TitleDementia patient suffering and caregiver depression.
Publication TypeJournal Article
Year of Publication2008
AuthorsSchulz, R, McGinnis, KA, Zhang, S, Martire, LM, Hebert, RS, Beach, SR, Zdaniuk, B, Czaja, SJ, Belle, SH
JournalAlzheimer Dis Assoc Disord
Volume22
Issue2
Pagination170-6
Date Published2008 Apr-Jun
ISSN1546-4156
KeywordsAged, Alzheimer Disease, Caregivers, Cross-Sectional Studies, Dementia, Depression, Female, Home Nursing, Humans, Longitudinal Studies, Male, Middle Aged, Odds Ratio, Prevalence, Stress, Psychological, United States
Abstract

<p>Cross-sectional and longitudinal analyses were carried out to assess the relationship between dementia patient suffering, caregiver depression, and antidepressant medication use in 1222 dementia patients and their caregivers. We assessed the prevalence of 2 types of patient suffering, emotional and existential distress, and examined their independent associations with caregiver depression and antidepressant medication use when controlling for sociodemographic characteristics of caregivers and patients, cognitive and physical disability of the patient, the frequency of patient memory problems and disruptive behaviors, and the amount of time spent caring for the patient. Multiple linear regression models showed that both aspects of perceived patient suffering independently contribute to caregiver depression (emotional distress: beta=1.24; P<0.001; existential distress: beta=0.66; P<0.01) whereas only existential suffering contributes to antidepressant medication use: odds ratio=1.25 95% confidence interval, 1.10-1.42; P<0.01. In longitudinal analyses, increases in both types of suffering were associated with increases in caregiver depression (emotional distress: beta=1.02; P<0.01; existential distress: beta=0.64; P<0.01). This is the first study to show in a large sample that perceived patient suffering independently contributes to family caregiver depression and medication use. Medical treatment of patients that maintain or improve memory but do not address suffering may have little impact on the caregiver. Alzheimer disease patient suffering should be systematically assessed and treated by clinicians.</p>

DOI10.1097/WAD.0b013e31816653cc
Alternate JournalAlzheimer Dis Assoc Disord
PubMed ID18525290
PubMed Central IDPMC2782456
Grant ListR01 AG015321 / AG / NIA NIH HHS / United States
R24 HL076858 / HL / NHLBI NIH HHS / United States
P30 AG024827 / AG / NIA NIH HHS / United States
HL076858 / HL / NHLBI NIH HHS / United States
K08 AG019180-05 / AG / NIA NIH HHS / United States
K08 AG019180 / AG / NIA NIH HHS / United States
AG015321 / AG / NIA NIH HHS / United States
R01 NR008272 / NR / NINR NIH HHS / United States
R01 AG015321-10 / AG / NIA NIH HHS / United States
R24 HL076852 / HL / NHLBI NIH HHS / United States
AG20677 / AG / NIA NIH HHS / United States
P01 AG020677-02 / AG / NIA NIH HHS / United States
U01 AG013305-08 / AG / NIA NIH HHS / United States
P30 AG024827-06 / AG / NIA NIH HHS / United States
P30 MH071944 / MH / NIMH NIH HHS / United States
MD000207 / MD / NIMHD NIH HHS / United States
P30 MH071944-02 / MH / NIMH NIH HHS / United States
NR08272 / NR / NINR NIH HHS / United States
HL076852 / HL / NHLBI NIH HHS / United States
P01 AG020677 / AG / NIA NIH HHS / United States
R24 HL076858-05 / HL / NHLBI NIH HHS / United States
R01 NR009573 / NR / NINR NIH HHS / United States
P60 MD000207 / MD / NIMHD NIH HHS / United States
R01 NR009573-03 / NR / NINR NIH HHS / United States
MH071944 / MH / NIMH NIH HHS / United States
AG13305 / AG / NIA NIH HHS / United States
U01 AG013305 / AG / NIA NIH HHS / United States
AG024827 / AG / NIA NIH HHS / United States
AG19180 / AG / NIA NIH HHS / United States
P60 MD000207-019001 / MD / NIMHD NIH HHS / United States
R24 HL076852-05 / HL / NHLBI NIH HHS / United States
R01 NR008272-05 / NR / NINR NIH HHS / United States
NR0009573 / NR / NINR NIH HHS / United States