Disengagement coping partially mediates the relationship between caregiver burden and anxiety and depression in caregivers of people with Alzheimer's disease. Results from the MÁLAGA-AD study

Background: Caring for people with Alzheimer's disease can be considered stressful and demand adjustment strategies. While various variables have been associated with caregiver anxiety and depression, a possible mediator role of coping strategies adopted by caregivers between caregiver burden and anxiety and depression is still unclear. We hypothesized that caregivers with clinically significant anxiety and depression were more likely to use disengagement coping strategies that non-anxious and non-depressed caregivers.

Methods: This study involved 80 Alzheimer disease patients and their primary caregivers. Patients were evaluated using the Mini Mental State Examination, the Bayer Activities of Daily Living Scale, the Global Deterioration Scale and the Neuropsychiatric Inventory. Caregivers were evaluated with the Caregiver Burden Interview, the Beck Depression Inventory, the State-Trait Anxiety Inventory and the Coping Strategies Inventory. We conducted a series of multiple linear regressions to determine the relationship between caregiver burden and caregiver anxiety and depression, and if the coping strategies mediated this relationship.

Results: Using more disengagement (β=0.270, p<0.001) and less engagement coping (β=-0.310, p<0.001) were predictors for anxiety scores. Using more disengagement (β=0.250, p<0.001) and less engagement coping (β=-0.261, p<0.001) were predictors for depression scores.

Limitations: This study was a cross-sectional design, so the direction of causality should be strengthened by a longitudinal study.

Conclusions: Most caregivers reported higher anxiety and depression levels and this was partially mediated by their dysfunctional coping strategies.