A Landscape of Subjective and Objective Stress in African-American Dementia Family Caregivers

Abstract

Stress is a significant part of daily life, and systemic social inequities, such as racism and discrimination, are well-established contributors of chronic stress for African Americans. Added exposure to the stress of caregiving may exacerbate adverse health outcomes. This secondary analysis describes subjective and objective stress in African American family caregivers, and relationships of subjective and objective stress to health outcomes. Baseline data from 142 African American dementia family caregivers from the “Great Village” study were described using means and frequencies; regression models and Pearson’s correlation were used to examine associations between demographics, social determinants of health, and health outcomes. Mixed models were used to examine change and change variation in cortisol. Most caregivers had moderate degrees of stress. Stress was associated with sleep disruption and depressive symptoms, and discrimination appeared to be an independent contributor to depressive symptoms. This work provides a foundation for interpreting subjective and objective indicators of stress to tailor existing multicomponent interventions.

2023 Alzheimer's disease facts and figures

“…In a nationally representative study, 428 Black and Hispanic participants had poorer health prior to becoming a caregiver for a spouse with dementia than those of similar race/background who did not become caregivers; such differences were not apparent among White caregivers. Discrimination is also linked with depressive symptoms among African American dementia caregivers 429 …”

“…Discrimination is also linked with depressive symptoms among African American dementia caregivers. 429 Existing research also suggests nuanced findings related to racial and ethnic differences in dementia caregiving. For example, Black caregivers are more likely than White caregivers to report positive aspects of caregiving.…”

COVID-19 Related Stress and Emotion Regulation: An Examination of their Effect on Sleep, Dreaming, and Social Cognition.

“…Covid stress also failed to demonstrate an association with any of the measured sleep variables. These findings were unexpected as many of the initial studies examining sleep reported a disruptive effect of the pandemic (Partinen, 2021), with chronic stress previously demonstrating reliable associations with sleep disruption (Cothran et al, 2022). However, such results are not replicated across every study.…”

A Culturally and Linguistically Appropriate Telephone Support Intervention for Diverse Family Caregivers of Persons With Dementia During the COVID-19 Pandemic

“…Evidence shows that telephone-based programs are effective alternatives to in-person support programs (Cothran et al, 2021; Greenberg et al, 2020; Hwang et al, 2021; Kasar & Karaman, 2021; Mok et al, 2020; Sitges-Macia et al, 2021). More so, in the early pandemic, many caregivers were unfamiliar with web-based interfaces such as Zoom or Google Meet, which would have allowed for camera accessibility.…”