Health of family members caring for elderly persons with dementia. A longitudinal study

Abstract

Objective: To estimate the change in depression and physical symptoms during a 1-year period in a group of caregivers for elderly persons with dementia and in a group of comparison participants.

Design: Cohort study with a comparison group.

Setting: Outpatient geriatric assessment unit and ophthalmology service in an acute care hospital.

Participants: 218 close family members of a consecutive sample of patients with dementia and patients having cataract surgery were interviewed to obtain a baseline assessment. Of these, 86 caregivers (family members of patients with dementia) and 95 comparison participants (family members of patients with cataracts) were interviewed again approximately 1 year later.

Main outcome measures: Center for Epidemiologic Studies depression scale and Aday and Andersen's 24-item physical symptom checklist.

Results: For the Center for Epidemiologic Studies depression score, the difference between caregivers and comparison participants with respect to change during the 1-year study period was 2.1 (95% CI, 1.0 to 5.2); for physical symptoms, the difference was 0.4 (CI, -0.3 to 1.1). A higher level of behavioral disturbance in the patients with dementia at time 1 and institutionalization of the patient between time 1 and time 2 were predictive of worsening caregiver depression and physical symptoms during the study period. The magnitude and direction of changes in caregiver health varied considerably.

Conclusions: Overall mean changes in depression and physical symptoms during 1 year were small. The observed variability in the individual response to the caregiving situation suggests that future research should focus on the identification of salient prognostic factors.