Does being a retired or employed caregiver affect the association between behaviours in Alzheimer’s disease and caregivers’ health-related quality-of-life?

OBJECTIVE: We examined whether caregivers’ employment status (i.e., retired or employed) might modify the association between the behaviours of persons with Alzheimer’s disease (PwAD) and caregivers’ health-related quality-of-life (HRQoL). Data came from a cross-sectional study of the primary informal caregivers of 200 persons with mild or moderate Alzheimer’s disease. Caregivers completed the EQ-5D-3L to rate their HRQoL and generate health utility scores, and the Dementia Behaviour Disturbance Scale (DBDS) to assess the degree to which PwAD exhibited each of 28 behaviours. Caregivers’ health utility scores were regressed on overall DBDS scores, with caregiver employment status (retired, employed) treated as an effect modifier and confounder in separate regression models. We also controlled for age, sex, income, education, caregivers’ relationship to the PwAD, and whether caregivers gave up paid employment/cut down working hours to care for PwAD. RESULTS: Effect modification by caregiver employment status is possible, with the inverse association between DBDS score and health utility score largely existing for retired versus employed caregivers. Research using larger samples and longitudinal data would further inform this area of inquiry.