Does the relationship between stress and quality of life differ among informal caregivers of older adults with Alzheimer’s disease and children with autism spectrum disorder? Results from a cross-sectional survey

Informal caregiving may impact the physical, mental and economic well-being and ultimately the quality of life (QOL) of the caregivers, however, each caregiver may differ in the degree to which their QOL is impacted. Little is known about association of stressors and coping mechanism in subjective variation of QOL among informal caregivers. This study aimed to understand the appraisal process for QOL among informal caregivers and compare informal caregivers of older adults and children with respect to their appraisal of QOL. This cross-sectional study utilized a web-based survey to gather data from two distinct groups of informal caregivers: those caring for older adults with Alzheimer’s Disease (AD) and those caring for children with Autism Spectrum Disorder (ASD). Caregivers at least 18 years of age were administered a survey that included previously-developed scales to measure stress, coping mechanism, and QOL. Structural equation modeling was employed to assess the mediating role of coping behaviors in the relationship between perceived stress and QOL and multiple-group analysis was performed to evaluate differences between the caregiver groups. Of the 417 included caregivers, 210 (50.4%) were AD patient caregivers and 207 (49.6%) were ASD patient caregivers. In model testing, perceived stress was negatively associated with global QOL for both groups (i.e. direct effects) (estimate = −0.637, 95% CI: −0.777 to −0.529 for the ASD caregiver group; estimate = −0.601, 95% CI: −0.731 to −0.468 for the AD caregiver group). The only statistically significant indirect effect was perceived stress on global QOL through dysfunctional coping for the AD caregivers (estimate = −0.026, 95% CI: −0.048 to −0.005). None of the differences in indirect and direct effects between the two caregiver groups were statistically significant. Perceived stress was significantly associated with QOL among informal caregivers, irrespective of the condition of the patient cared for, be it AD or ASD. Dysfunctional coping strategies played a significant role in mediating this relationship only among AD caregivers. However, the two caregiver groups did not differ between them in appraisal of QOL. Stress management among caregivers will aid in their ability to have a good QOL.