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Open AccessArticle

Neighborhood Characteristics and the Mental Health of Caregivers Cohabiting with Care Recipients Diagnosed with Alzheimer’s Disease

1
Epidemiology Branch, National Institute of Environmental Health Sciences, National Institute of Health, Department of Health and Human Services, Research Triangle Park, NC 27709, USA
2
Urban Health Collaborative, Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA 19104, USA
3
Intramural Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Department of Health and Human Services, Bethesda, MD 20814, USA
4
Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
*
Author to whom correspondence should be addressed.
Academic Editor: Paul B. Tchounwou
Int. J. Environ. Res. Public Health 2021, 18(3), 913; https://doi.org/10.3390/ijerph18030913
Received: 8 December 2020 / Revised: 14 January 2021 / Accepted: 16 January 2021 / Published: 21 January 2021
(This article belongs to the Special Issue Epidemiology and Mental Health among Older Adults)
While studies have documented the influence of caregiver and care recipient factors on caregiver health, it is important to address the potential impact of neighborhood contexts. This study estimated the cross-sectional associations between neighborhood characteristics and mental health among caregivers cohabiting with Alzheimer’s disease care recipients that were experiencing severe or non-severe neuropsychiatric symptoms (NPSs) (e.g., aggression/anxiety). We obtained data collected in 2010 on caregivers and care recipients (n = 212) from a subset of South Carolina’s Alzheimer’s Disease Registry. Neighborhood measures (within 1 mile of the residence) came from the American Community Survey and the Rural-Urban Commuting Area Code. We categorized the neighborhood median household income into tertiles, namely, “low” (<$31,000), “medium” ($31,000–40,758), and “high” (>$40,758), and rurality as “large urban,” “small urban,” and “rural.” We used negative binomial regression to estimate the prevalence ratios (PRs) and 95% confidence intervals (CIs) for caregiver mental health using neighborhood characteristics. The mean age was 58 ± 10.3 years, 85% were women, and 55% were non-Hispanic Black. Among the caregivers cohabiting with a recipient experiencing severe NPS, higher distress was experienced by caregivers living in low- (PR = 1.61 (95% CI = 1.26–2.04)) and medium- (PR = 1.45 (95% CI = 1.17–1.78)) vs. high-income neighborhoods after an adjustment. These results suggest that neighborhood characteristics may amplify other social stressors experienced by caregivers. View Full-Text
Keywords: Alzheimer’s disease; caregivers; caregiving; dementia; mental health; poverty; poverty area; residence characteristics; rural health Alzheimer’s disease; caregivers; caregiving; dementia; mental health; poverty; poverty area; residence characteristics; rural health
MDPI and ACS Style

Alhasan, D.M.; Hirsch, J.A.; Jackson, C.L.; Miller, M.C.; Cai, B.; Lohman, M.C. Neighborhood Characteristics and the Mental Health of Caregivers Cohabiting with Care Recipients Diagnosed with Alzheimer’s Disease. Int. J. Environ. Res. Public Health 2021, 18, 913. https://doi.org/10.3390/ijerph18030913

AMA Style

Alhasan DM, Hirsch JA, Jackson CL, Miller MC, Cai B, Lohman MC. Neighborhood Characteristics and the Mental Health of Caregivers Cohabiting with Care Recipients Diagnosed with Alzheimer’s Disease. International Journal of Environmental Research and Public Health. 2021; 18(3):913. https://doi.org/10.3390/ijerph18030913

Chicago/Turabian Style

Alhasan, Dana M.; Hirsch, Jana A.; Jackson, Chandra L.; Miller, Maggi C.; Cai, Bo; Lohman, Matthew C. 2021. "Neighborhood Characteristics and the Mental Health of Caregivers Cohabiting with Care Recipients Diagnosed with Alzheimer’s Disease" Int. J. Environ. Res. Public Health 18, no. 3: 913. https://doi.org/10.3390/ijerph18030913

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