Depressive Symptoms Among Dementia Caregivers: Role of Mediating Factors

Abstract

Objectives To compare depressive symptoms between caregivers to persons with dementia and other illnesses, and determine whether caregiver role captivity and care recipient disruptive behaviors mediate this association. Design Prospective cohort study of older women in four U.S. communities followed from 1999 to 2009. Setting Home-based interviews. Participants 345 caregiving participants from the Caregiver-Study of Osteoporotic Fractures. Measurements Caregiver status based on self-report of performing one or more instrumental or basic activities of daily living for care recipient. Depressive symptoms measured using the 20-item Center for Epidemiologic Studies Depression Scale. Scores of 16 or greater represented high depressive symptoms. Caregiver role captivity and care recipient problematic behaviors measured using validated instruments. Results Approximately one-third of the caregivers cared for a person with dementia. High depressive symptoms were more common among dementia caregivers (22.8% vs. 11.2%, p <0.001), (unadjusted odds ratio [OR] 2.12, 95% CI 1.20-3.74). This association was completely mediated by caregiver role captivity and care recipient problematic behaviors. In adjusted results, high depressive symptoms was associated with middle and highest tertiles of role captivity (adjusted odds ratios [AOR] 5.01, 95% CI 2.31-11.05 and 9.41, 95% CI 3.95-22.40 for the middle and highest tertiles, respectively) and care recipient problematic behaviors (AOR 2.52 95% CI 1.02-6.19 and 5.26, 95% CI 2.00-13.8 for each tertile, respectively). Conclusions Older caregivers to persons with dementia are at increased risk of high depressive symptoms. Targeting problematic behaviors among dementia patients and addressing aspects of dementia care that result in role captivity may ameliorate caregiver depression.

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

“…For instance, among 206 caregivers for a PWD, 22·8% had significant depressive symptoms, vs only 11·2% for caregivers of older adults without dementia (Givens et al . ).…”

Impact of an Individualized Physical Activity Intervention on Improving Mental Health Outcomes in Family Caregivers of Persons with Dementia: A Randomized Controlled Trial

“…Caregiver depressive symptoms are well documented effects of dementia caregiving [14,15]. A caregiver meta-analysis determined that although 51% of studies reported reduction of caregiver depressive symptoms, there were no statistically significant effects on depressive symptoms in studies that exclusively enrolled dementia caregivers [16].…”

Stressors and Caregivers’ Depression: Multiple Mediators of Self-Efficacy, Social Support, and Problem-Solving Skill

“…Compared with caring for persons with other illnesses, dementia caregiving is particularly demanding and stressful due to the duration of illness, degree of functional dependence, and prevalence of behavioral disturbances (Ory, Hoffman, Yee, Tennstedt, & Schulz, 1999). Despite benefits from caregiving, such as family togetherness and satisfaction of helping others (Zarit, 2012), family caregivers are at increased risk of adverse physical and psychological outcomes (Givens, Mezzacappa, Heeren, Yaffe, & Fredman, 2014). Depression is one of the most important potential adverse consequences of dementia caregiving (Covinsky et al, 2003).…”

“…Depression is one of the most important potential adverse consequences of dementia caregiving (Covinsky et al, 2003). A growing body of evidence suggests high prevalence and incidence of depressive and anxiety disorders among family caregivers for older adults with dementias (e.g., Givens et al, 2014; Schulz & Martire, 2004). It is estimated that between 30 and 40 percent of dementia caregivers suffer from depression (Covinsky et al, 2003; Harwood et al, 1998).…”