Research Insights

Does type of disease matter? Gender differences among Alzheimer’s and Parkinson’s disease spouse caregivers

Hooker, Manoogian-O’Dell, Monahan, Frazier, and Shifren (2000) Does type of disease matter? Gender differences among Alzheimer’s and Parkinson’s disease spouse caregivers , Oct;40(5):568-73

These authors cited multiple studies in the caregiver literature suggesting that female caregivers experienced more burdens as compared to male caregivers. They also indicated that female caregivers were more likely to develop depression, although there may be multiple factors that contribute to this difference, such as women are more likely to express and report depression as well as more women are represented in the caregiving literature. The authors also noted that within the caregiving literature there many discrepancies amongst samples (e.g. age, disease severity, parent/child relationship vs. spouse/spouse, and living in or out of the home) that makes it difficulty to compare one study to another. The authors indicated that the gender differences seen in caregivers may be due to the type of coping mechanism used by the spouse. They reported that low-distress caregivers (often men) may be more likely to compartmentalize, use acceptance and use problem focused strategies, where as high-distress caregivers (often women) may use emotion-focused coping skills (e.g. wishfullness). The authors acknowledged that AD and PD are different diseases with different symptoms but noted that both are chronic, have a later disease onset, variable and unspecified disease course, no immediate danger of death, and have affects on caregiver’s. The purpose of this article was to clearly define two different caregiver disease groups (one with cognitive impairment-dementia/Alzheimer’s disease and one with physical impairment-PD) and look at gender effects as well as the coping strategies used by each group. They studied 175 spouse caregivers (88 AD, 87 PD) recruited from various sources. Cognitive functioning of each group was limitedly measured by a gross screening measure, the Mini Mental Status Examination. AD Caregiver demographics for the women (N=52; mean age of caregiver=68.1, mean age of care recipient=73.9, education=13.2, years of caregiving=3.8, and years married=41.1) and men (N=36; mean age of caregiver=73.1, mean age of care recipient=73.5, education=13.4, years of caregiving=5.3, and years married=46.6), while PD caregiver demographics for the women (N=55; mean age of caregiver=65.9, mean age of care recipient=70.2, education=14.3, years of caregiving=7.7, and years married=38.4) and men (N=32; mean age of caregiver=68.7, mean age of care recipient=66.6, education=13.4, years of caregiving=7.5, and years married=40.6). Most caregivers of either group were Caucasian (N=170). There was a statistically significant difference between the ages of the two groups (patients and caregivers AD>PD) and the PD caregivers knew of the diagnosis for longer than the AD group. Each caregiver was given a measure of perceived stress, depression, state related anxiety (due to the situation versus personality trait), and a coping checklist. In this study, the authors controlled for age, socioeconomic status, and number of years of caregiving as prior research has shown these three variables are highly related to caregiver stress/burden. The results of this study suggested that there was not a difference between men and women in the PD group on measured areas, but the female caregivers in the AD group reported more depression, stress, and anxiety than the men in the same group. The authors also looked at coping strategies and did not find a significant difference amongst any of the groups or genders in using social support or emotion-focused coping but they did find that wives in the AD group did not use problem-focused coping as much as the husbands. Another interesting finding in their study was that many of the PD caregivers resisted using the term "caregiver" compared to none in the AD group. The authors concluded by discussing the limitations of their study as well as the recommendation to continue looking at gender differences within caregiver situations.

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