A – 7 Effects of Caregiver Burden on Sleep Quality and Executive Functions in a Sample of Informal Caregivers of Alzheimer’s Disease Patients in Puerto Rico

Abstract Objective This study investigated the impact of sleep quality on executive functions in informal caregivers of individuals with Alzheimer’s disease (AD), with a focus on the mediating and moderating roles of caregiver burden. Method A total of 43 Puerto Rican caregivers from various AD community support groups (Mean age = 65.67 years, SD = 12.88) participated in this cross-sectional study. Participants were selected via convenience sampling. They were 21 years or older, of Puerto Rican residency, had spent at least six months caring for the patient, and were cognitively healthy. Data were collected using the Spanish versions of the Pittsburgh Sleep Quality Index, Caregiver Burden Inventory, and Behavioral Rating Inventory of Executive Function – Adult, which assessed the variables sleep quality, caregiver burden, and executive functions (behavioral regulation and metacognition) over the past month. Hypotheses were tested using partial least squares structural equation modeling. Results Poor sleep quality was directly associated with metacognitive difficulties (β = 0.437, p = 0.003) and caregiver burden (β = 0.713, p = 0). Caregiver burden fully mediated the effect of sleep quality on behavioral regulation (β = 0.294, p = 0.043), but not on metacognition. The results did not support the moderating effects of caregiver burden on behavioral regulation or metacognition. Conclusion Poor sleep quality disrupts the executive functions through direct and indirect mechanisms. The overload experienced by caregivers may further weaken their capacity for executive functions, exacerbating difficulties in behavioral regulation, particularly after poor sleep. Studies with larger samples are needed to assess potential moderating effects.