Care Partner Perspectives on Hypertension Management in Alzheimer Disease and Related Dementias (ADRD): Qualitative Thematic Analysis of an Online Forum (Preprint)
Bibliographic record
Abstract
Background: Family care partners manage care for individuals with Alzheimer disease and related dementias (ADRD), including hypertension management crucial for preventing cognitive decline. Nurses frequently interact with these caregiver-patient dyads but have limited evidence about caregivers' real-world experiences of managing this comorbidity. Understanding these experiences is essential for developing nurse-led interventions that support both patients and caregivers. Objective: This study aimed to explore ADRD care partners' perceptions, experiences, and challenges related to hypertension management. A qualitative thematic analysis of care partner posts from an online forum focused on ADRD was conducted. Methods: We analyzed 300 posts from ALZConnected, collected using the keywords "hypertension" and "blood pressure." Two independent researchers used reflexive thematic analysis, following the Braun and Clarke framework until data saturation was achieved. Results: Among posts from predominantly family care partners (10,427/11,092, 94%, mostly adult children), 7 themes emerged: Pharmacotherapy (155/300, 51.7%), addressing medication efficacy, polypharmacy, and side effects; Patient Health Care Implementation Strategies (n=125, 41.7%), encompassing care coordination and provider interactions; Comorbid Care Management (n=136, 45.3%), highlighting caregiving demands, behavioral symptoms of ADRD, and care coordination challenges as barriers to hypertension control; Hypertension Management and Outcomes (n=71, 23.7%), including hypertensive crises; Managing Behavioral Symptoms (n=38, 12.7%), particularly care resistance; Peer Medical Advice Exchange (n=9, 3%); and Caregiver Burden and Self-Care for Hypertension (n=25, 8.3%), revealing care partners' own hypertension attributed to caregiving stress. Conclusions: Managing comorbid hypertension in ADRD presents challenges spanning medication management, behavioral symptoms, and health care coordination. Caregivers reported developing hypertension themselves, highlighting bidirectional health impacts. Health care providers should implement dyadic interventions addressing both patient hypertension management and caregiver health within the care partnership.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.044 | 0.090 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.015 | 0.008 |
| Scholarly communication | 0.008 | 0.008 |
| Open science | 0.002 | 0.012 |
| Research integrity | 0.003 | 0.006 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".