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The Relationship Between Caregiver Burden and Emotion Recognition Deficits in Persons With MCI and Early AD

The Mediating Role of Caregivers’ Subjective Evaluations

Spitzer, Naama PhD*; Shafir, Tal PhD; Lerman, Yaffa MD; Werner, Perla PhD§

Alzheimer Disease & Associated Disorders: July–September 2019 - Volume 33 - Issue 3 - p 266–271
doi: 10.1097/WAD.0000000000000323
Original Articles

Objectives: Emotion recognition (ER) abilities change in people with early Alzheimer disease (AD) and mild cognitive impairment (MCI) and can influence their caregivers’ lives and experiences. The aims of this study were: (1) to assess caregivers’ awareness of ER deficits in care-receivers with early AD or MCI; (2) to examine the mediating role of caregivers’ subjective evaluations on the relationship between caregiver burden and ER deficits in persons with MCI and early AD.

Methods: Persons with MCI (N=29) and with early AD (N=26) performed an ER task (objective emotion recognition, OER) of watching short clips of dynamic bodily and dynamic facial expressions of 6 basic emotions. In addition, their family caregivers (N=55) were interviewed to measure their evaluation of their relatives’ ER ability (subjective emotion recognition, SER) as well as their own experience of burden.

Results: Two thirds of the caregivers either underestimated or overestimated the care-receivers’ ER deficits. Regression results yielded a significant positive relationship between OER and SER, as well as a significant negative relationship between SER and caregiver burden. Moreover, SER was found to mediate the relationship between OER and caregiver burden.

Conclusion: Caregivers’ better awareness of ER deficits in people with MCI and early AD might mitigate the deleterious consequences of caregiving for persons with cognitive deterioration and might therefore allow better chances for people with dementia to age in a homecare setting.

Departments of *Gerontology

§Community Mental Health

The Graduate School of Creative Arts Therapies, University of Haifa, Haifa

Geriatrics Division, Sackler School of Medicine, Tel Aviv Sourasky Medical Centre, Tel Aviv University, Tel Aviv, Israel

The authors declare no conflicts of interest.

Reprints: Perla Werner, PhD, Department of Community Mental Health, University of Haifa, 199 Aba Khoushy Ave. Mount Carmel, Haifa, Israel (e-mail:

Received November 18, 2018

Accepted April 8, 2019

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