Views on Lifestyle Change From Caregivers of People With Cognitive Impairment in China

Y John Mei ,Bei Wu,Zongfu Mao,Huali Wang,Quan Wang,Cui Dan,Sue E Levkoff

doi:10.1177/2158244013499160

Abstract

Lifestyle changes such as in physical exercise, social activity, and diet can mitigate cognitive decline and improve quality of life in caregivers and care recipients with cognitive impairment. However, caregiver perspectives on lifestyle change remain largely unexamined. This study compares perspectives among caregivers for those with dementia and those with mild cognitive impairment (MCI). Interviews were conducted with caregivers in two sites in China, and thematic similarities and differences were examined between the two groups. Caregivers from both groups identified exercise, social activity, and diet as healthy ways of life. Differences were found in approaching lifestyle change based on health of the care recipient. Caregivers for patients with dementia found more often that they had no time or possibility for change, while caregivers for individuals with MCI were more often hopeful about change.

Highlights

It is projected that more than 30% of the Chinese population will be age 60 or older—about 400 million people—by 2050, adding to a projected 2 billion age 60+ population worldwide (Banister, Bloom, & Rosenberg, 2010; Gu & Cai, 2009), making age-related diseases and conditions like cognitive impairment a priority in intervention-oriented research
After contacting caregivers referred by physicians in Zhongnan Hospital, a teaching hospital affiliated with Wuhan University, the study team recruited 21 participants (14 caregivers of persons with mild cognitive impairment (MCI) and 7 caregivers of persons with dementia)
The present study looks at views on healthy lifestyles, focusing on the questions, “What are some ways of maintaining a healthy lifestyle and improving mental health”; “From your own experience, is physical exercise, healthy diet, or social activity most conducive to maintaining good health and mood”; “Which changes would be most willing to make to your lifestyle”; and “In order for you to improve your physical health or mood to better take care of the elderly, which of the following aspects would be most helpful?” Analysis of translated transcripts included coding lineby-line or paragraph-by-paragraph, and the emergence of main themes and subthemes were identified in a code matrix

Summary

Introduction

It is projected that more than 30% of the Chinese population will be age 60 or older—about 400 million people—by 2050, adding to a projected 2 billion age 60+ population worldwide (Banister, Bloom, & Rosenberg, 2010; Gu & Cai, 2009), making age-related diseases and conditions like cognitive impairment a priority in intervention-oriented research. Increasing attention has been paid to lifestyle behaviors, such as physical activity, social engagement, and diet in improving cognitive health. A growing body of evidence demonstrates the importance of physical activity (Angevaren, Aufdemkampe, Verhaar, Aleman, & Vanhees, 2008; Heyn, Abreu, & Ottenbacher, 2004; Lautenschlager et al, 2008; Lautenschlager, Cox, & Kurz, 2010) and social interactions (Bassuk, Glass, & Berkman, 1999; Seeman, Lusignolo, Albert, & Berkman, 2001) in mitigating the advancement of cognitive impairment. Physical activity seems to provide mood benefits to individuals with mild cognitive impairment (MCI) and mild to moderate dementia (Olazarán et al, 2004). Telephone-supervised, home-based physical activity regimens resulted in improvements in self-reported quality of sleep, blood pressure reactivity to a laboratory-based emotional challenge, and psychological distress (King, Baumann, O’Sullivan, Wilcox, & Castro, 2002). Other physical activity studies have found positive effects on caregiver sense of burden (Hirano et al, 2011), anxiety, depression, and perceived self-efficacy in controlling negative thoughts (Waelde, Thompson, & Gallagher-Thompson, 2004)

Objectives

Methods

Results

Conclusion