Performance of the Modified Caregiver Strain Index in a Sample of Black and White Persons Living With Dementia and Their Caregivers (2024)

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Carolina Pereira-Osorio, MS

Ochsner Health, Center for Brain Health

New Orleans, Louisiana

USA

Address correspondence to: Carolina Pereira-Osorio, MS. E-mail: carolina.pereiraosorio@ochsner.org

https://orcid.org/0000-0002-6192-8166

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Emily Brickell, PsyD

Ochsner Health, Center for Brain Health

New Orleans, Louisiana

USA

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Bern Lee, PhD

Ochsner Health, Center for Brain Health

New Orleans, Louisiana

USA

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Beth Arredondo, PhD

Ochsner Health, Center for Brain Health

New Orleans, Louisiana

USA

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Robert John Sawyer, PhD

Abstract

Background and Objectives

This study examined the performance of the Modified Caregiver Strain Index (MCSI) in a sample of Black and White caregivers of persons living with dementia.

Research Design and Methods

Data on 153 dyads enrolled in the Care Ecosystem dementia care management program were analyzed, including sociodemographic variables, dementia severity, and caregiver burden and wellbeing. Factor structure, item-response patterns, and concurrent validity were assessed across racial groups.

Results

Differences between Black and White caregivers included gender, dyad relation, and socioeconomic disadvantage. Factor structure and item loadings varied by racial cohort, with parameters supporting a 3-factor model. For Black caregivers, finances and work, emotional and physical strain, and family and personal adjustment items loaded together on individual factors. For White caregivers physical and emotional strain items loaded on separate factors, although personal and family adjustment items loaded with work and financial strain items. Item-level analysis revealed differences between groups, with Black caregivers endorsing physical strain to a greater degree (p = .003). Total MCSI scores were positively correlated with concurrent measures like the PHQ-9 (White: r = 0.67, Black: r = 0.54) and the GAD-2 (White: r = 0.47, Black: r = 0.4), and negatively correlated with self-efficacy ratings (White: r = −0.54, Black: r = −0.55), with a p < .001 for all validity analysis.

Discussion and Implications

The MCSI displayed acceptable statistical performance for Black and White caregivers of persons living with dementia and displayed a factor structure sensitive to cultural variations of the construct. Researchers results highlight the inherent complexity and the relevance of selecting inclusive measures to appropriately serve diverse populations.

Caregiver burden, Cross-cultural research, Diversity and ethnicity, Factor analysis, Major neurocognitive disorder

© The Author(s) 2024. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.

This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/pages/standard-publication-reuse-rights)

Decision Editor: Joseph E Gaugler, PhD, FGSA

Joseph E Gaugler, PhD, FGSA

Decision Editor

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