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This four-year longitudinal study in Hong Kong examined shifts in care demands, resource use, and predictors of adaptive family responses. Telephone interviews (2021–2025) with 90 informal caregivers analyzed repeated measures and multiple regression. Care recipients declined in ADL, IADL, and health-related QoL; predictors linked to decision-making patterns and caregiver burden informed maladaptive versus sustained use of support services.",{"@graph":69,"@context":126},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":40,"@type":76,"position":81},"https://docshare.wps.com/document/research-report/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/adaptive-family-responses-to-dementia-care-a-four-year-longitudinal-study-in-hong-kong/427144/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/adaptive-family-responses-to-dementia-care-a-four-year-longitudinal-study-in-hong-kong/427144.png","ImageObject",300,407,{"name":92,"@type":93},"moss~","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-22","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":29},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118,122],{"name":109,"@type":110,"acceptedAnswer":111},"What was the study’s primary objective?","Question",{"text":112,"@type":113},"To examine how care demands and resources change over time and to identify predictors of adaptive family responses to dementia care in Hong Kong.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How were the data collected and analyzed?",{"text":117,"@type":113},"Telephone interviews were conducted in 2021 and 2025, and the results were analyzed using repeated measures and multiple regression.",{"name":119,"@type":110,"acceptedAnswer":120},"What changes were observed in people living with dementia over four years?",{"text":121,"@type":113},"Significant declines occurred in ADL, IADL, and health-related quality of life, with all reported p-values less than .001.",{"name":123,"@type":110,"acceptedAnswer":124},"Which factors were linked to maladaptive functioning in family responses?",{"text":125,"@type":113},"Families with enmeshed dynamics and misaligned care expectations were suggested to be at higher risk, with predictors including fewer members involved in care-related decision-making and higher caregiver burden.","https://schema.org",{"og:url":83,"og:type":128,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":130,"canonical":83},"index,follow",{"doc_id":132,"site_id":62},427144,1790795245,{"code":4,"msg":5,"data":135},{"doc_id":132,"user_id":136,"nickname":92,"user_avatar":137,"doc_module":4,"category_id":39,"category_name":40,"doc_title":65,"doc_description":67,"doc_content":138,"file_id":139,"file_url":140,"file_type":141,"file_size":142,"view_count":29,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":8,"language":143,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":144,"faqs":145,"seo_title":146,"seo_description":67,"update_tm":147,"read_time":81},962090895452,"https://ap-avatar.wpscdn.com/davatar_a8503ba1806abce46bf441b54a3ca4cd","Innovation in Aging, 2025, Vol. 9, No. S2 1213  \nservices (39% to 62%), and informal care time (512 to 729hours/ month). Caregivers reported increased care burden (p\u003C.001) and reduced health-related QoL (p=.005) . After adjusting for functional decline, predictors of involving more informal caregivers were fewer members participating in care-related decision making (B=-0.716, p\u003C.001) and higher care burden (B = 0.043, p=.007). Predictors of increased or sustained use of social services included fewer decision-making caregivers (OR = 0.341, p=.036), better relationship quality with PLwD (OR = 2.13, p=.048), and higher expectations for future caregiving needs (OR = 1.16, p=.028) . Our findings suggest that families with enmeshed dynamics and misaligned care expectations may be at higher risk for maladaptive functioning, highlighting the need for early identification and targeted support programs in shaping adaptive responses to dementia care over time.  \nAbstract citation ID: igaf122.4059  \nADAPTIVE FAMILY RESPONSES TO DEMENTIA CARE:  \nA FOUR-YEAR LONGITUDINAL STUDY IN  \nHONG KONG  \nJacky C. P. Choy1, Gloria Hoi Yan Wong2, and Cheng Shi3, 1. The University of Hong Kong, Hong Kong, Hong Kong, China (People’s Republic), 2. University of Reading, Reading, United Kingdom, 3. Lingnan University, Hong Kong, Hong Kong, China (People’s Republic)  \nMultiple informal caregivers are often involved in dementia caregiving, yet little is known about how families collectively respond to care-related changes over time. Guided by family stress theories, this longitudinal study aimed to 1) examine changes in care demands and use of resources, and 2) identify predictors of adaptive family responses. Participants were 90 informal caregivers (22% spouses; mean age = 55.8 ± 12.4 years) of community-dwelling PLwD in Hong Kong. Data were collected via telephone interviews in 2021 and 2025, and analyzed using repeated measures and multiple regression. Over four years, PLwD showed significant declines in ADL, IADL, and health-related quality of life (QoL) (all p\u003C.001). While the number of informal caregivers remained stable, there were increases in the use of foreign domestic helpers (38% to 52%), formal care","cbCaifDQDiJdJDpC","https://ap.wps.com/l/cbCaifDQDiJdJDpC","pdf",1065016,"English","# Study Aim and Framework\n## Participants and Data Collection\n## Measures and Analysis\n## Key Findings and Predictors\n## Implications for Adaptive Responses","[{\"question\":\"What was the study’s primary objective?\",\"answer\":\"To examine how care demands and resources change over time and to identify predictors of adaptive family responses to dementia care in Hong Kong.\"},{\"question\":\"How were the data collected and analyzed?\",\"answer\":\"Telephone interviews were conducted in 2021 and 2025, and the results were analyzed using repeated measures and multiple regression.\"},{\"question\":\"What changes were observed in people living with dementia over four years?\",\"answer\":\"Significant declines occurred in ADL, IADL, and health-related quality of life, with all reported p-values less than .001.\"},{\"question\":\"Which factors were linked to maladaptive functioning in family responses?\",\"answer\":\"Families with enmeshed dynamics and misaligned care expectations were suggested to be at higher risk, with predictors including fewer members involved in care-related decision-making and higher caregiver burden.\"}]","ADAPTIVE FAMILY RESPONSES TO DEMENTIA CARE - A FOUR-YEAR LONGITUDINAL STUDY IN HONG KONG | PDF",1790642973]