ArticleBMC geriatrics2026
Informal caregivers of people living with dementia as invisible second patients: examining the dual role of burden and resilience in perceived stress.
Article in BMC geriatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundInformal caregivers (ICs) of people living with dementia (PwD) are often referred to as invisible second patients, as they frequently experience chronic stress and related health issues. Identifying factors that contribute to or buffer caregiver stress is therefore of critical importance. This study aimed to explore how caregiver burden and resilience jointly are associated with stress among ICs of PwD - a rarely adopted approach.
methodsThe sample consists of n = 172 ICs. To examine the associations between our dependent variable, stress (PSS), and caregiver burden (BIZA-D-PV), caregiver resilience (BRS), the quality of life of the PwD (QoL-AD), as well as the IC's sociodemographic characteristics, we conducted a hierarchical multivariate regression analysis. Resilience was included as a second block to assess changes in model fit and variable effects. Furthermore, an interaction model was calculated to investigate potential moderating effect of resilience.
resultsIn Block 1, without considering resilience, personal constraints of the IC (p < 0.001), the QoL of the PwD (p < 0.001), and cohabitation of the IC and PwD (p = 0.006) were significantly associated with stress. In Block 2, only personal constraints (p < 0.001) and the QoL of the PwD (p = 0.001) remained significant, and, additionally, the explained variance (R²) increased significantly (p < 0.001). In the interaction model, only the main effects of resilience (p = 0.004), personal constraints (p = 0.002), and QoL of the PwD (p = 0.002) were significant.
conclusionsThese findings might highlight important considerations for future interventions aimed at supporting ICs and PwD. Special attention could be given to cohabiting IC-PwD dyads, as these relationships often involve unique challenges and stressors that could be mitigated through tailored support strategies.
trial registrationGerman Register of Clinical Trials (Deutsches Register Klinischer Studien, DRKS), DRKS00023560. Registered 13 November 2020 Retrospectively registered, https//www.drks.de/drks_web/navigate.do? navigationId=trial.HTML&TRIAL_ID=DRKS00023560.
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