A comparison of marital interaction patterns between couples in which the husband does or does not have Alzheimer's disease

Objectives. Our main purpose was to examine similarities and differences in patterns of interpersonal interaction be tween Alzheimer's disease (AD) caregiving and noncaregiving couples (n = 54). Methods. Twenty-seven wives caring for moderately impaired husbands with probable AD and 27 noncaregiving wives from comparable sociodemographic backgrounds were videotaped in their homes during both mealtime and a future event planning task. In addition. they completed elf-report questionnaires to assess depression, stress, relationship mutuality. and perceived hope. Results, Compared with their counterparts. caregiving wives reported higher levels, of depression and stress, but similar shored values and closeness. For the three factors developed from the Marital interaction Coding System (MICS, version IV; Supportive Facilitative, and Rapport Building), a complex pattern of results was found in which disease status, type of task. and gender interacted significantly. Noncaregiving couples were more interactive overall and expressed more support to each other. Caregiving wives were found to be most facilitative during the planning task. whereas AD husbands were highest on interactions that built rapport (e.g.. smiling) during that same task. Caregiving gives actually increased their facilitative behavior from the mealtime to planning task. probably reflecting the increased demand characteristics of the latter. Discussion. This study is one of a small body of literature to describe the negative impact of AD on spousal communication as observed anti coded in two videotaped interaction situations in the home. Suggestions are made for future research, including the inclusion of longitudinal designs and non-Caucasian couples.