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Caregivers' adaptation to change: the impact of increasing impairment of persons suffering from dementia on their caregivers' subjective well-being

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As progressive dementia involves changes in patients’ behaviour and cognitive and functional abilities, dementia caregiving can be considered as a process that demands continuous adaptation to change. The current intervention study investigated associations between the course of dementia patients’ impairment and their caregivers’ well-being over two years. One hundred and twenty-eight care recipient-caregiver dyads participated in a controlled randomised intervention study (psycho-educational group intervention), 99 dyads in which the care recipients still lived at home participated in the second assessment, and 75 dyads in the third assessment. Caregivers were interviewed about their subjective well-being (emotional well-being and life satisfaction) as well as care recipients’ behavioural problems and functional disability. Care recipients completed various neuropsychological tests. The assessments were repeated one and two years later. The psycho-educational intervention had a positive impact on caregivers’ well-being. Level and increase in behavioural problems and increases in cognitive and functional impairment negatively affected caregiver well-being over time. For participants from the control condition the negative association between increase in impairment and decrease in caregiver well-being over time was stronger than for the caregivers in the intervention group. Our results suggest that it is not only the severity of current problems and stress, but also the rate of change, that is important for caregivers’ well-being. Psycho-educational group intervention may help caregivers to adapt to the increasing impairment of care recipients with dementia.


Perren, S., Schmid, R., & Wettstein, A. (2006). Caregivers' adaptation to change: the impact of increasing impairment of persons suffering from dementia on their caregivers' subjective well-being. Aging & mental health, 10(5), 539–548.





Conent Area


EWB-Related Construct

(2) Life Satisfaction
(3) Positive Affect
(4) quality of life

Study Design

Species or Study Population

(5) RCT

Sex (%Female)

caregivers: 44%
care recipients: 90%

Age (Mean, SD)

caregivers: 68.4, 11
care recipients: 74.7, 7.8

Younger Controls?


Longitudinal Data?


Sample Size



Caregiver education sessions

Ethnicity (%white)

none stated (Switzerland)

Inclusion Criteria

(1) mild-to-moderate dementia of any cause
fulfilling DSM III R diagnostic criteria,
(2) caregiver living in the same household or in walking distance of the care recipient,
(3) fluency in the German language,
(4) consenting to participate in a prospective randomized trial of eight weekly caregiver education sessions or instruction in memory training, as well as a follow-up assessment.

Exclusion Criteria


EWB Measures

Swiss health survey (emotional well-being)
Schedule for the Evaluation of Individualized Quality of Life

Non-EWB Behavioral

(1) neuropsychiatric inventory (NPI)
(2) Care recipients’ cognitive ability (explicit memory, semantic memory, and spatial cognition): learning and recall test, The clock drawing test, verbal fluency

Physiological Measures


Brain IMaging Modality

Brain IMaging Paradigm


Brain Region/Circuit


Biological Measures


Other Neural Measures

Data Availability?


Data Avalability Details


Diagnostic Measures

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