Hardiness, cultural values, and the mental health of non-paid primary caregivers of community-dwelling Alzheimer's patients

Alzheimer's disease has a negative effect on the quality of life of the caregiver. The demand in fulfilling this responsibility limits the caregiver's leisure time and can lead to depression and/or anxiety. However, research has found that African American caregivers of family members with dementia experience less depression and anxiety compared to Caucasian caregivers. Few studies have investigated the psychological endurance of African American caregivers of an elderly relative with dementia. This study investigated the mediating effects of Hardiness and Cultural Justification for Caregiving (CJC) on depression and anxiety of African American and Caucasian caregivers living in North and South Carolina. Fifty-eight participants were recruited through various sources. There were four groups: 13 African American caregivers, 19 Caucasian caregivers, 14 African American non-caregivers, and 12 Caucasian non-caregivers. Participants' Bill of Rights and consent forms were mailed to each participant after a phone interview determined that they met study inclusion criteria. Self-report measures, specific instructions, and return envelopes were mailed after signed consent forms were received. Data analyses revealed that African American caregivers presented with higher levels of anxiety (although not clinical) compared to the non-caregiver groups, as well as higher depression levels that were below the clinical threshold compared to Caucasian caregivers. Mediation could not be tested on Hardiness because there was no significant difference between the caregiver groups on Hardiness and anxiety. However, there was a significant negative relationship between Hardiness and depression, between race and depression, and between Hardiness and anxiety. Mediation could not be tested on CJC, since there were no significant differences between the two caregiver groups on anxiety. However, there was a significant negative relationship between CJC and race, and between depression and race. All groups presented with high levels of CJC, but the African American caregiver group scored higher. The association of CJC to low levels of depression and anxiety, as well as the association of Hardiness to low levels of depression and anxiety, could not be determined since there was no difference between the two caregiver groups on all paths.