Advisory Committee Chair
Frank Puga
Advisory Committee Members
Karen Heaton
Liang Shan
Michael Crowe
Verna Keith
Document Type
Dissertation
Date of Award
1-1-2025
Degree Name by School
Doctor of Philosophy (PhD) School of Nursing
Abstract
Background: Hispanic and Latinx (H&L) caregivers of individuals living with Alzheimer’s disease and related dementias (ADRD) experience elevated caregiving burden and poorer mental health outcomes compared to caregivers from other racial and ethnic groups. Limited research has examined H&L caregivers’ involvement in everyday decision-making for persons living with dementia (PLWD), particularly how this involvement may relate to daily mental health symptoms such as anxiety and depression. Purpose: This study examined baseline decision-making involvement (DMI), its associations with individual-level factors, and its relationship with daily anxiety and depressive symptoms in H&L ADRD caregivers. Methods: A secondary analysis was conducted using data from 100 H&L caregivers enrolled in an ongoing national study. At baseline, caregivers reported their involvement in 10 decision-making domains (e.g., medical care, meals, finances), coded dichotomously (0 = no, 1 = yes). Scores were summed to create a total DMI score (range: 0–10), with higher scores indicating greater involvement. Caregivers then completed 21 days of daily surveys measuring daily anxiety and depressive symptoms. Linear regression examined associations between individual-level factors and total DMI. Linear mixed-effects models tested whether baseline DMI (total and domain-specific) were associated with daily mental health symptoms. Results: Caregivers reported high DMI at baseline (M = 7.81, SD = 2.35), with most involvement in medical decision-making (95%), meal planning (89%), and bedtime routines (81%). Male caregivers (B = -1.662, p = .013) and English-native speakers (B = -1.666, p = .034) reported lower total DMI. Traditional gender role beliefs were also negatively associated with DMI (B = -0.136, p = .029). While total DMI was not significantly associated with daily anxiety or depressive symptoms, greater involvement in financial decisions was significantly linked to increased daily anxiety symptoms (B = 0.452, p = .005) and depressive symptoms (B = 0.337, p = .017). Conclusions: Although H&L caregivers reported high overall decision-making involvement, financial decision-making involvement was uniquely associated with poor daily mental health. Findings suggest the type of involvement in PLWD decision-making may have a stronger influence on caregiver well-being than total involvement. Culturally responsive supports should target decision-specific stressors, especially financial ones, in this population.
Recommended Citation
Poe, Abigail, "Everyday Decision-Making Involvement Among Hispanic & Latinx Dementia Caregivers And Its Associations With Daily Anxiety And Daily Depressive Symptoms" (2025). All ETDs from UAB. 6882.
https://digitalcommons.library.uab.edu/etd-collection/6882
Comments
etdadmin_upload_1147516