Center for Health Equity Research and Promotion

Notably, the demographic composition of Veterans with dementia and their caregivers differs from that in the general population; patients with dementia receiving care from the VA are significantly more likely to be males being cared for by their spouses. Nationally, dementia patients tend to be females who are cared for by adult children.

New VA HSR&D-funded merit review led by Shahrzad Mavandadi, PhD and Laura O. Wray, PhD: “Comparative Effectiveness of Delivery Models for Caregiver Support and Education”

Within the VA, approximately half a million Veterans have dementia and are faced with chronic, progressive declines in cognitive, physical, behavioral, and psychosocial functioning.  As many as 80% of persons with dementia receive care at home from members of their social network.  MIRECC’s Shahrzad Mavandadi, PhD, who is also a CHERP Core Investigator, is testing strategies to address barriers to dementia care while supporting caregivers and increasing positive outcomes.  Her Co-Investigator, Laura O. Wray, PhD, is a Clinical Psychologist and Director, Education/Clinical Core, VA Center for Integrated Healthcare in Buffalo, NY. 

Dementia takes a significant toll not only on individuals with the condition, but also on their family and friends.  These informal caregivers, who provide a wide range of assistance and support, are often referred to as “hidden patients” as they are at increased risk for experiencing chronic stress and fatigue as well as declining emotional and physical health.   Moreover, factors such as lack of knowledge regarding services and difficulty coping with patients’ behavioral symptoms are associated not only with caregivers’ quality of life, but also with patient outcomes (e.g., behavioral symptoms, nursing home placement, morbidity, and mortality).  Previous studies have demonstrated that successful dementia management requires interventions aimed at both patients’ and caregivers’ needs.  Dr. Mavandadi and her team are studying the comparative effectiveness of group vs. individual intervention modalities and the added value of group participation and receipt of support from caregiving peers. Group interventions may have a greater impact on the composition of the caregivers’ social network and their perceived social support, which may help account for the positive outcomes seen in some interventions.  In addition, the type of relationship between the caregiver and patient (i.e., adult child vs. spouse/partner) may lead to differential engagement and intervention outcomes.

Notably, the demographic composition of Veterans with dementia and their caregivers differs from that in the general population; patients with dementia receiving care from the VA are significantly more likely to be males being cared for by their spouses.  Nationally, dementia patients tend to be females (66%) who are cared for by adult children (approximately 50%). Veterans may be particularly vulnerable to developing dementia later in life.  Both Post Traumatic Stress Disorder (PTSD) and traumatic brain injury (TBI), two conditions that are prevalent among Veterans due to military service and combat, are associated with a nearly twofold increase in the risk of developing dementia.