The Heterogeneous Course of Depressive Symptoms for the Dementia Caregiver

Abstract

Caregiving may be burdensome to caregivers, negatively affecting health and impacting decisions to institutionalize patients. It is unclear how caregiver depression changes over longer periods or whether heterogeneous trajectories for caregivers are apparent. The goals of this article are to characterize the course of depressive symptoms among caregivers over time and to examine the impact of baseline patient and caregiver characteristics on these trajectories. Patients with dementia and their caregivers were followed every 6 months for up to 6 years or until death (n = 133). Growth mixture modeling identified trajectories of caregiver depression over time. Most caregivers had stable trajectories of symptoms, with a smaller subset showing evidence of wear-and-tear. Patient clinical characteristics had no impact on symptom course for caregivers. Future work should utilize a longitudinal perspective and consider that there may be heterogeneous trajectories for caregivers. Those caregivers who follow a wear-and-tear trajectory may require targeted interventions to improve outcomes.

A randomized controlled trial of a home‐based training programme to decrease depression in family caregivers of persons with dementia

“…Based on the suggested CES-D cut points (Chien & Cheng 1985), about one-quarter of FCGs experienced few depressive symptoms (24Á1%), 57Á2% were mildly blue but not yet depressed and fewer than one-fifth could be characterized as depressed (18Á7%). These trajectories add to the current knowledge base by showing heterogeneity in the courses of depressive symptoms for FCGs of PWD after completing our caregiver-training programme and relatively stable depressive-symptom levels over time (Schulz & Williamson 1991, Ornstein et al 2014). These trajectories of caregivers' depressive symptoms are more informative than measures of depression or depressive risk at one or two time points because a significant health difference at one time may diminish or even reverse at a later time.…”

“…These trajectories add to the current knowledge base by showing heterogeneity in the courses of depressive symptoms for FCGs of PWD after completing our caregiver‐training programme and relatively stable depressive‐symptom levels over time (Schulz & Williamson , Ornstein et al . ). These trajectories of caregivers’ depressive symptoms are more informative than measures of depression or depressive risk at one or two time points because a significant health difference at one time may diminish or even reverse at a later time.…”

“…To the best of our knowledge, this study is the first randomized controlled trial to depict distinct trajectories of depressive symptoms among FCGs of PWD. A recent longitudinal study of depressive-symptom trajectories in FCGs of PWD found two trajectories, with most FCGs having a stable trajectory and a smaller subset showing a steady increase in depressive symptoms measured every 6 months for up to 6 years or until death (Ornstein et al 2014). Studying depressive symptoms in FCGs of PWD is important because they have a higher prevalence of depressive symptoms than FCGs of other patient populations or the general population (Pinquart & S€ orensen 2006, Hernandez & Bigatti 2010.…”

Condition of informal caregivers in long-term care of people with dementia

“…Pain (SF result) was another dependent variable in the study. The difference between those who felt pain (N=33) and those who did not feel pain (N=8) was not statistically significant (t [11]=0.00; p=1.000). Similarly, there were no statistically significant differences between age (t[9]=-0.08; p=0.934) and the time of caregiving (W=121.50; p=0.931) and the level of depression of caregivers.…”

Aspectos psicológicos da qualidade de vida de cuidadores de idosos: uma revisão integrativa

“…A depressão, por exemplo, tem sido citada na literatura como desfecho importante na relação com as demandas de cuidado. Foi verificada associação em cuidadores entre maior tempo de cuidado, corresidência, 12 comportamento controlador e manipulativo do alvo de cuidados e restrição de atividades do cuidador com sintomas depressivos. 13 A sobrecarga percebida pelo cuidador de tais demandas também tem se mostrado como um relevante preditor de saúde do mesmo.…”