If you’re a senior who cares for a spouse with dementia, you may be at an increased risk of developing cognitive problems yourself, not only because of the stress of caring for a loved one who is ill, but also because of certain lifestyle choices that you may be making. These findings, which were recently published in the Journal of the American Geriatrics Society, show that certain steps are needed to help caregivers maintain cognitive and functional health and the ability to care for those who need them.
“Persons who are caring for a spouse with dementia may themselves be at risk for cognitive problems which, in turn, will not only negatively influence their quality of life, but may reduce their ability to provide the necessary care for their spouse,” said principal investigator Dr. Peter Vitaliano of the University of Washington School of Medicine. “Spouse caregivers are extremely important because most care-recipients prefer to be cared for in their homes, and, by remaining in their homes, health care costs are reduced greatly.”
To examine the issue more thoroughly, Dr. Vitaliano and his team reviewed research studies that looked at the cognitive health of older adults caring for a family member—usually a spouse—with dementia. The review revealed that spouses who are caregivers may have a higher risk of cognitive impairment or dementia than spouses who are not caregivers, meaning that they often have trouble with cognition, which involves attention and memory. Furthermore, they found that this cognitive decline may be due to a very wide range of causes: psychosocial factors such as depression, loneliness, social isolation and sleep problems—you have less time to devote to hobbies and favorite pastimes and seeing friends and family; behavioral factors such as little or no exercise and a poor diet—you may rely on fatty fast food because there’s no time to shop and prepare meals; and physiological factors such as obesity, chronically elevated insulin and inflammation.
Many of these causes are inter-related. According to the study authors, “diet, often a shared lifestyle factor for persons with dementia and their spouses, has, together with physical activity, been receiving greater attention as a risk factor for cognitive decline and dementia." Diets high in saturated and transunsaturated fats in particular may increase Alzheimer’s risk, whereas mono- and polyunsaturated fats including omega-3 fatty acids may protect against cognitive decline.
Obesity, often the result of no exercise and a bad diet, particularly in midlife, is another risk factor for cognitive impairment and dementia and, according to some studies, caregivers do have greater weight problems than noncaregivers.
Having long-term diabetes—again, often a consequence of poor lifestyle choices—is linked to 57 to 114 percent greater risk for cognitive decline. Insulin resistance and high insulin levels themselves have been linked to some of the proteins implicated in the development of Alzheimer’s.
And the risk for dementia grows as you accrue more risk factors. "For example, if obesity, insulin resistance and inflammation occur together, they may have synergistic relationship with cognitive decline," say the reseachers.
Caregivers unfortunately often put themselves last, neglecting their own health and wellness needs, not eating a well-balanced diet and not getting medical attention when they have a problem. A man caring for his wife may fare the worst if he has always relied on her to take care of him and has little experience in caregiving or self-care.
Rather than thinking of self-care as selfish, think of it as essential to continuing in your role of caregiver. Step one is to decrease your stress level. That might very well necessitate getting caregiving help and not necessarily from another family member. A company like Homewatch Caregivers, is a service business with home helpers trained to aid dementia patients; they can assist you and enable you to take a break each day, even if it’s just to clear your head. Of course a better use of this newfound time would be to take healthy lifestyle steps, like exercising and preparing healthy, home cooked meals. If you’re unsure of what better health fixes you need the most, ask your doctor for a referral to a registered dietitian or fitness trainer.
Joining a support group is another great step you can take to gain motivation and a renewed outlook. Organizations like the Alzheimer’s Association have extensive networks of local chapters and offices, even online groups that offer an exchange of informative or even just a virtual shoulder to lean on. Focus on interacting with others to avoid the consequences of isolation, like depression.
Next, check in with your doctor. Have your blood pressure, blood glucose levels and insulin levels checked. According to Dr. Vitaliano, your blood sugar levels can seem within range even as type 2 diabetes is developing. Testing insulin can give a more complete picture.
Know, too, that sometimes caregiving can have an overwhelmingly negative effect on your emotional outlook—and on top of that you can feel guilty for feeling angry or frustrated by what’s happened to you and your loved one. One avenue of help is cognitive behavioral therapy, or talk therapy, with a skilled therapist who can help you identify and deal with your particular stressors and give you the support you need.
You want to be a good caregiver—that means taking care of yourself so that you can effectively take care of others.