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Stress and coping in older people with Alzheimer's disease.

AIM
To investigate stress intensity and coping style in older people with mild Alzheimer's disease.


BACKGROUND
The potential risk assessment of a stress event and the devising of coping strategies are dependent on cognitive function. Although older individuals with Alzheimer's disease present significant cognitive impairment, little is known about how these individuals experience stress events and select coping strategies in stress situations.


DESIGN
Survey.


METHOD
A convenient sample of 30 cognitively healthy older people and 30 individuals with mild Alzheimer's disease were given an assessment battery of stress indicators (Symptom Stress List, Cornell Scale for Depression in Dementia, State-Trait Anxiety Inventory), coping style (Jalowiec Coping Scale) and cognitive performance (mini-mental state exam) were applied in both groups. Statistical analysis of the data employed the Mann-Whitney test to compare medians of stress indicators and coping style, Fischer's exact test to compare proportions when expected frequencies were lower than five, and Spearman's correlation coefficient to verify correlation between coping style and cognitive performance.


RESULTS
Both groups suffered from the same stress intensity (p = 0.254). Regarding coping styles, although differences were not statistically significant (p = 0.124), emotion-oriented coping was predominant in the patients with Alzheimer's disease. However, those individuals displaying better cognitive performance in the Alzheimer's disease group had selected coping strategies focused on problem solving (p = 0.0074).


CONCLUSIONS
Despite a tendency for older people with Alzheimer's disease to select escape strategies and emotional control, rather than attempting to resolve or lesser the consequences arising from a problem, coping ultimately depends on cognitive performance of the individual.


RELEVANCE TO CLINICAL PRACTICE
The findings of this study provide information and data to assist planning of appropriate support care for individuals with Alzheimer's disease who experience stress situations, based on their cognitive performance.