STRESS-RELATED GROWTH AND RESILIENCE AMONG CAREGIVERS OF ALZHEIMER’S PATIENTS RECEIVING CHOLINOMIMETIC TREATMENT

Alzheimer's disease (AD) causes severe social and psychological burden on the patients' caregivers. In previous studies we showed that traumatic stress can be followed by stress related growth (SRG). In this study we examined the inter-relationships between Caregivers' burden, SRG, resilience and the cognitive and emotional status of AD patients receiving cholinomimetic treatment A prospective study including 17 caregivers of patients with AD treated in the Neurogeriatric and memory clinic in Hadassah Mount Scopus Hospital. Patients' cognitive and behavioral levels were evaluated using the Mini Mental State Examination (MMSE), Alzheimer's disease assessment scale-cognitive (ADAS-Cog) and Mindstream computerized program and Neuropsychiatric inventory (NPI), respectively. Caregivers' characteristics were evaluated using the stress related growth, resilience and burden of disease questionnaires. Evaluations were performed at baseline, after 6 months and following one year of cholinomimetic therapy. Caregivers group consisted of 10 women and 7 men with mean age of 68 ±13 years. During the year of treatment, most of the patients' cognitive and behavioral state deteriorated whereas among caregivers, a trend towards increase in SRG, resilience and disease' burden was noted. Among caregivers, greater disease' burden was associated with greater levels of SRG and resilience in the second and first evaluation but not at baseline. Greater decline in cognitive abilities as measured by a reduction in ADAS-cog among patients was associated with lower levels of SRG among caregivers. No correlation was found between any of the cognitive measurements and resilience or disease burden among caregivers. Among caregivers of AD patients, greater levels of stress as reflected by caregiver's burden are associated with greater levels of SRG and resilience. This trend became more evident during the year of follow up. Decline of cognitive abilities was associated with lower levels of SRG. The results promote the notion that better treatment of cognitive functions of AD patients may have positive implications on the psychological status of caregivers.