Short-term changes in sleep, mastery &amp; stress: Impacts on depression and health in dementia caregivers

ObjectiveIndividuals suffering from dementia are affected by a progressive and significant global deterioration and, consequently, might require longer assistance in the advanced stage of the illness. The illness is a great burden on the person who takes care of a patient, namely, the caregiver. This study aims to analyze the presence and relationship of specific sociodemographic variables, subjective burden, and depressive symptoms among caregivers of patients with dementia.MethodsThe participants of this study were caregivers at a health care unit for the elderly in southern Italy. An evaluation of the burden of patients with dementia on caregivers was carried out using the Caregiver Burden Inventory (CBI) and depressive symptoms using the Self-Rating Depression Scale (SDS).ResultsA total of 150 caregivers completed the study. In all, 83 (55%) caregivers showed a total CBI score ≥36, of whom 70% showed pathological depression scores in SDS. According to SDS, 28 (19%) caregivers showed a total CBI score from 24 to 36, of whom 32% were depressed. Depression was present in 5% of the caregivers whose CBI score was <24. Hence, an association between burden and depression was evident (χ2=47.446, P<0.001). A multiple linear regression analysis showed that depression (adjusted R2=0.622, F=50.123, P<0.001) was associated with higher physical (β=0.666, P=0.001) and developmental (β=0.712, P<0.001) burdens, lower socioeconomic status (β=−4.282; P=0.002), higher level of urbanicity (β=3.070; P=0.012), and advanced age (β=2.132; P=0.08).ConclusionOur study confirms the presence of depressive symptoms in a large number of caregivers with high burden. Nevertheless, this study demonstrates that depressive symptoms are mainly associated with sociodemographic variables and, to a lesser degree, physical and developmental burdens.

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“…In our sample, women are overrepresented among caregivers, demonstrating that females are the principal figures of support in families. 19 – 21 …”

Section: Discussionmentioning

confidence: 99%

Depressive symptoms in caregivers of patients with dementia: demographic variables and burden

Fazio¹,

Ciambrone²,

Cerminara³

et al. 2015

CIA

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“… 33 Action Theme 3: Maintaining Carer's Physical Health Status (i) Perceived level of carer health Carers’ health is mutually bound to the PWD's health rather than mutually exclusive 35 Carers’ health status ultimately decides between maintenance of family care or cessation 46 Safeguarding carers’ own health remains a priority in dementia care via a supportive health-care system 42 While the actual physical health status of carers remains crucial so too does how well they perceive their general health, e.g. perceived levels of stress can make a unique contribution to depression 63 & carers of PWD are vulnerable to depression. 21 Strong links have been drawn between the maintenance of good physical health & resilience.…”

Section: Methodsmentioning

confidence: 99%

Investigating what works to support family carers of people with dementia: a rapid realist review

Parkinson¹,

Carr²,

Rushmer³

2016

J Public Health

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IntroductionAdvances in longevity and medicine mean that many more people in the UK survive life-threatening diseases but are instead susceptible to life-limiting diseases such as dementia. Within the next 10 years those affected by dementia in the UK is set to rise to over 1 million, making reliance on family care of people with dementia (PWD) essential. A central challenge is how to improve family carer support to offset the demands made by dementia care which can jeopardise carers’ own health. This review investigates ‘what works to support family carers of PWD’.MethodsRapid realist review of a comprehensive range of databases.ResultsFive key themes emerged: (1) extending social assets, (2) strengthening key psychological resources, (3) maintaining physical health status, (4) safeguarding quality of life and (5) ensuring timely availability of key external resources. It is hypothesized that these five factors combine and interact to provide critical biopsychosocial and service support that bolsters carer ‘resilience’ and supports the maintenance and sustenance of family care of PWD.Conclusions‘Resilience-building’ is central to ‘what works to support family carers of PWD’. The resulting model and Programme Theories respond to the burgeoning need for a coherent approach to carer support.

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“…Nighttime behaviors of patients with dementia are often associated with sleep problems in family caregivers (McCurry, Logsdon, Teri, & Vitiello, 2007), and sleep disruption is a major reason why family members institutionalize their care recipients (Hope, Keene, Gedling, Fairburn, & Jacoby, 1998; Yaffe et al, 2002). Poor sleep quality has been shown to contribute to depression and elevated biomarkers of increased atherosclerotic risk among family caregivers of persons with AD (Rowe, McCrae, Campbell, Benito, & Cheng, 2008; Simpson & Carter, 2013; von Känel et al, 2010), and more research describing the nature of sleep disruptions and their impact on sleep quality in patients with FTD and their caregivers are needed. Caregivers of patients with FTD have not been the focus of sleep research, although a case of a spouse caregiver of a patient with bvFTD whose ratings of emotional distress for the patient’s nighttime behavior increased during a three-year period of caregiving was reported (Merrilees et al, 2009).…”

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confidence: 99%

Sleep in Persons With Frontotemporal Dementia and Their Family Caregivers

Merrilees

Hubbard

Mastick³

et al. 2014

Nursing Research

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Background Dementia is associated with disruptions in sleep and sleep quality for patients and their family caregivers. Little is known about the impact of frontotemporal dementia (FTD) on sleep. Objective The purpose of this study was to characterize sleep in patients with frontotemporal dementia and their family caregivers. Methods Twenty-two patient-caregiver dyads were enrolled: Thirteen behavioral variant FTD (bvFTD) and nine semantic dementia (SD). Sleep and sleep quality data were collected for two weeks using diaries and Actiwatches. Results Patients with bvFTD and SD spent more time in bed at night compared to their caregivers. Nighttime behaviors were reported more frequently by caregivers for the bvFTD patients and strongly correlated with caregiver distress. Actigraphy data demonstrated normal sleep efficiency and timing of the nighttime sleep period for both patients and their caregivers. Caregivers of patients with bvFTD reported poorer sleep quality compared to the SD caregivers. A greater number of bvFTD caregivers compared to SD reported negative aspects of sleep quality for themselves and used sleep medications more frequently. Conclusion The clinical manifestations of bvFTD appear to be associated with different and more distressing impacts on the caregiver sleep quality than SD.

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Short-term changes in sleep, mastery & stress: Impacts on depression and health in dementia caregivers

Cited by 30 publications

References 54 publications

Depressive symptoms in caregivers of patients with dementia: demographic variables and burden

Depressive symptoms in caregivers of patients with dementia: demographic variables and burden

Investigating what works to support family carers of people with dementia: a rapid realist review

Sleep in Persons With Frontotemporal Dementia and Their Family Caregivers

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