Shared Activities as a Protective Factor Against Behavioral and Psychological Symptoms of Dementia and Caregiver Stress

Darina V Petrovsky; Mustafa Yildiz; Maria Yefimova; Justine S Sefcik; Zachary G Baker; Kris Pui Kwan Ma; Zahra Rahemi; Juanita-Dawne R Bacsu; Matthew Lee Smith; Carolyn E Z Pickering

doi:10.1093/geroni/igae034

Shared Activities as a Protective Factor Against Behavioral and Psychological Symptoms of Dementia and Caregiver Stress

Innov Aging. 2024 Mar 11;8(5):igae034. doi: 10.1093/geroni/igae034. eCollection 2024.

Authors

Affiliations

¹ Division of Women, Children, & Families, Duke University School of Nursing, Durham, North Carolina, USA.
² Department of Research, Jane and Robert Cizik School of Nursing, University of Texas Health Science Center at Houston, Houston, Texas, USA.
³ Center for Nursing Excellence & Innovation, University of California, San Francisco, San Francisco, California, USA.
⁴ Department of Physiological Nursing, UCSF School of Nursing, San Francisco, California, USA.
⁵ College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA.
⁶ Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA.
⁷ Department of Family Medicine, University of Washington, Seattle, Washington, USA.
⁸ School of Nursing, Clemson University, Greenville, South Carolina, USA.
⁹ School of Nursing, Thompson Rivers University, Kamloops, British Columbia, Canada.
¹⁰ Department of Health Behavior, Texas A&M University School of Public Health, College Station, Texas, USA.

Abstract

Background and objectives: Most persons with dementia experience behavioral and psychological symptoms (BPSD). While there is evidence that structured activity programs can be beneficial for persons with dementia and their caregivers, it is not well understood how joint engagement in shared activities affects BPSD and caregiver stress. The purpose of this study was to examine the moderating effect of doing a shared activity on the BPSD and caregiver stress.

Research design and methods: This study used an intensive longitudinal observational design in which caregivers completed baseline and once-a-day diary surveys for 21 days. Caregivers were asked whether they did a pleasant noncare activity with their relative, the presence of 8 BPSD, and their stress level. A moderation model in a structural equation model examined the relationship between these variables.

Results: Our sample consisted of 453 caregivers (87.4% female, 51.4% non-Hispanic White, mean age 53 years [standard deviation {SD}: 14]) and person living with dementia whose mean age was 79 years (SD: 9). On days when the caregivers engaged in a shared activity together with person living with dementia, there was a significant decrease in the BPSD (estimate -0.038, standard error [SE] = 0.016, 95% confidence interval [CI]: -0.069, -0.007, p value = 0.018). The effects of engaging in a shared activity decreased the impact of caregiver stress by 0.052 (estimate -0.052, SE = 0.018, 95% CI: -0.087, -0.017, p value = 0.004). At the between-person level, no differences were found in BPSD across caregivers who engaged or did not engage in shared activities.

Discussion and implications: The results of our study indicate that doing a shared activity is associated with reduced BPSD among persons with dementia and may buffer the impact of caregiver stress on BPSD. Shared activities should be considered a key intervention component for dementia caregivers.

Keywords: Activities; Caregiving; Dementia; Quantitative research methods; Stress.