Dementia Care Research and Psychosocial Factors

The quality of the caregiver-patient relationship is essential for both parties, as it significantly influences the emotional well-being of patients, and the satisfaction and burden of caregivers. This study aimed to assess the quality of caregiver-patient relationships in informal caregivers of patients with mild cognitive impairment (MCI) and to identify associated factors.

A non-interventional, cross-sectional study was conducted at 19 memory clinics in collaboration with the Spanish Confederation of Alzheimer's Disease (CEAFA). Informal caregivers of patients with MCI (NIA-AA criteria) and a Global Deterioration Scale score of 3 were included. The quality of the patient-caregiver relationship was measured using the Quality of Carer-Patient Relationship Scale (QCPR). A score >56 indicates a good-quality relationship. Associations between QCPR scores and caregiver demographic, psychological, and behavioral factors, as well as patient characteristics, were analyzed through logistic regression.

A total of 196 caregivers were studied (mean age: 63.5 ± 13.1 years; 63% female). Of these, 68.4% were spouses of patients (mean age: 72.9 ± 7.0 years) with a median disease duration of 2 years (IQR 1.0-4.0) and a median MMSE score of 26.0 (IQR 23.0-27.0). Over half of the participants reported a good relationship with the patient (53.6%, mean QCPR score: 26.1 ± 6.1). Higher QCPR scores were associated with lower caregiving burden, greater care competence, better quality of life, stronger social support, greater resilience, and higher levels of anxiety and depression. Younger caregivers, employed, and living separately from the patient reported having better relationships with them. In multivariate analysis, a good patient-caregiver relationship was independently associated with higher MMSE score (OR=1.165, 95% CI 1.034-1.312, p = 0.012), fewer neuropsychiatric symptoms (OR=0.865, 95% CI 0.795-0.942, p = 0.001), lower use of avoidant coping strategies (OR=0.424, 95% CI 0.182-0.987, p = 0.047), and lower perception of stigma (OR=0.048, 95% CI 0.048-0.007, p = 0.002).

The quality of the relationship is influenced by demographic, psychological, and behavioral factors relating to both the caregiver and the patient. Specific interventions on these factors could be useful in enhancing caregiver-patient relationships.