Anger and Dementia Caregiving: A Systematic Review of the Effects of Anger and Hostility on Caregivers' Physical Health

Abstract

Background: Anger is commonly experienced by family caregivers of people living with dementia yet its effect on caregivers' physical health remains unknown. Objective: The primary aim of this study was to systematically review current evidence on the effects of anger and hostility on caregivers' physical health. Methods: We searched Medline, EMBASE, PubMed, and PsycINFO up to January 2022. Two review authors independently extracted data on study characteristics, study quality, and effect sizes of associations of anger and hostility with caregiver health outcomes. Results: We found eight studies examining the effects of anger and hostility on caregivers' physical health reporting on a total of 937 participants, of which four were cross-sectional and four were longitudinal. Overall findings indicated that higher levels of anger and hostility exerted a negative effect on caregivers' physical health. Higher anger control was longitudinally associated with increased weight gain (β=1.13, p<0.001), whereas higher anger out predicted higher glucose dysregulation at long-term follow-up (r=0.27, p<0.05). Higher levels of caregiver hostility were associated with increased risk of chronic low-grade inflammation long-term (r=0.18, p<0.05), and increased risk of cognitive decline over time (r=0.16, p<0.05). Conclusion: Our review provides the first systematic synthesis of the evidence demonstrating the harmful effects of anger and hostility on dementia caregivers' health and highlights the need for preventative interventions to support family caregivers experiencing high levels of anger.