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As Alzheimer’s disease (AD) care shifts to institutions, differences between psychiatric hospitals and nursing homes remain unclear. We compared AD patients and professional caregivers across these settings and explored institution-specific links between caregiver burden, mental health, and sleep quality. A cross-sectional study (January to November 2024) enrolled 121 AD patients and 123 caregivers from 2 psychiatric hospitals and 2 nursing homes in Shanghai. Assessments used standardized scales. Analyses included nonparametric tests, χ 2 tests, Spearman correlations, and stepwise regression. Post hoc power was adequate for moderate-to-large effects. AD patients in psychiatric hospitals are more severe, and caregivers face greater burden and psychological risk. Tailored, institution-specific mental health interventions are needed. Psychiatric hospital patients had poorer cognition and greater functional dependence ( P < .001). Hospital caregivers reported higher burden, depression, anxiety, and worse sleep in specific domains ( P < .05; effect sizes r = 0.18–0.47). Burden correlated positively with depression, anxiety, and poor sleep ( r = 0.397–0.458). In the total sample, anxiety and poor sleep predicted burden (adjusted R 2 = 0.285). In psychiatric hospitals, sleep quality was the dominant predictor (β = 0.483). In nursing homes, anxiety and workload predicted burden (adjusted R 2 = 0.418); sleep quality was a negative predictor (β = −0.222), likely from floor effects and adaptive coping.
Chen et al. (Fri,) studied this question.