Abstract
Objective: Dementia caregiving is associated with elevated psychological distress, yet limited research has examined how caregiving demands shape mental health among East Asian American caregivers, a rapidly growing but understudied population. Guided by the stress process framework, this study examined three temporal dimensions of objective caregiving demands - time intensity, frequency, and chronicity - and their associations with subjective caregiving demands and depressive symptoms among older East Asian American caregivers of individuals living with Alzheimer's disease and related dementias (AD/ADRD).Design: Survey data were collected from 82 East Asian American caregivers aged 50 years or older who were providing care to individuals with dementia in the United States. Participants were recruited through community-based organizations and ethnic community settings. Ordinary least squares regression models were estimated to examine associations among temporal caregiving demands, subjective caregiving demands, and depressive symptoms. An exploratory post hoc structural equation model was also estimated to examine indirect associations.Result: Caregivers in this sample reported substantial caregiving involvement, averaging more than 10 hours of care per day, five days per week, over a period exceeding five years. In adjusted regression models, time intensity and chronicity were not directly associated with depressive symptoms, while caregiving frequency was negatively associated with depressive symptoms. Subjective caregiving demands were strongly and positively associated with depressive symptoms. Temporal caregiving demands were positively associated with subjective caregiving demands when examined separately. An exploratory post hoc analysis suggested that chronicity was indirectly associated with depressive symptoms through subjective caregiving demands.Conclusion: Findings suggest that the mental health implications of dementia caregiving may depend less on objective time exposure alone and more on caregivers' subjective appraisal of caregiving demands. Culturally and linguistically responsive interventions should address perceived caregiving burden, improve access to formal support, and attend to the long-term caregiving experiences of East Asian American dementia caregivers.