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