Subjective stressors moderate effectiveness of a multi‐component, multi‐site intervention on caregiver depression and burden

Abstract

The present study assessed whether caregiving contextual factors moderated outcomes of a caregiver intervention. Extant data from the Resources for Enhancing Alzheimer's Caregiver Health (REACH) II study, a randomized-control trial of a multi-component, multi-site intervention for dementia caregivers was utilized. 498 caregivers {83.1% women; mean [standard deviation (SD)] age = 60.3 (13.1)}, and their care recipients [58.6% women, mean (SD) age = 78.5 (9.6)] were randomly assigned to intervention or control group. Multiple regression was used to regress Center for Epidemiological Studies of Depression Scale (CES-D) and Zarit burden scores on the interaction between group membership and various factors reflecting the caregiving context. Lower follow-up CES-D scores in the intervention group were found only for those: in the fourth quartile of baseline CES-D (β = -0.13, p = 0.05; overall interaction p = 0.009), with high Revised Memory and Behavior Problems Checklist (RMBPC) stress (β = -0.16, p = 0.03) and with a home health aide (β = -0.29, p = 0.009). Diminished burden was found in the intervention group only for the following: those in the fourth quartile of baseline burden (β = -0.16, p = 0.01), and in the fourth quartile (β = -0.16, p = 0.05) of Mini Mental State Examination, and with high RMBPC stress (β = -0.18, p = 0.008), with a trend for diminished burden among those with a paid homemaker (β = -0.19, p = 0.075). Results suggest greater intervention efficacy among caregivers experiencing subjective stress.