Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2023 Mar 30:11:915387.
doi: 10.3389/fpubh.2023.915387. eCollection 2023.

Association between advance care planning and depressive symptoms among community-dwelling people with dementia: An observational cross-sectional study during the COVID-19 pandemic in Japan

Miharu Nakanishi  1   2 , Taeko Nakashima  3 , Yuki Miyamoto  4 , Mai Sakai  1 , Hatsumi Yoshii  1 , Syudo Yamasaki  2 , Atsushi Nishida  2
Affiliations
Observational Study

Association between advance care planning and depressive symptoms among community-dwelling people with dementia: An observational cross-sectional study during the COVID-19 pandemic in Japan

Miharu Nakanishi et al. Front Public Health. .

Abstract

Objectives: Advance care planning (ACP) is an increasing priority for people with dementia during the COVID-19 pandemic. This study evaluated the association between ACP initiation and depressive symptoms among home-dwelling people living with dementia.

Methods: An internet-based questionnaire survey was conducted with Japanese family caregivers of home-dwelling persons with dementia in June 2021. Family caregivers evaluated the level of depressive symptoms in persons with dementia using the Neuropsychiatric Inventory (NPI). Caregivers also rated the quality of life of persons with dementia using the EQ-5D-5L.

Results: A total of 379 family caregivers participated in the survey. Depressive symptoms were reported in 143 persons with dementia (37.7%). A total of 155 persons with dementia (40.9%) had initiated ACP, of which 88 (56.8%) had care professionals involved in ACP conversation. After adjusting for the characteristics of persons with dementia and caregivers, persons with professional involvement showed significantly more severe depressive symptoms compared to those who did not initiate ACP. There was no significant difference in the quality of life of persons with dementia according to ACP initiation.

Conclusions: Many home-dwelling persons with dementia experienced depressive symptoms during the COVID-19 pandemic, especially in cases where care professionals were involved in ACP conversations. Optimal and proactive ACP approaches need to be developed to prevent depressive symptoms in newly diagnosed persons.

Keywords: advance care planning; community; dementia; depression; family caregiver.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

References

    1. Prince M, Wimo A, Gherchet M, Ali G, Wu Y, Prina M. World Alzheimer Report 2015: The Global Impact of Dementia. An Analysis of Prevalence, Incidence, Cost Trends 2015. (2015). Available online at: https://www.alzint.org/u/WorldAlzheimerReport2015.pdf (accessed March 26, 2022).
    1. Brodaty H, Seeher K, Gibson L. Dementia time to death: a systematic literature review on survival time and years of life lost in people with dementia. Int Psychogeriatr. (2012) 24:1034–45. 10.1017/S1041610211002924 - DOI - PubMed
    1. Todd S, Barr S, Roberts M, Passmore AP. Survival in dementia and predictors of mortality: a review. Int J Geriatr Psychiatry. (2013) 28:1109–24. 10.1002/gps.3946 - DOI - PubMed
    1. Nakanishi M, Nakashima T, Shindo Y, Miyamoto Y, Gove D, Radbruch L, et al. . An evaluation of palliative care contents in national dementia strategies in reference to the European association for palliative care white paper. Int Psychogeriatr. (2015) 27:1551–61. 10.1017/S1041610215000150 - DOI - PubMed
    1. Erlangsen A, Zarit SH, Conwell Y. Hospital-diagnosed dementia and suicide: a longitudinal study using prospective, nationwide register data. Am J Geriatr Psychiatry. (2008) 16:220–28. 10.1097/01.JGP.0000302930.75387.7e - DOI - PMC - PubMed

Publication types