Predictors of Perceived Social Support for Patients with Dementia: A Mixed-Methods Study

PURPOSE: Perceived social support (PSS) is closely linked to health outcomes in dementia patients. However, its continuous benefits are unclear. This mixed-methods study examined the impact of social support perceptions and differentiation among patients and carers during disease progression. PATIENTS AND METHODS: Persons with dementia (PWDs), family caregivers, and community family physicians were recruited from nine community health centers. Semi-structured interviews conducted with 12 PWDs (7 PWDs in mild dementia and 5 in moderate dementia), 12 family caregivers, and 6 community family physicians and conventional content analysis were used to explore social support perspectives at different dementia stages. A total of 470 PWDs were divided into mild (n=224), moderate (n=190), and severe (n=56) groups. Demographic, physical, and psychological factors related to PSS were examined by the group using multiple regression analysis. The group-based characteristics were entered into three prediction models. RESULTS: In the qualitative study, three themes of social support were identified: two viewpoints refer to social support; different needs and preferences in each stage; non-personalized support services. Quantitatively, the mild group scored lowest in perceived social support, while the severe group scored highest (χ(2)=64.70, P<0.001). The mild group PSS was predicted by depression (β=−0.07, P=0.04), cognitive capacity (β=−0.18, P<0.001), and instrumental ability (β=−0.78, P<0.001), which differed from the moderate and severe groups. CONCLUSION: This study provided comprehensive insight into PSS from PWDs’ perspective at different stages of the disease. Results indicated the need for a stratified care approach and direction for further research on intervention.