Caregiving burden and mental health among older East Asian American dementia caregivers: the role of perceived threat of AD/ADRD

OBJECTIVES: This study examined the association of subjective caregiving burden and objective caregiving demands with depressive symptoms and subjective cognitive decline among older East Asian American dementia caregivers and. Guided by the transactional model of stress and coping, it also explored whether perceived concerns about AD/ADRD might partly account for these associations. METHODS: Survey data were collected from 83 older East Asian American informal caregivers of persons with AD/ADRD. Recruitment occurred through community organizations and caregiver networks in the United States. Subjective burden captured appraised strain; objective demands reflected the frequency and intensity of caregiving tasks. Multivariate linear regression models adjusted for age, gender, citizenship, income, and social support. Potential indirect associations were explored through two-step coefficient comparisons. RESULTS: Greater subjective burden was associated with more depressive symptoms and greater subjective cognitive decline, whereas objective demands were not significantly associated with either outcome. Perceived Alzheimer's concern about AD/ADRD was positively related to subjective burden. Including these concerns attenuated the association between subjective burden and depressive symptoms whereas attenuation was smaller for subjective cognitive decline. CONCLUSION: Subjective appraisal of caregiving burden matters more than caregiving volume. Interventions that reduce AD/ADRD concerns appraisals and strengthen coping and support may improve depressive symptoms and potentially protect cognitive well-being in this underrepresented population.