How does carer management style influence the performance of activities of daily living in people with dementia?

INTRODUCTION: People with Dementia (PwD)’s performance of activities of daily living (ADLs) has been associated with apathy, cognitive deficits, carers’ depression and burden. However, it is not known if the carers’ management style affects ADL performance, particularly alongside PwD’s cognitive deficits and apathy. Thus, the aim of this study was to explore the contribution of intrinsic (cognition, apathy) and extrinsic (carer management styles) dementia factors to ADL performance.

METHODS: PwD (n=143) were assessed on global cognition (ACE-III); apathy (CBI-R); ADLs (Disability Assessment for Dementia-DAD). Carers’ (n=143) criticism, encouragement and active-management styles were assessed with the Dementia Management Strategy Scale (DMSS). Multiple linear regression analysis investigated contributions of carer styles, cognition, apathy (independent variables) on ADLs (dependent variable).

RESULTS: The best model explaining the variance of the DAD scores included cognition (β =0.413, t(142)=4.463, p=0.001), apathy (β =-0.365, t(142)=-5.556, p=0.001), carer criticism (β =-0.326, t(142)=-2.479, p=0.014) and carer encouragement styles (β =0.402, t(142)=2.941, p=0.004) accounting for 40% of the variance of the DAD scores.

CONCLUSIONS: This novel study demonstrated that PwD’s level of apathy and the carer’s use of criticism negatively affected ADL performance while PwD’s cognitive abilities and carer encouragement style improved ADL performance. These findings have critical implications for the development of novel multi-component non-pharmacological interventions to maintain function and delay disease progression in dementia, as well as direct relevance to current carers and families.

This is the peer reviewed version of the following article: How does carer management style influence the performance of activities of daily living in people with dementia?, which has been published in final form at https://onlinelibrary.wiley.com/doi/10.1002/gps.5607. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited.