Associations between dementia symptoms and caregiver and relationship health: A prominent role for speech and language

Background Dementia is a significant public health issue globally. People with dementia (PWD) exhibit symptoms in multiple domains (e.g., cognition, emotion, motor, speech/language) that can vary in their impact on the caregiver and the PWD-caregiver relationship. Objective We assessed the relative impact of various dementia symptoms on caregiver health and well-being and on the PWD-caregiver relationship using a broad sampling of PWD symptoms and caregiver/relationship outcome measures. Methods Data were analyzed from 54 primary caregivers of PWDs who completed seven questionnaires assessing caregiver health and well-being and PWD-caregiver relationship quality. An exploratory factor analysis of these questionnaires revealed two primary factors: (a) General Distress (anxiety, burden, depression, general health, loneliness), and (b) Relationship Quality (interpersonal closeness, relationship satisfaction). Caregivers also rated nine categories of PWD symptoms (memory, executive functions, speech/language, visual/spatial, motor, changes in behavior, sleep, medical/sensory, activities of daily living). Results Greater caregiver General Distress was associated with greater PWD speech/language and sleep symptoms. Lower caregiver Relationship Quality was associated (at trend, p < 0.10, levels) with greater PWD speech/language and activities of daily living symptoms. Correlations with the seven individual caregiver outcome measures revealed that speech/language symptoms were the most robust predictors (correlated with five measures), followed by sleep and activities of daily living symptoms (correlated with two measures), and memory, visual/spatial, and motor symptoms (correlated with one measure). Conclusions Findings highlight the profound adverse effects that PWD speech and language deficits may have on caregivers and underscore the importance of addressing these deficits in dementia care.