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Marital Relationship Quality in Early-Stage Dementia: Perspectives From People With Dementia and Their Spouses

Clare, Linda PhD*; Nelis, Sharon M. PhD*; Whitaker, Christopher J. MSc; Martyr, Anthony MSc*; Markova, Ivana S. MD; Roth, Ilona DPhil§; Woods, Robert T. MSc; Morris, Robin G. PhD

Alzheimer Disease & Associated Disorders: April-June 2012 - Volume 26 - Issue 2 - p 148–158
doi: 10.1097/WAD.0b013e318221ba23
Original Articles

Spouse caregivers of people with dementia (PwD) report relatively poor marital relationship quality (RQ), but few studies have obtained the perspective of the PwD, examined discrepancies between spouses, or considered changes in RQ over time. This study explored caregiver and PwD perceptions of RQ, identified associated factors, and examined changes over an 18-month period. Participants were 54 couples where one spouse had early-stage dementia and 54 were control couples. RQ was assessed with the Positive Affect Index. Measures of mood, stress, and quality of life (QoL) were also administered. The clinical couples were followed up after 9 and 18 months. Caregivers gave significantly lower RQ ratings than controls. PwD ratings did not differ significantly from those of caregivers or controls. Dyadic discrepancies were significantly greater in the clinical than in the control group. Caregiver ratings were associated with stress, whereas PwD ratings were associated with depression and QoL. Discrepancies were associated with caregiver stress and with PwD mood, QoL, and age. Caregiver ratings declined significantly over time; PwD ratings did not decline significantly, but showed different trends for men and women. It is important to consider RQ when considering how to support couples where one partner has early-stage dementia.

*School of Psychology

North Wales Organisation for Randomised Trials in Health and Social Care

Institute of Medical and Social Care Research, Bangor University, Bangor, Gwynedd

University of Hull, Hull

§The Open University Milton Keynes

King's College Institute of Psychiatry, London, UK

Funding: The MIDAS study was funded by Economic and Social Research Council (ESRC) grant RES-062-23-0371 to L. Clare (PI), R.T. Woods, I.S. Markova, R.G. Morris, and I. Roth.

The authors declare no conflict of interest.

Reprints: Linda Clare, PhD, School of Psychology, Bangor University, Bangor, Gwynedd LL57 2AS, United Kingdom (e-mail:

Received July 29, 2010

Accepted November 30, 2010

© 2012 Lippincott Williams & Wilkins, Inc.