WITHDRAWN: Gender Differences in Social Activity Engagement and Depressive Symptoms Among Dementia Caregivers: Findings from the Reach II

Background: Providing care to older adults with dementia entails a great amount of physical and emotional strain to family caregivers, which may negatively influence their mental health outcomes including depressive symptoms. Based on Pearlin’s stress process theory, numerous studies have examined how primary stressors (e.g., caregiving burden, care recipient’s cognitive status and problematic behaviors) may serve as major predictors for depressive symptoms among dementia caregivers. However, fewer studies focused on how the secondary role strains such as the constriction of social life can be associated with depressive symptoms. Considering the fact that engagement in social activities can serve as one of the coping strategies to relieve caregiving stress, this study delineated the relationship between social activity engagement and depressive symptoms among dementia caregivers. Gender differences were further explored in this relationship as male and female caregivers may show distinguishable pattern of social engagement, which may moderate the association between social engagement and depressive symptoms.

Methods: This study includes dementia caregivers (N=634) from the Resource for Enhancing Alzheimer’s Caregivers Health II Study. Social activity engagement was measured with 7-items asking how often caregivers were engaged in various activities (e.g., visiting family and friends, doing fun things with other people, going out for meals, doing hobbies, attending church/meetings) over the past months. It was measured in both frequency and satisfaction of social engagement. This measure has shown good validity and reliability from the previous study. Depressive symptom was measured with the 10-item Center for Epidemiologic Studies Depression Scale. Due to the skewness of depressive symptoms, it was transformed using a square root function. Multivariate linear regression was conducted to examine the relationship between social engagement (frequency and satisfaction, respectively) and depressive symptoms as well as the moderating effect of gender in this relationship. Covariates including age, race, education, marital status, financial strain, working status, caregiving hours, received social support, self-rated health, problem behavior and cognitive status of care recipient were controlled.

Results: Out of 634 caregivers, 109 (17.2%) were male and 525 (82.8%) were female. Findings showed that more frequent (b=-0.17, p<.001) and higher satisfaction (b=-0.13, p<.001) of engagement in social activities were related with lower level of depressive symptoms. There was a significant gender effect in the relationship (b=0.08, p<.05) between social engagement frequency and depressive symptoms. When analyzed separately by gender, the negative relationship between social engagement frequency and depressive symptoms was more pronounced among male (b=-0.13, p<.001) than female (b=-0.09, p<.001) caregivers. However, there was no gender effect in the relationship between social engagement satisfaction and depressive symptoms.

Discussion: This study shows that both frequency and satisfaction of social engagement are crucial factors for predicting depressive symptoms among dementia caregivers. Supporting dementia caregivers to have more respite time and access to engagement in social activities is suggested as a way of coping caregiving strain among this population. Male caregivers may benefit more from engaging in social engagement than female caregivers related to depressive symptoms. Promoting social engagement among male dementia caregivers is also recommended to reduce their depressive symptoms.