Moderating Effects of Dementia on Health Outcomes in Dyads of Older Adults and Family Caregivers.

Background: While both older adults receiving assistance with daily living tasks for health or functioning reasons and the family members or kin-like friends who help them are affected by the context of caregiving, little is known about how their interactions might simultaneously affect each other's well-being.

Objective: This study aimed to determine the influence of intrapersonal factors on health outcomes for dyads of older adults and their family caregivers and to examine the moderating effect of dementia status on these associations.

Methods: Cross-sectional dyadic data were obtained from the National Health and Aging Trends Study (NHATS; Round 12, 2022) linked to the National Study of Caregiving (NSOC; IV, 2022), yielding a sample of 1,560 older adults paired with their respective primary family caregiver, defined as the person providing the greatest number of hours of care. A series of actor-partner interdependence models (APIMs), which statistically account for nonindependent observations, examined associations between older adults' and caregivers' positive affect, negative affect, and self-realization on both their own and each other's mental health (depression and anxiety) and perceived general health. A second series of APIMs explored interactions between predictors and the dementia status of the care recipient. All models controlled for dyad members' own age, gender, race/ethnicity, and dementia status.

Results: Dyad members' positive affect, negative affect, and self-realization were significantly associated with their own depression, anxiety, and perceived general health. In addition, caregivers' negative mood was associated with their care recipients' symptoms of depression, and older adults' self-realization was associated with their caregivers' perceived general health. Dementia status of the older adult was also found to moderate the relationship between older adults' positive affect and their own depression. Probing revealed that this relationship was stronger for older adults with dementia than for those without dementia.

Discussion: Considering caregiving dyads together provides a more holistic perspective. Intrapersonal factors are potentially modifiable aspects of caregiving contexts, and addressing older adults and their family caregivers simultaneously could be synergistically beneficial.