Strain and its correlates among carers of people with dementia in low-income and middle-income countries. A 10/66 Dementia Research Group population-based survey
Article first published online: 29 MAR 2012
Copyright © 2012 John Wiley & Sons, Ltd.
International Journal of Geriatric Psychiatry
Volume 27, Issue 7, pages 670–682, July 2012
How to Cite
Prince, M., Brodaty, H., Uwakwe, R., Acosta, D., Ferri, C. P., Guerra, M., Huang, Y., Jacob, K., Llibre Rodriguez, J. J., Salas, A., Sosa, A. L., Williams, J. D., Jotheeswaran, A. and Liu, Z. (2012), Strain and its correlates among carers of people with dementia in low-income and middle-income countries. A 10/66 Dementia Research Group population-based survey. Int. J. Geriat. Psychiatry, 27: 670–682. doi: 10.1002/gps.2727
- Issue published online: 11 JUN 2012
- Article first published online: 29 MAR 2012
- Manuscript Accepted: 8 MAR 2011
- Manuscript Received: 15 NOV 2010
- Wellcome Trust Health Consequences of Population Change Programme. Grant Numbers: GR066133, GR08002
- World Health Organisation
- US Alzheimer's Association. Grant Number: IIRG-04-1286
- developing countries;
- epidemiologic studies
In a multi-site population-based study in several middle-income countries, we aimed to investigate relative contributions of care arrangements and characteristics of carers and care recipients to strain among carers of people with dementia. Based on previous research, hypotheses focused on carer sex, care inputs, behavioural and psychological symptoms (BPSD) and socioeconomic status, together with potential buffering effects of informal support and employing paid carers.
In population-based catchment area surveys in 11 sites in Latin America, India and China, we analysed data collected from people with dementia and care needs, and their carers. Carer strain was assessed with the Zarit Burden Interview.
With 673 care recipient/carer dyads interviewed (99% of those eligible), mean Zarit Burden Interview scores ranged between 17.1 and 27.9 by site. Women carers reported more strain than men. The most substantial correlates of carer strain were primary stressors BPSD, dementia severity, needs for care and time spent caring. Socioeconomic status was not associated with carer strain. Those cutting back on work experienced higher strain. There was tentative evidence for a protective effect of having additional informal or paid support.
Our findings underline the global impact of caring for a person with dementia and support the need for scaling up carer support, education and training. That giving up work to care was prevalent and associated with substantial increased strain emphasizes the economic impact of caring on the household. Carer benefits, disability benefits for people with dementia and respite care should all be considered. Copyright © 2012 John Wiley & Sons, Ltd.