Coping, stress, and burden among caregivers of older adults with Alzheimer’s: a network analysis

Abstract

Caregiving for older adults with Alzheimer’s disease (AD) has intensified in Brazil, highlighting the emotional and physical burden faced by caregivers. Understanding the factors contributing to this burden is essential for developing more effective and sustainable support strategies. Objective: The aim of this study was to analyze the relationship between coping strategies, caregiver burden, and perceived stress using network analysis. Methods: This was a quantitative, analytical, observational, and cross-sectional study with a final sample of 126 formal and informal caregivers from different regions of Brazil. Data were collected via an online questionnaire, using the Perceived Stress Scale, Zarit Burden Interview, and the Coping Strategies Inventory (EMEP). Statistical analysis was conducted with JASP software. Data showed nonparametric distribution, and Spearman’s correlation and LASSO network analysis were applied. Results: Results revealed weak but significant positive correlations (p<0.05; r<0.40) among coping domains. Problem-focused coping was negatively correlated with burden (r=-0.34) and stress (r=-0.60), while emotion-focused coping showed positive correlations with both (r=0.40; r=0.42). Religious/fantasy coping and seeking social support were also positively associated with burden. The LASSO network highlighted emotion-focused and religious coping as central nodes. Problem-focused coping was negatively associated with stress, while emotional and religious strategies were linked to increased burden and stress. Centrality indices indicated emotional coping and religious practices as highly influential. Conclusion: These findings underscore the protective role of problem-focused coping and the need for targeted interventions to foster adaptive strategies and support caregiver well-being.