DOI: 10.1002/alz.075184 ISSN: 1552-5260

A longitudinal study of care‐recipient relationship type on the quality of life in community‐dwelling older adults with dementia

Aiping Lai, Lauren E. Griffith, Ayse Kuspinar, Jenna Smith‐Turchyn, Julie Richardson
  • Psychiatry and Mental health
  • Cellular and Molecular Neuroscience
  • Geriatrics and Gerontology
  • Neurology (clinical)
  • Developmental Neuroscience
  • Health Policy
  • Epidemiology



With the prolongation of the human lifespan, dementia has become a significant public health issue. In 2050, the number of people living with dementia (PLWD) globally is projected to increase from 50 million in 2018 to 152 million ‐ a 204% increase1. Without a cure or effective treatment for these diseases, maintaining the quality of life (QoL) of PLWD has been identified as the primary goal of care services. In the current study, we used five rounds of National Health and Aging Trends Study (NHATS) data (Round 5 to Round 9) to evaluate how the care‐recipient relationship type influences changes in QoL of PLWD over time.


This was a secondary analysis of longitudinal data. Older adults were categorized into different groups by the type of relationship: (1) spouse/partner; (2) adult child; (3) informal caregiver other than spouse/partner and adult child, such as child‐in‐law, sibling, friend, etc.; (4) If older adults indicated having multiple caregivers, they were assigned to the group of “multiple caregivers.” QoL was assessed in 4 domains: mental health (assessed by Patient Health Questionnaire for Depression and Anxiety, PHQ‐4), self‐reported physical health, pain (Yes/No) and functional limitations (i.e. number of ADLs assistance). Backward and forward stepwise regressions were used to determine the prediction of older adults’ socio‐demographics (age, sex, race, income, education, marital status, living arrangement) and dementia status (probable dementia, possible dementia, and no dementia) on their QoL over 4 years; the generalized estimating equation (GEE) approach was used to examine the prediction of relationship type on QoL across the 4 years.


Older adults cared for by an adult‐child or multiple caregivers predicted increased risk for functional limitations after adjustment for their socio‐demographic and dementia status. The interaction between the type of relationship and education was significant, indicating that the effect of relationship types on functional limitations is not uniform across education levels.


The relationship type between care recipients and caregivers is linked to QoL changes, particularly with functional limitations in PLWD. Socio‐demographics such as education attainment might shape the influence of care‐recipient relationship type on changes in functional limitations over time.

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