Background and Objective: Research has documented the stigma that individuals with
degenerative neurological diseases experience, but caregivers also experience stigma by association
(i.e., affiliate stigma). In order to shed light on the stigma of caregivers of people with degenerative
neurological diseases, the current study aimed to explore cross-cultural differences in the prevalence
of Parkinson’s disease (PD) caregiver affiliate stigma, as well as the relationship between
PD symptoms and caregiver affiliate stigma. Applications for Alzheimer’s disease are discussed.
Methods: Survey data were collected in PD clinics at public, academic medical centers. Informal
caregivers of an individual with PD from the US (n = 105) and from Mexico (n = 148) participated
in the study. Caregivers completed a questionnaire that included the MDS Unified PD Rating Scale
to describe the symptoms of the individual with PD, as well as the Affiliate Stigma Scale and demographic
Results: A series of multiple regressions was run to examine whether PD symptoms were associated
with affiliate stigma and if these differed by country. These regressions suggested that different
patterns of PD symptoms predicted affiliate stigma in each country. Stigma was higher in the US
compared to Mexico, and the relationship between bowel/bladder symptoms and affiliate stigma
was significantly stronger in the US.
Conclusion: Symptoms of individuals with neurodegenerative diseases are related to affiliate stigma
experienced by caregivers, and these relationships may differ cross-culturally. Negative public
attitudes concerning bowl and bladder issues and the physical symptoms that accompany PD remain
a source of stigma for caregivers and families, particularly in the US. Interventions for caregivers
of individuals with neurodegenerative diseases should include strategies for coping with stigma
concerning bladder and bowel problems, as well as other physical and mental health issues.