Associations between dementia staging, neuropsychiatric behavioral symptoms, and divorce or separation in late life: A case control study.

Autor: Monin JK; Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, United States of America., McAvay G; Internal Medicine, Yale School of Medicine, New Haven, CT, United States of America., Zang E; Sociology, Yale University, New Haven, CT, United States of America., Vander Wyk B; Internal Medicine, Yale School of Medicine, New Haven, CT, United States of America., Carrión CI; Neurology, Yale School of Medicine, New Haven, CT, United States of America., Allore H; Internal Medicine, Yale School of Medicine, New Haven, CT, United States of America.; Biostatistics, Yale School of Public Health, New Haven, CT, United States of America.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2023 Aug 16; Vol. 18 (8), pp. e0289311. Date of Electronic Publication: 2023 Aug 16 (Print Publication: 2023).
DOI: 10.1371/journal.pone.0289311
Abstrakt: Dementia can be difficult for married couples for many reasons, including the introduction of caregiving burden, loss of intimacy, and financial strain. In this study, we investigated the impact of dementia staging and neuropsychiatric behavioral symptoms on the likelihood of divorce or separation for older adult married couples. For this case-control study, we used data from the National Alzheimer's Coordinating Center (NACC) Uniform dataset (UDS) versions 2 and 3. This dataset was from 2007 to 2021 and contains standardized clinical information submitted by NIA/NIH Alzheimer's Disease Research Centers (ADRCs) across the United States (US). This data was from 37 ADRCs. We selected participants who were married or living as married/domestic partners at their initial visit. Cases were defined by a first divorce/separation occurring during the follow-up period, resulting in 291 participants. We selected 5 controls for each married/living as married case and matched on age. Conditional logistic regression estimated the association between overall Neuro Psychiatric Inventory (NPI) score and severity of individual symptoms of the NPI with case/control status, adjusted for education, the CDR® Dementia Staging Instrument score, living situation, symptom informant, sex, and race. Separate analyses were conducted for each symptom. Multiple comparisons were accounted for with the Hochberg method. Later stage of dementia was negatively associated with divorce/separation with an adjusted odds ratio (AOR) = 0.68 (95%CI = 0.50 to 0.93). A higher overall NPI score was positively associated with divorce/separation AOR = 1.08 (95% CI = 1.03 to 1.12,). More severe ratings of agitation/aggression, depression/dysphoria, disinhibition, and elation/euphoria were associated with greater odds of divorce/separation. Among older adults in the US, a later stage of dementia is associated with a lower likelihood of divorce or separation, while having more severe neuropsychiatric behavioral symptoms of agitation/aggression, depression/dysphoria, disinhibition, and elation/euphoria are associated with a higher likelihood of divorce or separation.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2023 Monin et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
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