Predictors of Appraisal and Psychological Well-Being in Alzheimer's Disease Family Caregivers

The objective of this study was to test a model of stress, appraisal, and adaptation in 114 family caregivers of patients diagnosed with dementia of the Alzheimer's type (white non-Hispanic, N = 64; Hispanic-American, N = 50). Results of structural equation analysis show that appraised caregiver burden played a central role in determining the psychological well-being of family caregivers. The findings indicate that this mediating variable, negative caregiver appraisal, was predicted by increased functional limitations and behavioral disturbances in the patient, poorer perceived physical health, and lower levels of perceived emotional support. Contrary to a priori hypotheses, functional limitations in the patient also exhibited a direct association with caregiver depression. Further, patient cognitive impairment and caregiver ethnicity were not related to caregiver appraisal. Overall, these results support the role of appraised burden in mediating the relationships between caregiving factors and the adaptational outcome of depression. The implications of these findings, limitations of the study, and future directions are discussed.