Original ArticlesAnticipatory Grief in New Family Caregivers of Persons With Mild Cognitive Impairment and DementiaGarand, Linda PhD, GCNS-BC*; Lingler, Jennifer H. PhD, RN, FNP*,†; Deardorf, Kaitlyn E. SN*; DeKosky, Steven T. MD†,‡; Schulz, Richard PhD§; Reynolds, Charles F. III MD∥; Dew, Mary Amanda PhD¶,**Author Information *Department of Health & Community Systems, University of Pittsburgh School of Nursing †Alzheimer Disease Research Center, University of Pittsburgh ‡University of Virginia School of Medicine, James Carroll Flippin Professor of Medical Science and Professor of Neurology §University Center for Social and Urban Research, Aging Institute of UPMC Senior Services at the University of Pittsburgh ∥Advanced Center for Interventions and Services Research for late-life Mood Disorders, and the John A. Hartford Center for Excellence in Geriatric Psychiatry, UPMC Endowment in Geriatric Psychiatry ¶Advanced Center for Interventions and Services Research for late-life Mood Disorders **Prof of Psychiatry, Psychology, Epidemiology, and Biostatistics, University of Pittsburgh School of Medicine, Pittsburgh, PA Supported by Grants MH070719, AG05133, and MH52247 from the National Institutes of Health, Rockville, MD, and Grant 07-59900 from the Alzheimer's Association, and Dr Lingler was supported by the Brookdale Foundation Leadership in Aging Fellowship Program. The authors declare no conflict of interest. Reprints: Linda Garand, PhD, Health & Community Systems Department, 415 Victoria Building, University of Pittsburgh School of Nursing, 3500 Victoria Street, Pittsburgh, PA 15261 (e-mail: firstname.lastname@example.org). Received February 16, 2011 Accepted July 24, 2011 Alzheimer Disease & Associated Disorders: April-June 2012 - Volume 26 - Issue 2 - p 159-165 doi: 10.1097/WAD.0b013e31822f9051 Buy Metrics Abstract Anticipatory grief is the process of experiencing normal phases of bereavement in advance of the loss of a significant person. To date, anticipatory grief has been examined in family caregivers to individuals who have had Alzheimer disease (AD) an average of 3 to 6 years. Whether such grief is manifested early in the disease trajectory (at diagnosis) is unknown. Using a cross-sectional design, we examined differences in the nature and extent of anticipatory grief between family caregivers of persons with a new diagnosis of mild cognitive impairment (MCI, n=43) or AD (n=30). We also determined whether anticipatory grief levels were associated with caregiver demographics, caregiving burden, depressive symptoms, and marital quality. The mean anticipatory grief levels were high in the total sample, with AD caregivers endorsing significantly more anticipatory grief than MCI caregivers. In general, AD caregivers endorsed difficulty in functioning, whereas MCI caregivers focused on themes of “missing the person” they once knew. Being a female caregiver, reporting higher levels of objective caregiving burden, and higher depression levels each had independent, statistically significant relationships with anticipatory grief. Given these findings, family caregivers of individuals with mild cognitive deficits or a new AD diagnosis may benefit from interventions specifically addressing anticipatory grief. © 2012 Lippincott Williams & Wilkins, Inc.