All ETDs from UAB

Advisory Committee Chair

Patricia Drentea

Advisory Committee Members

Shawn Bauldry

Olivio Clay

Patricia Sawyer

Irena Stepanikova

Document Type

Dissertation

Date of Award

2014

Degree Name by School

Doctor of Philosophy (PhD) College of Arts and Sciences

Abstract

Depression is a leading mental health issue effecting the aging population. The current body of research contends that stress, social disconnectedness, and disability are possible causes of depression. Research, however, widely neglects the study of caregiver burden as other probable causes of depression in this group. This study investigates subjective and objective caregiver burden as possible causes of adverse mental health for a non-institutionalized older adult care recipient. Additionally, the conditional effects of race/ethnic background of the care recipient are evaluated using the most recent wave of the National Long Term Care Study (NLTCS) and using both the life stress paradigm and the social exchange perspective as theoretical guides. Using logistic regression analysis, I found that greater levels of objective caregiver burden were associated with an increased likelihood of the care recipients reporting depressive symptoms. Increased cognitive functioning of the care recipient reduced the negative effect that objective caregiver burden had on care recipient depressive symptoms. However, this mediating relationship did not vary by race. Providing helpful company to the caregiver was a weak moderator of the relationship between objective caregiver burden and care recipient depressive symptoms. However, when the conditional effects of race were considered, the effects of providing helpful company on the depressive symptoms of the care recipient, net of the effects of objective caregiver burden, were more pronounced. Results showed that the average predicted probability for African American care recipients who exchanged helpful company with their caregiver was lower than for those who did not. Alternately, among non-black care recipients, individuals who exchanged social goods with their care recipient had a higher predicted probability of reporting any depressive symptoms than those who did not. This suggests that reasons other than an unbalanced care relationship are causing depressive symptoms in this group. Future research should make use of longitudinal analytic methods to investigate caregiver burden's effects on the mental health of the older adult care recipient. Additionally, other work should consider possible characteristics of the caregiver beyond burden that could potentially lead to depression in older adult care recipients.

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