Dataset Information

Grief, Mindfulness and Neural Predictors of Improvement in Family Dementia Caregivers.

ABSTRACT: Background: Family dementia caregivers often suffer from an immense toll of grief while caring for their loved ones. We sought to identify the clinical relationship between grief, depression and mindfulness and identify neural predictors of symptomatology and improvement. Methods: Twenty three family dementia caregivers were assessed at baseline for grief, mindfulness and depression, of which 17 underwent functional magnetic resonance imaging (fMRI). During fMRI, caregivers were shown faces of either their dementia-stricken relative or that of a stranger, paired with grief-related or neutral words. In nine subjects, post fMRI scans were also obtained after 4 weeks of either guided imagery or relaxation. Robust regression was used to predict changes in symptoms with longitudinal brain activation (BA) changes as the dependent variable. Results: Grief and depression symptoms were correlated (r = 0.50, p = 0.01), and both were negatively correlated with mindfulness (r = -0.70, p = 0.0002; r = -0.52, p = 0.01). Relative to viewing strangers, caregivers showed pictures of their loved ones (picture factor) exhibited increased activation in the dorsal anterior cingulate gyrus and precuneus. Improvement in grief but not mindfulness or depression was predicted by increased relative BA in the precuneus and anterior cingulate (different subregions from baseline). Viewing grief-related vs. neutral words elicited activity in the medial prefrontal cortex and precuneus. Conclusions: Caregiver grief, depression and mindfulness are interrelated but have at least partially nonoverlapping neural mechanisms. Picture and word stimuli related to caregiver grief evoked brain activity in regions previously identified with bereavement grief. These activation foci might be useful as biomarkers of treatment response.

SUBMITTER: Jain FA

PROVIDER: S-EPMC6530345 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Grief, Mindfulness and Neural Predictors of Improvement in Family Dementia Caregivers.

Jain Felipe A FA Connolly Colm G CG Moore Leonardo C LC Leuchter Andrew F AF Abrams Michelle M Ben-Yelles Ramzi W RW Chang Sarah E SE Ramirez Gomez Liliana A LA Huey Nora N Lavretsky Helen H Iacoboni Marco M

Frontiers in human neuroscience 20190514

<b>Background</b>: Family dementia caregivers often suffer from an immense toll of grief while caring for their loved ones. We sought to identify the clinical relationship between grief, depression and mindfulness and identify neural predictors of symptomatology and improvement. <b>Methods</b>: Twenty three family dementia caregivers were assessed at baseline for grief, mindfulness and depression, of which 17 underwent functional magnetic resonance imaging (fMRI). During fMRI, caregivers were sh ...[more]

PMID: 31156412

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Project description:IntroductionThe objective was to develop and refine a version of the Prolonged-Loss Grief-12 (PG-12) specific to caregivers of people living with dementia. Confirmatory factor analysis (CFA) was performed to test the fit of the data from the caregivers and to assess the factor structure of the PG-12 in order to evaluate pre-loss grief accurately by identifying relevant items and eliminating items that are not appropriate for caregivers of persons with dementia.MethodsA total of 699 eligible caregivers of persons living with dementia (PLWDs) were recruited through relevant dementia associations and organizations. The e-mail for recruitment provided potential participants with information about the study and detailed instructions on how to participate by following a link to the online survey. Secondary analysis was based on the survey data. CFA was conducted via the Full Information Maximum Likelihood estimation method to test the unidimensional model of PG-12 in the study population. Standard procedures were used to establish the parameters in the factor loading, factor variance-covariance, and uniqueness matrices.ResultsThe initial model was modified to develop a better fitting model and to detect misfitting parameters in the PG-12 by deleting irrelevant items for the PLWD's caregiver. The adjusted dementia-specific 10-item version (PG-10-D) had significantly improved fit indices. An overall assessment of fit indicated that the model adequately approximated the data. Factor loadings ranged from 0.53 to 0.85.DiscussionWe found that the dementia-specific, unidimensional PG-10-D, modifying the original PG-12, may be useful and parsimonious in assessing and quantifying pre-loss grief in dementia caregivers. Future studies are needed to further test its validity and reliability.HighlightsFirst study to evaluate a dementia-specific 10-item version (PG-10-D) of the Prolonged-Loss Grief-12 (PG-12).PG-10-D is useful in assessing and quantifying pre-loss grief in caregivers.PG-10-D could be an early identifier of caregivers at risk for pre-loss grief.PG-10-D could be the standard measure for effective intervention for caregivers.

Dataset Information

Grief, Mindfulness and Neural Predictors of Improvement in Family Dementia Caregivers.

Publications

Grief, Mindfulness and Neural Predictors of Improvement in Family Dementia Caregivers.

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