Relationship quality and sense of coherence in dementia: Results of a European cohort study: International Journal of Geriatric Psychiatry

M.J. Marques, B. Woods, L. Hopper, H. Jelley, K. Irving, L. Kerpershoek, G. Meyer, A. Bieber, A. Stephan, A. Sköldunger, B.-M. Sjölund, G. Selbaek, J. Rosvik, O. Zanetti, E. Portolani, M. de Vugt, F. Verhey, M. Gonçalves-Pereira, on behalf of the Actifcare Consortium

Research output: Contribution to journalArticlepeer-review


Objective: Quality of life of people with dementia and their family carers is strongly influenced by interpersonal issues and personal resources. In this context, relationship quality (RQ) and sense of coherence (SOC) potentially protect and promote health. We aimed to identify what influences RQ in dyads of people with dementia and their carers and to examine differences in their perspectives. Methods: Cross-sectional data were used from the Actifcare cohort study of 451 community-dwelling people with dementia and their primary carers in eight European countries. Comprehensive assessments included the Positive Affect Index (RQ) and the Orientation to Life Questionnaire (SOC). Results: Regression analyses revealed that RQ as perceived by people with dementia was associated with carer education, stress, and spouse caregiving. RQ as perceived by carers was associated with carer stress, depression, being a spouse, social support, reported neuropsychiatric symptoms of dementia, and carer SOC. Neuropsychiatric symptoms and carer stress contributed to discrepancies in RQ ratings within the dyad. The only factor associated with both individual RQ ratings and discrepancies was carer stress (negative feelings subscore). No significant differences in the overall perception of RQ were evident between spouses and adult children carers, but RQ determinants differed between the two. Conclusions: In this European sample, carer SOC was associated with carer-reported RQ. RQ determinants differed according to the perspective considered (person with dementia or carer) and carer subgroup. A deeper understanding of RQ and its determinants will help to tailor interventions that address these distinct perspectives and potentially improve dementia outcomes. © 2019 John Wiley & Sons, Ltd.
Original languageEnglish
Pages (from-to)745-755
Number of pages11
JournalInt. J. Geriatr. Psychiatry
Issue number5
Publication statusPublished - 2019


  • Alzheimer disease
  • dementia
  • dyadic perspective
  • family care
  • relationship quality
  • sense of coherence
  • adult
  • aged
  • Article
  • caregiver
  • cohort analysis
  • community dwelling person
  • controlled study
  • cross-sectional study
  • depression
  • education
  • European
  • family counseling
  • female
  • health care quality
  • health promotion
  • human
  • major clinical study
  • male
  • primary medical care
  • questionnaire
  • regression analysis
  • social competence
  • social support
  • spouse
  • stress
  • very elderly
  • Europe
  • human relation
  • middle aged
  • psychology
  • quality of life
  • Adult
  • Aged
  • Aged, 80 and over
  • Caregivers
  • Cohort Studies
  • Cross-Sectional Studies
  • Dementia
  • Depression
  • Female
  • Humans
  • Interpersonal Relations
  • Male
  • Middle Aged
  • Quality of Life
  • Regression Analysis
  • Sense of Coherence
  • Social Support
  • Spouses


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