Empathy involves being able to understand and respond to others’ emotional experiences. Whilst deficits in empathy have been observed in frontotemporal dementia, the extent to which empathy is disrupted in dementia syndromes with predominant language impairment remains unclear. The current study investigated cognitive and affective empathy in the two non-fluent primary progressive aphasia syndromes: progressive non-fluent aphasia (PNFA) and logopenic progressive aphasia (LPA). Informants of 23 PNFA and 16 LPA patients completed the Interpersonal Reactivity Index (IRI), regarding patients’ capacity for empathy pre- and post-disease onset. Twenty-four healthy control participants completed the self-rated IRI for comparison of post-disease empathy capabilities. Within-group analyses revealed reduced cognitive empathy and increased personal distress in both patient groups. In addition, lowered affective empathy was reported in PNFA, with a similar trend observed in LPA. Interestingly, reduced affective empathy was associated with greater carer burden in LPA. Between-group analyses revealed reduced cognitive empathy in both patient groups relative to controls. The current study is the first to document empathy changes in PNFA and LPA, offering insight into the social cognitive deficits experienced in these syndromes. Future neuroimaging studies are needed to identify the underlying neural correlates and mechanisms driving empathy deficits in PNFA and LPA.

Background: A high degree of burden is often experienced by informal caregivers of stroke survivors. However, little is known about the long-term impact of the caregiving role. This study sought to examine the relationship between social support and the psychological effects experienced by long-term caregivers of stroke survivors. Methods: The design was a prospective, multicentre, hospital-based stroke cohort study with 3 years of follow-up. Caregivers of participating stroke survivors completed questionnaires either through face-to-face interview or over the telephone. Primary outcome measures were the Medical Outcome Study (MOS) Social Support Survey and the Irritability, Depression, and Anxiety (IDA) Scale, and the association between them was investigated using multivariate logistic regression. Results: 174/217 (80%) stroke survivors participated at 3 years, involving 116 informal caregivers (mean age 66.9 years, 71% female). Increasing social support was correlated with lower levels of depression, anxiety and inward irritability in caregivers. Social support was independently associated with anxiety (OR 0.55, 95% CI 0.35–0.85; p = .007) and inward irritability (OR 0.47, 95% CI 0.29–0.77; p = .002). Furthermore, social support was significantly associated with carer strain, as assessed by the Caregiver Strain Index. Conclusions: The amount of social support available to long-term caregivers of stroke survivors may be an important factor in lowering psychological burden in these caregivers.

Background: Preliminary evidence indicates that the quality of the carer-care recipient relationship predicts those carers most at risk from anxiety. Attachment style is related to higher carer burden, psychological morbidity and increased care recipient institutionalization. We tested, for the first time, the hypothesis that carer burden and the coping strategies used mediate a relationship between attachment style and anxiety.

Methods: We interviewed 83 people with Alzheimer's disease and their family carers, originally recruited for a larger community study. Carers filled in a validated measure about their attachment style, the Hospital Anxiety and Depression Scale, the COPE to measure coping strategies, and the Zarit-Burden interview.

Results: More avoidant attachment (β = 0.28) and less secure attachment (β = −0.32) predicted anxiety. After adding coping strategies to the equation, the relationship with avoidant attachment (β = 0.15) was no longer significant, and that with less secure attachment was reduced (β = −0.23). A well-fitting structural equation model supported our finding that dysfunctional coping mediated the relationship between attachment style and anxiety.

Conclusion: Carers who were less secure or more avoidantly attached reported higher anxiety. Interventions that aim to modify coping strategies have shown promise in reducing carer anxiety. Our finding that coping strategies also appear partially to explain the excess of anxiety among less securely attached carers suggests they are likely to benefit from such interventions.