International Journal of Geriatric Psychiatry, 27(7), July 2012, pp.670-682.
Publisher:
Wiley
This multi-site population-based study covered eleven sites in Latin America, India and China. It was designed to examine the relative contributions of care arrangements and characteristics of carers and care recipients to strain among carers of people with dementia. Drawing on the results of previous work, the researchers focused on carer sex, care inputs, behavioural and psychological symptoms...
This multi-site population-based study covered eleven sites in Latin America, India and China. It was designed to examine the relative contributions of care arrangements and characteristics of carers and care recipients to strain among carers of people with dementia. Drawing on the results of previous work, the researchers focused on carer sex, care inputs, behavioural and psychological symptoms (BPSD) and socioeconomic status, and the potential buffering effects of informal support and employing paid carers. Carer strain was assessed with the Zarit Burden Interview. A total of 673 care recipient/carer dyads were interviewed (99% of those eligible), revealing mean Zarit Burden Interview scores ranging between 17.1 and 27.9 by site. Women carers reported more strain than men. The most substantial correlates of carer strain were the primary stressors BPSD, dementia severity, needs for care and time spent caring. There was no consistent evidence of for an association between socioeconomic status and carer strain but cutting back on work did predict carer stain across most sites. There was tentative evidence for a protective effect of having additional informal or paid support. These findings underline the global impact of caring for a person with dementia and support the need for scaling up carer support, education and training.
British Journal of Psychiatry, 185(11), November 2004, pp.429-436.
Publisher:
Cambridge University Press
The Geriatric Mental State (GMS) is the most widely used psychiatric research assessment for older persons. Evidence for validity comes from the developed world. The aims was to assess the validity of GMS/AGECAT organicity and depression diagnoses in 26 centres in India, China, Latin America and Africa. The authors studied 2941 persons aged 60 years and over: 742 people with dementia and three...
The Geriatric Mental State (GMS) is the most widely used psychiatric research assessment for older persons. Evidence for validity comes from the developed world. The aims was to assess the validity of GMS/AGECAT organicity and depression diagnoses in 26 centres in India, China, Latin America and Africa. The authors studied 2941 persons aged 60 years and over: 742 people with dementia and three groups free of dementia (697 with depression, 719 with high and 783 with low levels of education). Local clinicians diagnosed dementia (DSM–IV) and depression (Montgomery–Åsberg Depression Rating Scale score 18). For dementia diagnosis GMS/AGECAT performed well in many centres but educational bias was evident. Specificity was poor in India and sensitivity sub-optimal in Latin America. A predictive algorithm excluding certain orientation items but including interviewer judgements improved upon the AGECAT algorithm. For depression, sensitivity was high. The EURO–D depression scale, derived from GMS items using European data, has a similar factor structure in Latin America, India and, to a lesser extent, China. Valid, comprehensive mental status assessment across cultures seems achievable in principle.
Subject terms:
mental health problems, older people, psychiatry, research methods, ageing, comparative studies, dementia, depression, diagnosis, diagnostic tests, evidence-based practice;