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The impact of caregiver's depressive symptoms on trajectories of cognitive function in older adults with functional limitations
- Authors:
- JIANG Nan, SUN Qian, LOU Vivian W.Q.
- Journal article citation:
- International Journal of Geriatric Psychiatry, 36(8), 2021, pp.1284-1294.
- Publisher:
- Wiley
Objectives: Family caregivers are important to older adults' health, but few studies have examined how caregivers' mental health is associated with older adults' cognitive function. This study examined the trajectories of cognitive function of older adults and whether caregivers' depressive symptoms shape the pattern of cognitive function trajectories. Methods: This 6-year longitudinal sample consisted 1188 older adults aged ≥75 years with deficits in activities of daily living (ADL) and their family caregivers in Shanghai, China (Rounds 1–3). Cognitive function trajectories were identified based on an enhanced group-based trajectory modeling that accounted for nonrandom attrition. Multinomial logistic regression tested the association between caregivers' depressive symptoms and older adults' cognitive function trajectory. Results: Three trajectory groups were identified: a “newly onset” group (50.4%) had an increased risk of being cognitive impaired during the 6-year period; a “never” group (46.2%) remained cognitive active; and a “chronic” group was largely persistently cognitive impaired (3.4%). Caregivers' depressive symptoms increased the relative risk of having the “onset” or “chronic” versus “never” trajectory. Among the four dimensions of depressive symptoms, only somatic complaints were associated with a higher risk of the “newly onset” trajectory in 6 years. Conclusion: The progression of cognitive function among older adults with deficits in ADL followed three distinct trajectories during a 6-year period. Addressing the mental health of caregivers may prevent or delay progression of cognitive impairment among older adults. (Edited publisher abstract)
The nature of informal caregiving for medically ill older people with and without depression
- Authors:
- McCUSKER Jane, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 24(3), March 2009, pp.239-246.
- Publisher:
- Wiley
In this Canadian study 154 patient-caregiver pairs were recruited from a larger prospective observational study of three groups of medical inpatients aged 65 and over, with major, minor, and no depression, respectively, and with at most mild cognitive impairment. Interviews were conducted at the time of hospital admission to assess characteristics of patients (disability, comorbidity, perceptions of support) and caregivers (relationship, residence, types of assistance and time spent caregiving). Time spent on the physical tasks of caregiving (assistance with activities of daily living, physical care, transport) was estimated by all caregivers. Time spent on emotional or other support was estimated only for non-coresident caregivers. In multivariable analyses, neither major nor minor depression was associated with time spent on physical support; major depression was associated with significantly increased time spent by non-coresident caregivers on emotional or other support; minor depression was associated with perceived inadequacy of support. Major depression is independently associated with greater time spent by non-coresident caregivers on emotional or other support; minor depression is associated with perceived inadequacy of support.
Building on the benefits: assessing satisfaction and well-being in elder care
- Authors:
- JENSEN Christine J., FERRARI Michael, CAVANAUGH John C.
- Journal article citation:
- Ageing International, 29(1), Winter 2004, pp.88-110.
- Publisher:
- Springer
- Place of publication:
- New York
One hundred interviews were conducted with primary caregivers who completed the Caregiver Well-Being Scale (CWB), the Caregiving Uplifts Scale (CUPL), the Caregiving Satisfaction Scale (CSS), and the Center for Epidemiologic Studies Depression Scale. CWB, CUPL and CSS scores were significantly higher for caregivers for elders with a primarily physical (e.g. heart disease) rather than a primarily cognitive impairment (e.g. dementia), indicating greater perceived caregiver benefits based on type of care recipient impairment. Little evidence of depressive symptoms was found in either group. These findings advance previous research by indicating that caregivers experience satisfaction in their role and potential for personal fulfillment even when faced with challenging circumstances. Discusses validation of positive experiences and the impact of positive appraisals on depression levels.
The prevalence of depression in the carers of dementia sufferers
- Authors:
- COOPE Bernie, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 10(3), March 1995, pp.237-242.
- Publisher:
- Wiley
Aims to evaluate psychiatric morbidity in the carers of dementia sufferers using a semi-structured psychiatric interview.
The mediating role of sense of coherence on mental health outcomes in carers of older dependent relatives: a longitudinal study
- Authors:
- LOPEZ-MARTINEZ Catalina, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 36(5), 2021, pp.722-730.
- Publisher:
- Wiley
Background: Sense of coherence (SOC) is an important protective factor for carer well‐being but research to date remains cross‐sectional, focusing primarily on the direct effects of SOC on carers' mental health. The study's aim was to investigate the mediating role of SOC in the longitudinal relationship between caregiver strain and carers' psychological health, and its stability over time. Methods: Prospective longitudinal study conducted in Jaén (Spain) with a probabilistic sample of 132 carers of older people, with data collected at baseline and at 1‐year follow‐up. We measured SOC, caregiver strain, anxiety and depressive symptoms, and several care‐recipient characteristics and intensity of care provided. We used multiple linear regression modelling and the Sobel test to analyse mediation effects. Results: SOC was significantly negatively longitudinally associated with both anxiety (β = −0.38, p = 0.001) and depressive symptoms (β = −0.28, p = 0.023), after controlling for several confounders. SOC mediated both the relationship between caregiver strain and anxiety, and caregiver strain and depressive symptoms (Sobel test: p < 0.001 for anxiety and p < 0.001 for depressive symptoms). Differences between baseline and 1‐year follow‐up SOC scores were not statistically significant (p = 0.617). Conclusions: SOC appears to buffer the impact of caregiver strain on symptoms of depression and anxiety in informal carers of older people. Our data showed that SOC is an important psychological resource for carers that remained relatively stable under non‐experimental conditions over a period of 1 year in this sample. The findings suggest that interventions aimed at strengthening SOC may protect carer psychological well‐being. (Edited publisher abstract)
Informal caregiving transitions, subjective well-being and depressed mood: findings from the English Longitudinal Study of Ageing
- Authors:
- RAFNSSON Snorri Bjorn, SHANKAR Aparna, STEPTOE Andrew
- Journal article citation:
- Aging and Mental Health, 21(1), 2017, pp.104-112.
- Publisher:
- Taylor and Francis
Objectives: To prospectively investigate the impact of transitions in informal caregiving on emotional well-being over two years in a large population study of older people. Methods: Information on provision of unpaid care in 2004/2005 and 2006/2007 was available for 6571 participants in the English Longitudinal Study of Ageing. Three well-being domains were also assessed on each occasion: life satisfaction (measured with the Satisfaction with Life Scale); quality of life (assessed with the CASP-19 scale); and depression symptoms (measured using the Centers for Epidemiologic Studies Depression Scale). Multivariable analyses of the impact on well-being of two-year caregiving transitions (caregiving entry and caregiving exit, or continued caring) were conducted separately for spousal/child carers and carers of other family/non-relatives. Results: Compared to non-caregiving, entry into spousal/child caregiving was associated with decline in quality of life whereas entry into caregiving involving other kin relations increased life satisfaction and lowered depression symptoms. Contrary to expectations, caregiving exit was related to increased depression in both spousal/child and non-spousal/child carers. Continued spousal/child caregiving was also related to decline in quality of life. Other associations were suggestive but non-significant. Conclusion: The emotional impact of different caregiving transitions in later life differs across kin relationships; notably, spousal and child carers' well-being was consistently compromised at every stage of their caregiving career over the two-year study period. (Edited publisher abstract)
The effects of caregiver emotional stress on the depressive symptomatology of the care recipient
- Authors:
- EJEM Deborah B., DENTATO Michael P., CLAY Olivio J.
- Journal article citation:
- Aging and Mental Health, 19(1), 2014, pp.55-62.
- Publisher:
- Taylor and Francis
Objectives: Previous research widely neglects caregiver emotional stress as a probable contributing factor of depression in older people. Using the life stress paradigm as the theoretical foundation, this study investigates caregiver emotional stress as a chronic life stressor of an elderly care recipient. Methods: The relationships between caregiver emotional stress and care receiver depressive symptoms, as well as other social and psychological mediation factors, were investigated using the 2004 wave of the National Long-Term Care Study (NLTCS). The NLTCS is a nationally representative longitudinal study used to identify frail and disabled elderly Medicare recipients living in the United States. The analytic sample of this study included 1340 caregiver–care receiver dyads who were asked a series of questions concerning their mental health (i.e. emotional stress and depressive symptoms), as well as the availability of social and psychological resources. Results: Overall, the results showed that high levels of emotional stress reported by the caregiver were associated with a higher likelihood of the disabled care receiver reporting depressive symptoms. Conclusion: The findings of this investigation point to the importance of studying caregivers and care receivers as dyads as the stress associated with the caregiving role affects each member. (Edited publisher abstract)
Self-esteem in carers of frail older people: resentment predicts anxiety and depression
- Authors:
- AGGAR Christina, RONALDSON Susan, CAMERON Ian D.
- Journal article citation:
- Aging and Mental Health, 15(6), August 2011, pp.671-678.
- Publisher:
- Taylor and Francis
Anxiety and depression are major health problems for carers of frail older people. The aims of this study were to explore aspects of self-esteem, termed positive caregiving reactions, and to examine the relationship between self-esteem and caregiving anxiety and depressive symptoms in carers of community living frail older people. The study gathered information from 119 carers identified through participants enrolled in a randomised controlled trial investigating an intervention for frail older people living independently in Sydney, Australia. The carers completed questionnaires incorporating the Caregiver Reaction Assessment tool and the Hospital Anxiety and Depression Scale. The study found that anxiety and depressive symptoms were related significantly to 6 of the 7 self-esteem items, and that caregiving resentment scores were relatively low but analysis showed that this factor was the only independent predictor of anxiety and depressive symptoms. The authors conclude that the results of the study indicate that those carers who resent having to care for their frail older relative are susceptible to anxiety and depressive symptoms, and support the idea that there is a need for assessment of caregiving reactions in carers of frail older people.
Cognitive, functional and behavioral factors associated with the burden of caring for geriatric patients with cognitive impairment or depression: evidence from a South American sample
- Authors:
- MACHNICKI Gerard, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 24(4), April 2009, pp.382-389.
- Publisher:
- Wiley
Primary caregivers assessed were included if the geriatric patient cared for had a cognitive impairment or dementia (degenerative, vascular or mixed) (Group 1) or depression and cerebrovascular disease (CVD) (Group 2). Caregivers completed the Zarit questionnaire, the Neuropsychiatric Inventory (NPI) and Instrumental Activities of Daily Living (IADL). Patients were evaluated for dementia severity using the Clinical Dementia Rating (CDR), Mini Mental State Examination (MMSE) and Beck Depression Inventory (BDI). Structural equation modelling (SEM) was used to assess measurement models and the factors associated with burden. Two hundred and fifty-eight caregiver-patient pairs were included. The best model fit was obtained with a model with two constructs: function-cognition (CDR, MMSE, and IADL) and behaviour (neuropsychiatric symptoms from the NPI). In Group 1, both function and behaviour were significantly correlated with caregiver burden, although the strength of association was more than two times higher for behaviour. In Group 2, behaviour was related to caregiver burden but not function-cognition. These findings suggest that behavioural symptoms are an important factor associated with caregiver burden in patients with cognitive impairment, dementia, or depression, while functional and cognitive factors seem to also have an influence in patients with cognitive impairment.
Social productivity and depressive symptoms in early old age-results from the GAZEL study
- Authors:
- WAHRENDORF M., et al
- Journal article citation:
- Aging and Mental Health, 12(3), May 2008, pp.310-316.
- Publisher:
- Taylor and Francis
The associations of frequency of performing three types of socially productive activities (voluntary work, informal help and caring for a person) were tested with depressive symptoms in older people. Data on social activities and frequency of performance were collected in the frame of the annual follow-up of the French GAZEL cohort study in 2005. Depressive symptoms were measured by the CES-D scale. Perceived control was assessed by two items of a quality of life measure (CASP-19). Total of 14,477 respondents aged 52-66 years completed a standardized questionnaire. Linear regression models were calculated adjusting for important confounders including self-rated health assessed during the previous year. In activities characterized by high autonomy (in particular voluntary work) a negative association of frequency with depressive symptoms was observed, whereas the reverse effect was found in the type of activity with low autonomy (care for a person). Perceived control mediated in part the association of frequency of activity with depressive symptoms. It is concluded that being often socially productive in early old age may contribute to well-being to the extent that autonomy and perceived control are given.