Caregiving for a Spouse with Cognitive Impairment: Effects on Nutrition and Other Lifestyle Factors

Abstract

Background: Being a spousal caregiver (SCG) for a patient with cognitive impairment is well known to be associated with increased risk for dementia and cognitive decline. Objective: This study examined the impact of the care-recipient’s cognitive status on lifestyle factors influencing cognitive decline in SCGs, focusing on nutritional status and blood biomarkers. Methods: Fifty-one SCGs participated (mean age 73.5±7.0 years) in this study. All participants underwent clinical assessment including the Mini Nutritional Assessment (MNA), Geriatric Depression Scale, Pittsburgh Sleep Quality Index, and International Physical Activity Questionnaire to evaluate lifestyle factors, and the Mini-Mental State Examination to assess global cognition. Also, nutritional blood biomarkers were measured. Results: SCGs caring for a demented spouse showed significantly higher depression scores (t = –3.608, p = 0.001) and malnutrition risk (t = 2.894, p = 0.006) compared to those caring for a non-demented spouse. Decreased care recipients’ cognition was significantly correlated with higher GDS (β= –0.593, t = –4.471, p < 0.001) and higher MNA scores (β= 0.315, t = 2.225, p = 0.031) and lower level of high-density lipoprotein (HDL) cholesterol (β= 0.383, t = 2.613, p = 0.012) in their SCGs. Gender had moderating effects on association of care-recipients’ cognition with sleep quality (B[SE] = 0.400[0.189], p = 0.041) and HDL cholesterol (B[SE] = –1.137[0.500], p = 0.028) among SCGs. Poorer care-recipient’s cognition was associated with worse sleep quality and low HDL cholesterol among wives but not husband caregivers. Conclusion: This study provides substantial evidence that SCGs are at risk for depression and malnutrition, which can further affect cognitive decline. As such, these factors should be well assessed and monitored among SCGs for patient with cognitive impairment.