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Moderating role of positive aspects of caregiving in the relationship between caring burden and suicidal ideation in family caregivers of community-dwelling older adults with neurocognitive disorders

Title: Moderating role of positive aspects of caregiving in the relationship between caring burden and suicidal ideation in family caregivers of community-dwelling older adults with neurocognitive disorders
Authors: Zhaohua Huo; Benjamin Hon-Kei Yip; Allen Ting-Chun Lee; Sheung-Tak Cheng; Wai Chi Chan; Ada Wai-Tung Fung; Suk Ling Ma; Calvin Pak-Wing Cheng; Frank Ho-Yin Lai; Samuel Yeung-Shan Wong; Linda Chiu-Wa Lam
Source: BMC Geriatrics, Vol 25, Iss 1, Pp 1-13 (2025)
Publisher Information: BMC
Publication Year: 2025
Collection: Directory of Open Access Journals: DOAJ Articles
Subject Terms: Dementia; Cognitive impairment; Carer; Positive gain; Suicide; Geriatrics; RC952-954.6
Description: Background Psychological distress is common in family caregivers of individuals with neurocognitive disorders (NCDs). This study examined the prevalence of suicidal ideation in this population, and explored the moderating role of positive aspects of caregiving (PAC) in mitigating such severe psychological difficulties. Methods 445 older adults (NCDs: 322, normal cognition: 123) and their family caregivers were recruited from the population-based Hong Kong Mental Morbidity Survey for Older Persons. Caregivers’ suicidal ideation was screened by positive response to Item 9 of the Patient Health Questionnaire-9: thoughts of being better off dead or self-harm in the past two weeks. PAC were measured using a validated scale. A conceptual model was developed to test the mediation and moderation effects among caregiving burden, psychological distress, suicidal ideation, and PAC. Results Nearly one in ten (9%) dementia caregivers reported suicidal ideation in the past two weeks. Higher prevalence was observed among female carers, those with comorbid mood disorders, and those caring for individuals with high comorbidity or functional dependence. Psychological distress significantly mediated the relationship between caregiving burden and suicidal ideation (80.5%, p = 0.023). PAC moderated this pathway: higher levels of PAC were associated with reduced suicidal ideation among carers with moderate-to-high caregiving burden (p < 0.05). However, a rebound in suicidal ideation was observed in caregivers experiencing both high burden and high PAC. Conclusions Suicidal ideation among NCD caregivers is closely linked to caregiving burden and psychological distress. PAC plays a complex and non-linear moderating role in this relationship. Psychological intervention that strengthens PAC should be integrated into comprehensive caregiver support programmes, particularly for those experiencing high burden and high distress.
Document Type: article in journal/newspaper
Language: English
Relation: https://doi.org/10.1186/s12877-025-06147-6; https://doaj.org/toc/1471-2318; https://doaj.org/article/ae9266fc15904b22a978cd3eb32b7ffc
DOI: 10.1186/s12877-025-06147-6
Availability: https://doi.org/10.1186/s12877-025-06147-6; https://doaj.org/article/ae9266fc15904b22a978cd3eb32b7ffc
Accession Number: edsbas.2B462BA0
Database: BASE