Abstract Body (Do not enter title and authors here): Aims: Family caregivers of persons with dementia are at increased risk for cardiovascular disease (CVD), yet associated factors remain underexplored, particularly in Thailand’s rapidly aging society. This study examined the influence of psychological factors (resilience, caregiver burden, and social support) and health behaviors (physical activity and sleep quality) on CVD risk among family caregivers of Thai older adults with dementia.
Methods: We conducted a cross-sectional study using purposive sampling, enrolling 180 primary family caregivers at two hospitals in northern Thailand between June and October 2024. CVD risk was assessed using QRISK3, a 10-year CVD risk prediction algorithm incorporating demographic and health-related indicators. To gather the indicators, objective measures of body weight, height, blood pressure, and cholesterol levels were obtained following standardized protocols. Psychological and behavioral variables were assessed using validated Thai versions of the Connor-Davidson Resilience Scale, Zarit Burden Interview, Multidimensional Scale of Perceived Social Support, International Physical Activity Questionnaire, and Pittsburgh Sleep Quality Index. Generalized structural equation modeling (GSEM) was employed to investigate both direct and indirect effects.
Results: Approximately 60% of participants had a low 10-year CVD risk (<10%), while 40% were classified as having moderate to high risk. About 62% reported high perceived social support (scores 61–84/84), and nearly half experienced no to mild caregiver burden (scores 0–20/88). Approximately 47% engaged in moderate levels of physical activity (600–2,999 MET minutes per week). Regarding resilience, 57% demonstrated low levels (scores ≤30/40), and nearly 70% reported poor sleep quality (score ≥5/21). GSEM revealed that caregiver burden was positively associated with CVD risk (β = 0.180, p = 0.017), while resilience, social support, physical activity, and sleep quality had no significant direct effects. However, resilience was indirectly associated with reduced CVD risk through decreased caregiver burden (β = –0.145, p = 0.040), accounting for 86% of the total significant indirect effect (β = –0.168, p = 0.027).
Conclusions: Resilience may help reduce CVD risk by alleviating caregiver burden, although further research is needed to explore the underlying mechanisms. Interventions to enhance resilience and reduce caregiver burden may help mitigate CVD risk among dementia caregivers.