Identification of caregivers at greatest risk of major depression in two prevention studies

Blanco, Vanessa; Rohde, Paul; Vázquez, Fernando; Torres, Ángela

doi:10.1080/10503307.2013.847989

Cited by 10 publications

(8 citation statements)

References 51 publications

(51 reference statements)

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“…To our knowledge, this is the first report identifying RAR characteristics associated with depression symptom severity in strained caregivers, who are an important group known to be at elevated risk for developing depression (Ballard et al ., ; Beach et al ., ; Blanco et al ., ; Cuijpers, ; Joling et al ., , ). We found that greater night‐time sleep fragmentation and having the least steep/'square‐like’ RAR curves (those in the lowest quartile of RAR beta values) were, independently of each other, associated with having a greater burden of depression symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…Informal (unpaid) providers of care for a person with a disability or impairment form such a group, where the risk for major depressive disorder is very high (Ballard et al ., ; Cuijpers, ; Joling et al ., , ), especially when caregivers are already experiencing caregiving‐related strain or distress (Beach et al ., ; Blanco et al ., ). Several lines of evidence suggest that objectively measured RAR disturbances may mark depression symptom severity in dementia caregivers.…”

Section: Introductionmentioning

confidence: 97%

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Rest–activity rhythm and sleep characteristics associated with depression symptom severity in strained dementia caregivers

Smagula

Krafty

Taylor

et al. 2017

Journal of Sleep Research

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Summary Depression is associated with disturbances to sleep and the 24-hour sleep-wake pattern (known as the rest-activity rhythm or RAR). However, there remains a need to identify the specific sleep/RAR correlates of depression symptom severity in zpopulation sub-groups, such as strained dementia caregivers, who are at elevated risk for major depressive disorder. We assessed the cross-sectional associations of sleep/RARs with non-sleep depression symptom severity among n=57 (mean age=74, standard deviation=7.4) strained dementia caregivers who were currently without clinical depression. We derived sleep measures from polysomnography and actigraphy, modeled RARs using a sigmoidally transformed cosine curve, and measured non-sleep depression symptom severity using the Hamilton Depression Rating Scale (HRDS) with sleep items removed. The following sleep-wake measures were associated with greater depression symptom severity (absolute Spearman correlations ranged from 0.23–0.32): more time awake after sleep onset (WASO), higher RAR middle level (mesor), relatively shorter active periods (alpha), earlier evening settling time (down-mesor), and less steep RARs (beta). In multivariable analysis, high WASO and low RAR beta were independently associated with depression symptom severity. Predicted non-sleep HDRS means (95% confidence intervals) in caregivers with and without these characteristics were: normal WASO/beta=3.7 (2.3–5.0), high WASO/normal beta=5.5 (3.5–7.6), normal WASO/low beta=6.3 (3.6–8.9), high WASO/low beta=8.1 (5.3–10.9). Thus, in our sample of strained caregivers, greater sleep fragmentation (WASO) and less sustained/sharply segregated resting and active periods (low RAR beta) uniquely correlate with depression symptom severity. Longitudinal studies are needed to establish whether these independent sleep-wake correlates of depression symptoms explain heightened depression risk in dementia caregivers.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 97%

Rest–activity rhythm and sleep characteristics associated with depression symptom severity in strained dementia caregivers

Smagula

Krafty

Taylor

et al. 2017

Journal of Sleep Research

View full text Add to dashboard Cite

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“…Nevertheless, our findings (regarding the factors that attenuated the white matter-caregiving strain association) can be interpreted within the context of existing literature and current conceptual frameworks. Depression, a known consequence of strain in caregivers (4, 10), is often conceptualized as a consequence of white matter disease (11-13). Depression symptoms attenuated the association of interest, potentially because depression is an intermediate (mediator) between white matter pathology and caregiving strain, or a downstream consequence of caregiving strain.…”

Section: Discussionmentioning

confidence: 99%

“…Replacing older adults' informal caregiving services with skilled or unskilled workers, respectively, would cost an estimated 162 or 56 billion dollars per year (9). Since caregiver's depression risk is potentiated by strain (4) and emotional distress (10), caregivers with these characteristics represent those in the greatest need of pathophysiologically informed interventions for depression prevention.…”

mentioning

confidence: 99%

Brain Structural Markers and Caregiving Characteristics as Interacting Correlates of Caregiving Strain

Smagula

Beach

Rosso

et al. 2017

The American Journal of Geriatric Psychiatry

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Objective To evaluate the association between brain structural markers and caregiving strain among older informal caregivers. Design A secondary data analysis combining data from the Caregiver Health Effects Study (1993-1994) and the Cardiovascular Health Study MRI examination (1992-1994). Setting Four United States communities. Participants Co-residing spousal caregivers (n=237, mean age=76.2, standard deviation=2.2). Measurements Visually-rated ventricular and white matter (WM) grades from MRI, caregiving strain defined as “emotional or physical strain associated with providing care” for any of 12 activities of daily living (ADLs) and instrumental activities of daily living (IADLs), plus measures of caregiving characteristics and caregiver's health. Results Overall, 56% of caregivers reported strain. We detected an interaction where strain was very common (>82%) among caregivers who helped with ≥4 IADLs, regardless of WM grades, and among caregivers with the worst WM grades (WM grades ≥4), regardless of the number of IADLs they helped with. Among caregivers helping with <4 IADLs, having WM grades ≥4 was associated with a 55% higher prevalence ratio for reporting strain. This association remained statistically significant but was most markedly attenuated by adjustments for: care recipient's memory and behavioral problems, caregiver's depression symptoms, and caregiver's ADL impairment. Conclusions Caregiving strain is very common among older informal caregivers who provide help with many IADLs, and among caregivers who help with fewer IADLs, but have manifest signs of white matter pathology. Modern quantitative-neuroimaging studies are needed to evaluate whether more subtle variability in brain structure confers caregiving strain and the related health consequences.

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“…In another study, Vázquez et al [85] found signiicant diferences between a ive-session cognitive-behavioral intervention and a usual care control group in the reduction of depressive symptomatology (d = 1.33) and the incidence of depression (3.4% vs. 22.0%) at 12-month follow-up (see Figure 2). Both interventions were efective regardless of the condition of the person cared for [86,87]; those changes in depressive symptomatology were also clinically signiicant [88] and homework tasks played a fundamental role in the reduction of depressive symptomatology [89].…”

Section: Professional Support When Psychopathological Symptoms Occurmentioning

confidence: 99%

Psychopathological Symptoms in Caregivers of Demented and Nondemented Patients

Vázquez¹,

Otero²,

Blanco³

et al. 2018

Caregiving and Home Care

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Currently, more than 1 in 10 adults living in the Organization for Economic Co-operation and Development is involved in nonprofessional care of a dependent family member. The main causes of dependence are dementia, followed by other conditions such as cerebrovascular accidents, limb impairment, depression, and vision impairment. Although care provided by the caregiver is crucial to the well-being of the cared person, it can also have negative consequences on the caregiver's emotional state. This chapter aims to describe the psychopathological symptoms experienced by caregivers based on the condition of the person cared for. A bibliographic search was conducted to examine the efects of care on the emotional state of caregivers, distinguishing patients with dementia from those with other conditions. Depressive and anxiety symptoms were the most frequent psychopathological symptoms, both in caregivers of demented and nondemented patients, experienced by caregivers of patients with dementia, cerebrovascular accidents, traumatic brain injury, schizophrenia, cancer, amyotrophic lateral sclerosis, and autism spectrum disorder. In caregivers of patients with bipolar disorder and vision impairment, depressive symptoms were most prominent, whereas anxiety symptoms were common in caregivers of patients with spinal cord injuries. Sleep disturbances were found among caregivers of dementia and schizophrenia patients. Strategies for preventing psychopathological symptoms were provided and the importance of professional support when they occur was pointed out.

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Identification of caregivers at greatest risk of major depression in two prevention studies

Abstract: RESULTS implicate the utility of emotional distress for depression screening and the need to develop tailored interventions.

Cited by 10 publications

References 51 publications

Rest–activity rhythm and sleep characteristics associated with depression symptom severity in strained dementia caregivers

Rest–activity rhythm and sleep characteristics associated with depression symptom severity in strained dementia caregivers

Brain Structural Markers and Caregiving Characteristics as Interacting Correlates of Caregiving Strain

Psychopathological Symptoms in Caregivers of Demented and Nondemented Patients

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