The impact of care-recipient relationship type on health-related quality of life in community-dwelling older adults with dementia and their informal caregivers

Purpose To assess whether there was an association between care-recipient relationship type and health-related quality of life (HRQL) of older persons living with dementia (PLWD) and their informal caregivers, and whether this association was affected by PLWD' dementia severity. Methods This was a secondary data analysis study. PLWD (n = 1230) and caregivers (n = 1871) were identified from participants in the National Health and Aging Trends Study (NHATS) Round 5 and the National Study of Caregiving (NSOC) II, respectively. A series of bivariate and multivariable regression models examined the associations among relationship type and HRQL in PLWD and caregivers, adjusted for socio-demographic variables and dementia severity. Results PLWD and caregivers' HRQL outcomes varied by relationship type. PLWD cared for by an adult-child caregiver, or multiple caregivers experienced higher functional limitations than those cared for by a spousal caregiver (beta = .79, CI [.39, 1.19]; beta = .50, CI [.17, .82], respectively). "Other" caregivers, such as extended family members or friends, had lower odds of experiencing negative emotional burden and social strain than spousal caregivers (beta = .79, CI [.39, 1.19]; beta = .50, CI [.17, .82], respectively). Lower odds of experiencing negative emotional burden were also found with multiple caregivers. The effect of an adult-child caregiver on social strain was no longer significant when the dementia severity of PLWD was included in the analysis. Conclusion The type of care-recipient relationship impacts the HRQL in both PLWD and their informal caregivers. Dementia severity of the PLWD appears to affect this association.