Predictors of the one-year-change in depressiveness in informal caregivers of community-dwelling people with dementia

Kürten, Lara; Dietzel, Nikolas; Kolominsky-Rabas, Peter; Graessel, Elmar

doi:10.1186/s12888-021-03164-8

Cited by 14 publications

(9 citation statements)

References 54 publications

(25 reference statements)

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“…One explanation might be that spousal dyads most often live together and share the majority of daily life. In line with this, Kürten et al (2021) found that the time ICs need to supervise the PwD predicted depressiveness in ICs. This might explain the differences in treatment trajectories that we found between child–parent and spousal dyads, as spousal dyads may be required to spend more time on caregiver duties, if residing in the same household as the care recipient.…”

Section: Discussionsupporting

confidence: 61%

Psychobiological Evaluation of Day Clinic Treatment for People Living With Dementia – Feasibility and Pilot Analyses

Wuttke-Linnemann¹,

Palm²,

Geschke

et al. 2022

Front. Aging Neurosci.

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BackgroundHospitalization is often stressful and burdensome for people living with dementia (PwD) and their informal caregivers (ICs). Day clinic treatment may provide a suitable alternative, but is often precluded by a diagnosis of dementia. Furthermore, it is often caregiver-based ratings that measure treatment success as the validity of self-reports in PwD is critically discussed. We therefore set out to examine the feasibility of psychobiological stress measures in PwD and ICs and to evaluate treatment trajectories considering both the day clinic context and the daily life of the dyads.MethodA total of 40 dyads of PwD (mean age: 78.15 ± 6.80) and their ICs (mean age: 63.85 ± 13.09) completed paper-and-pencil questionnaires (covering stress, depressive symptoms, and caregiver burden among others) in addition to the measurement of hair cortisol concentrations (HCC) at admission, discharge, and follow-up 6 months after day clinic treatment. As part of an ambulatory assessment, for 2 days at the beginning and 2 days at the end of the day clinic treatment, PwD and ICs collected six saliva samples per day for the analysis of salivary cortisol (sCort) and alpha-amylase (sAA).ResultsPaper-and-pencil questionnaires and HCC assessments were more feasible than the ambulatory assessment. We found discrepancies between subjective and physiological markers of stress in PwD. Whereas HCC decreased over time, self-reported stress increased. Child–parent dyads reported decreases in neuropsychiatric symptoms, associated burden, and self-reported stress from admission to follow-up. In daily life, both PwD and ICs showed characteristic diurnal profiles of sAA and sCort, however, we found no differences in summary indicators of salivary stress markers over time.DiscussionThe psychobiological evaluation was feasible and added informative value, underlining the potential of physiological stress markers to complement self-reports on stress in PwD and to objectively evaluate treatment trajectories. In this sample, HCC was more feasible and acceptable as biological marker of stress compared to saliva samples. Concerning treatment trajectories, differential effects on the dyads were found, with child–parent dyads benefiting more from day clinic treatment compared to spousal dyads.

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Section: Discussionsupporting

confidence: 61%

Psychobiological Evaluation of Day Clinic Treatment for People Living With Dementia – Feasibility and Pilot Analyses

Wuttke-Linnemann¹,

Palm²,

Geschke

et al. 2022

Front. Aging Neurosci.

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“…Also, some studies have reported that caregivers were significantly more vulnerable to suffering from anxiety and depression ( 15 , 24 , 29 , 37 , 51 , 52 ). The psychological burden has become the most important aspect ( 29 , 52 ), and this may be related to the fact that the caregiver’s life is mainly focused on caring for the patient and has no time for personal life, employment, and social life ( 37 ), which creates a strong role conflict. In addition, the high cost of treatment, the patient’s BPSD symptoms, and the poor health status of caregivers can have a negative impact on the caregiver’s psychology ( 15 , 29 , 37 ).…”

Section: Discussionmentioning

confidence: 99%

Care burden on family caregivers of patients with dementia and affecting factors in China: A systematic review

Wang

Zhou²,

Fang³

et al. 2022

Front. Psychiatry

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BackgroundDementia is a chronic and progressive illness characterized by severe impairment and high dependencies. Under the influence of Chinese traditional culture, 80% of patients with dementia are watched over at home by family caregivers as primary caregivers. However, long-term care brings formidable burdens to them and reduces the quality of their life. It is necessary to find out the influencing factors of caregivers’ burden.MethodsA scoping search was conducted on eight electronic databases from 1 January 2010 to 14 June 2022: PubMed, Embase, the Cochrane Library, Web of Science, China National Knowledge Infrastructure, China VIP Database, China Biomedical Literature Database, and Wanfang Data Knowledge Service Platform. Research articles included in this review discussed the factors affecting Chinese dementia family caregivers’ care burden or stress, and the level of care burden was evaluated by a standardized care burden scale.ResultsA total of 1,888 related articles were found and 23 cross-sectional studies were eventually included. After quality assessment, 12 were of good quality and 11 were of fair quality. A total of 32 factors were identified that were associated with caregiver burden, and the results were grouped into three categories: patient, caregiver, and society. The severity of disease, poor self-care ability, neuropsychiatric symptoms, care time, number of helpers, poor health status, economic stress, poor psychological status, social support, and age were reported in many previous studies.ConclusionIn this review, the factors that affect the caregiver burden for people with dementia were clarified. By identifying these factors, hospitals, decision-makers, and communities can carry out special projects for these populations, provide appropriate assistance, or design corresponding intervention measures to reduce the caregiver burden and improve the quality of care for patients with dementia.Systematic review registration[https://www.crd.york.ac.uk/PROSPERO/], identifier [CRD42022347816].

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“…The ZBI and its different short versions are commonly used to measure caregiver burden, although their use differs among studies, such as in the selection of different cutoff points for burden (e.g., 40 points (12), 20 points (47), median (35)) or application of only item 22, which refers to the "overall felt caregiver burden" (37), to give just a few examples. Other studies use scales other than the ZBI, such as the Brief Symptom Inventory (BSI-18) (48), Perceived Social Stress Scale (20) and Burden Scale for Family Caregivers (BSFC-s) (49), to measure caregiver burden. Here, we used the short ZBI in dementia, a brief version with only four items that is validated to measure burden in caregivers of patients with dementia (27).…”

Section: Discussionmentioning

confidence: 99%

Burden in caregivers of primary care patients with dementia: Influence of neuropsychiatric symptoms according to disease stage (NeDEM project)

García-Martín

Hoyos-Alonso

Ariza-Cardiel

et al. 2023

Preprint

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Background Caregiver burden is related to personal factors and patient characteristics and is greater when neuropsychiatric symptoms (NPSs) are present. Objective: Estimate the prevalence of burden among caregivers of dementia patients and its association with NPSs and identify NPSs causing greater caregiver distress according to dementia stage.Methods Cross-sectional observational study in caregivers of noninstitutionalized dementia patients. Caregiver variables: sociodemographic, time of care, NPS-associated distress based on the Neuropsychiatric Inventory Caregiver Distress Scale (NPI-D) and burden based on the Zarit Burden Interview (ZBI). Patient variables: time since disease onset, Global Deterioration Scale (GDS) disease stage, functional assessment and NPS presence and intensity according to the Neuropsychiatric Inventory (NPI). The mean ZBI score, prevalence of burden and NPI-D score with 95% CIs at each dementia stage were estimated. Factors associated with burden were identified by multivariate analysis.Results Of the 125 caregivers included, 77.6% were women, with a mean age of 60.7 (± 14.3) years; 78.4% (95% CI: 71.0; 86.0) experienced burden. The mean ZBI score was 12.3 (95% CI: 11.6; 12.9) and increased according to NPS number (p = 0.042). The NPSs causing the most burden were disinhibition (93.5%), irritability (87.3%) and agitation (86.1%). Agitation, apathy, and sleep disorders were the NPSs generating the greatest overall caregiver distress; depression (max NPI-D 1.9), hyperactivity (max NPI-D 2.1), and psychosis symptoms (max NPI-D 1.6) generated the greatest distress at stage GDS 3, stages GDS 4–5, and stages GDS 6–7, respectively. The NPI score (OR = 1.0, 95% CI 1.0; 1.1), intensity of irritability (OR = 1.3, 95% CI 1.0; 1.6), disinhibition (OR = 2.3, 95% CI 1.1; 5.2) and hyperactivity subsyndrome (OR = 1.1, 95% CI 1.0; 1.2) were associated with caregiver burden. Other associated factors were female gender (OR = 6.0, 95% CI 1.6; 22.8), ≥ 8 hours daily care (OR = 5.6, 95% CI 1.4; 22.8), working outside the home (OR = 7.6, 95% CI 1.8; 31.8), living with the patient (OR = 4.5, 95% CI 1.1; 19.6), kinship (OR = 5.4, 95% CI 1.0; 28.2) and lower patient education (OR = 8.3, 95% CI 2.3; 30.3).Conclusions The burden on caregivers of dementia patients is high and associated with NPS presence and intensity. Disinhibition and irritability caused the highest burden. Depression, hyperactivity and psychosis produce more distress in mild, mild-moderate and severe dementia, respectively.

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Predictors of the one-year-change in depressiveness in informal caregivers of community-dwelling people with dementia

Cited by 14 publications

References 54 publications

Psychobiological Evaluation of Day Clinic Treatment for People Living With Dementia – Feasibility and Pilot Analyses

Psychobiological Evaluation of Day Clinic Treatment for People Living With Dementia – Feasibility and Pilot Analyses

Care burden on family caregivers of patients with dementia and affecting factors in China: A systematic review

Burden in caregivers of primary care patients with dementia: Influence of neuropsychiatric symptoms according to disease stage (NeDEM project)

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