Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-25T02:29:21.188Z Has data issue: false hasContentIssue false
  • English
  • Français

Specific effects of caring for a spouse with dementia: differences in depressive symptoms between caregiver and non-caregiver spouses

Published online by Cambridge University Press:  15 October 2007

Kathryn Betts Adams
Kathryn Betts Adams*
Affiliation:
The Mandel School of Applied Social Sciences andUniversity Memory and Aging Center, Case Western Reserve University, Cleveland, Ohio, U.S.A.
*
Correspondence should be addressed to: Dr. Kathryn Betts Adams, Assistant Professor of Social Work, The Mandel School of Applied Social Sciences, Case Western Reserve University, 10600 Euclid Avenue, Cleveland, OH 44106, U.S.A. Phone: +1 216 368 6155. Email: [email protected].
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: Caring for spouses with dementia is a risk factor for increased levels of depression. Less is known about specific symptom differences between groups of caregivers and non-caregivers. This study characterizes differences on the CES-D depression screening scale between caregiving and non-caregiving spouses.

Methods: Data were obtained from 391 spouse caregivers of persons with dementia and 226 control subjects. Significant between-group differences on demographic variables determined covariates used in two multivariate ANCOVA analyses, on the set of four CES-D subscales and on the set of the 20 CES-D individual items. Significant multivariate analyses were followed by univariate tests between the two groups.

Results: Dementia caregiving spouses had significantly more depressive symptoms than non-caregiving married adults, after controlling for group differences. Proportion of variance in the set of CES-D subscales explained by caregiver group status was 13.4%. The greatest between-groups difference in univariate analysis was found in the Positive Affect subscale, and significant differences were found in 11 of the 20 CES-D items. Caregiver spouses experienced less hope for the future and less happiness and enjoyment in life than the non-caregiving spouses. They also reported greater degrees of sadness, being bothered, and loneliness than the non-caregivers.

Conclusions: The differences, particularly caregivers' lack of positive affect, suggest the need for appropriate intervention approaches to assist spouse caregivers.

Keywords

dementia caregivingdepressionCES-Dpositive affecttwo-group MANCOVA
Type
Research Article
Information
International Psychogeriatrics , Volume 20 , Issue 3 , June 2008 , pp. 508 - 520
Copyright
Copyright © International Psychogeriatric Association 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Adams, K. B. (2006). The transition to caregiving: Experiences of family members embarking on the dementia caregiving career. Journal of Gerontological Social Work, 47 (3/4), 3–30.CrossRefGoogle ScholarPubMed
Adams, K. B. and Sanders, S. (2004). Caregiver differences in experience of loss, grief reactions, and depressive symptoms across the stages of Alzheimer's disease: a mixed methods analysis. Dementia: The International Journal of Social Research and Practice, 3, 195–210.CrossRefGoogle Scholar
Adams, K. B., Smyth, K. A. and McClendon, M. J. (2005). Psychosocial resources as moderators of the impact of spousal dementia caregiving on depression. Journal of Applied Gerontology, 24, 475–489.CrossRefGoogle Scholar
Arean, P. A. and Miranda, J. (1997). The utility of the Center for Epidemiological Studies-Depression Scale in older primary care patients. Aging and Mental Health, 1, 47–56.CrossRefGoogle Scholar
Blazer, D. G. (2003). Depression in late life: review and commentary. Journal of Gerontology: Medical Sciences, 58A, 249–265.Google Scholar
Blazer, D. G. and Hybels, C. F. (2004). What symptoms of depression predict mortality in community-dwelling elders? Journal of the American Geriatrics Society, 52, 2052–2056.CrossRefGoogle ScholarPubMed
Carter, P. A. (2002). Caregivers' descriptions of sleep changes and depressive symptoms. Oncology Nursing Forum, 29, 1277–1283.CrossRefGoogle ScholarPubMed
Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences, 2nd edn. Hillsdale, NJ: Erlbaum.Google Scholar
Covinsky, K. E. et al. (2003). Patient and caregiver characteristics associated with depression in caregivers of patients with dementia. Journal of General and Internal Medicine, 18, 1006–1014.CrossRefGoogle ScholarPubMed
Cuijpers, P. (2005). Depressive disorders in caregivers of dementia patients: a systematic review. Aging and Mental Health, 9, 325–330.CrossRefGoogle ScholarPubMed
Davidson, H., Feldman, P. H. and Crawford, S. (1994). Measuring depressive symptoms in the frail elderly. Journals of Gerontology: Psychological Sciences, 49, P159–P164.CrossRefGoogle ScholarPubMed
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.CrossRefGoogle ScholarPubMed
Gallo, J. J., Rebok, G. W., Tennstedt, S., Wadley, V. G. and Horgas, A. (2003). Linking depressive symptoms and functional disability in late life. Aging and Mental Health, 7, 460–480.CrossRefGoogle ScholarPubMed
Gupta, R., Punetha, D. and Diwan, S. (2006). The revised CES-D scale for caregivers of the elderly in India. International Journal of Aging and Human Development, 62, 61–78.CrossRefGoogle ScholarPubMed
Haley, W. E. et al. (1995). Psychological, social, and health impact of caregiving: a comparison of black and white dementia family caregivers and non-caregivers. Psychology and Aging, 10, 540–552.CrossRefGoogle Scholar
Hepburn, K. W., Lewis, M., Sherman, C. W. and Tornatore, J. (2003). The Savvy Caregiver Program: developing and testing a transportable dementia family caregiver training program. The Gerontologist, 43, 908–915.CrossRefGoogle ScholarPubMed
Markut, L. A. and Crane, A. (2005). Dementia Caregivers Share their Stories. Nashville, TN: Vanderbilt University Press.CrossRefGoogle Scholar
Marwit, S. J. and Meuser, T. M. (2001). A comprehensive, stage-sensitive model of grief in dementia caregiving. The Gerontologist, 41, 658–670.Google Scholar
McKhann, G. et al. (1984). Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology, 34, 939–944.CrossRefGoogle ScholarPubMed
Morris, J. C. (1993). The Clinical Dementia Rating (CDR): current version and scoring rules. Neurology, 43, 2412–2414.CrossRefGoogle ScholarPubMed
O'Rourke, N. (2004). Reliability generalization of responses by care providers to the Center for Epidemiologic Studies-Depression (CES-D) Scale. Educational and Psychological Measurement, 64, 973–990.CrossRefGoogle Scholar
Pearlin, L. I, Mullan, J. T., Semple, S. J. and Skaff, M. M. (1990). Caregiving and the stress process: an overview of concepts and their measures. The Gerontologist, 30, 583–594.CrossRefGoogle ScholarPubMed
Petersen, R. C. et al. (1999). Mild Cognitive Impairment: clinical characterization and outcome. Archives of Neurology, 56, 303–308.CrossRefGoogle ScholarPubMed
Pinquart, M. and Sorenson, S. (2003). Differences between caregivers and non-caregivers in psychological health and physical health: a meta-analysis. Psychology and Aging, 18, 250–267.CrossRefGoogle Scholar
Pinquart, M. and Sorenson, S. (2004). Associations of caregiver stressors and uplifts with subjective well-being and depressive mood: a meta-analytic comparison. Aging and Mental Health, 8, 438–449.CrossRefGoogle Scholar
Pressman, S. D. and Cohen, S. (2005). Does positive affect influence health? Psychological Bulletin, 131, 925–971.CrossRefGoogle ScholarPubMed
Radloff, L. S. (1977). The CES-D Scale: a self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401.CrossRefGoogle Scholar
Radloff, L. S. and Teri, L. (1986). Use of the Center for Epidemiological Studies-Depression Scale with older adults. Clinical Gerontologist, 5, 119–135.CrossRefGoogle Scholar
Sanders, S. and Adams, K. B. (2005). Grief reactions and depression in caregivers of individuals with Alzheimer's disease: results from a pilot study in an urban setting. Health and Social Work, 30, 287–295.CrossRefGoogle Scholar
Schroevers, M. J., Sanderman, R., van Sonderen, and Ranchor, A. V. (2000). The evaluation of the Center for Epidemiologic Studies Depression (CES-D) scale: depressed and positive affect in cancer patients and healthy reference subjects. Quality of Life Research, 9, 1015–1029.CrossRefGoogle Scholar
Schulz, R. and Martire, L. (2004). Family caregiving of persons with dementia: prevalence, health effects, and support strategies. American Journal of Geriatric Psychiatry, 12, 240–248.CrossRefGoogle ScholarPubMed
Schulz, R., O'Brien, A. T., Bookwala, J. and Fleissner, K. (1995). Psychiatric and physical morbidity effects of dementia caregiving: prevalence, correlates, and causes. The Gerontologist, 35, 771–791.CrossRefGoogle ScholarPubMed
Sheehan, T. J., Fifield, J., Reisine, S. and Tennen, H. (1995). The measurement structure of the Center for Epidemiologic Studies Depression Scale. Journal of Personality Assessment, 64, 507–521.CrossRefGoogle ScholarPubMed
Teel, C. S. and Press, A. N. (1999). Fatigue among elders in caregiving and noncaregiving roles. Western Journal of Nursing Research, 21, 498–520.CrossRefGoogle ScholarPubMed
Walker, R. J., Pomeroy, E. C., McNeil, J. S. and Franklin, C. (1994). Anticipatory grief and Alzheimer's disease: strategies for intervention. Journal of Gerontological Social Work, 22, 21–39.CrossRefGoogle Scholar