Does caring for a spouse with dementia promote cognitive decline? A hypothesis and proposed mechanisms

Peter P. Vitaliano, Michael Murphy, Heather M. Young, Diana Echeverria, Soo Borson

Research output: Contribution to journalArticlepeer-review

103 Scopus citations


Objective: To discuss why spouse caregivers (CGs) of people with dementia may be at higher risk for cognitive problems and decline than demographically similar people not caring for a spouse with dementia (noncaregivers; NCGs). Design: Literature review. Setting: Community. Participants: Older adults caring for a family member (primarily spouses) with dementia. Measurements: Cognitive, psychosocial, physiological, and behavioral. Results: This article reports a review of the literature examining relationships between CG status and cognitive problems in the context of a theoretical model of chronic stress. The model suggests that spouse CGs may be at higher risk of cognitive impairment or dementia than NCG spouses in response to several mediators, including psychosocial (e.g., depression, loneliness, social isolation, sleep problems), behavioral (e.g., exercise, diet), and physiological (e.g., metabolic syndrome and inflammation) variables. Conclusion: This research has important implications because it considers modifiable risk factors for dementia that, if unchecked, may compromise the lives of CGs and their ability to function. It is hoped that an understanding of such stress-mediator-cognitive processes will help clinicians, researchers, policy-makers, and stakeholders mitigate what may be characterized as an "ironic tragedy"-dementia in both members of the caregiving dyad-if left unchecked.

Original languageEnglish (US)
Pages (from-to)900-908
Number of pages9
JournalJournal of the American Geriatrics Society
Issue number5
StatePublished - May 2011
Externally publishedYes


  • caregiving
  • cognitive decline
  • dementia
  • depression
  • physiology


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