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Worry about Performance: Unravelling the Relationship between ‘Doing More’ and ‘Doing Better’

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The journal of nutrition, health & aging

Abstract

Objective

Recent studies have described worry about caregiver performance (WaP) as a distinct dimension of caregiver burden. We aimed to explore care recipient and caregiver characteristics between the concordant and discordant WaP groups in a population of caregivers of older adults with cognitive impairment. The secondary objective is to explore if there are differences between high and low WaP subsets in the ‘doing more’ and ‘doing better’ groups.

Design, setting and participants

This is a retrospective study of 936 dyads of community-dwelling older adults with cognitive complaints and their primary family caregiver from a hospital in Singapore.

Measurements

We performed descriptive and inferential statistics of the characteristics of caregivers and patients. We categorized caregiver-patient dyads into four groups, namely concordant (high vs low WaP) and discordant (‘doing more’ vs ‘doing better’) groups. For both concordant and discordant groups, we further defined low and high WaP subgroups using tertile cutoffs.

Results

The concordant low WaP group is predicted by the spousal relationship (p<.001) and care recipients with fewer neuropsychiatric symptoms (p<.001). There is no significant difference between the discordant groups, which were predominantly the adult children. Further analysis of subgroups found that in the ‘doing better’ group, there were more spouses in the high as compared to low WaP subgroups, with the reverse true in the ‘doing more’ group. In the ‘doing more’ group, caregivers with high WaP also had higher total ZBI (p<0.05) with higher factors (Fl, F2 and F3) scores (p<0.05). They also endorsed higher NPI-Q scores (p=0.045) particularly in the domain of depression / dysphoria (p=0.034). These differences are not seen in the ‘doing better’ group.

Conclusion

Our study suggests an association with caregiver characteristics (adult child) and disruptive behavior in the ‘do more’ high WaP discordant group. Delineating into the high and low WaP subgroups can help us identify the ‘do more’ high WaP subgroup that merits further attention and early intervention.

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Authors and Affiliations

  1. Department of Geriatric Medicine, Institute of Geriatrics and Active Aging, Tan Tock Seng Hospital, Annex 2 , Level 3, 11 Jalan Tan Tock Seng, Novena, Singapore, Singapore, 308433

    Louise Heyzer, N. B. Ali, A. P. Chew, M. Chan & W. S. Lim

Authors
  1. Louise Heyzer
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  2. N. B. Ali
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  3. A. P. Chew
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  4. M. Chan
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  5. W. S. Lim
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Corresponding author

Correspondence to Louise Heyzer.

Ethics declarations

Conflict of Interest: None.

Ethical Standards: This study was approved by the Domain-Specific Institutional Review Board of the National Health Group, Singapore (NHG DSRB Ref 2011/01251).

Additional information

Description of authors’ roles: L. Heyzer and W.S. Lim designed the study, conducted the statistical analysis, and wrote the first paper; N. Ali, A.P. Chew and M. Chan helped in patient recruitment and data collection, and contributed to the final paper.

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Heyzer, L., Ali, N.B., Chew, A.P. et al. Worry about Performance: Unravelling the Relationship between ‘Doing More’ and ‘Doing Better’. J Nutr Health Aging 23, 843–848 (2019). https://doi.org/10.1007/s12603-019-1225-7

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  • DOI: https://doi.org/10.1007/s12603-019-1225-7

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