Skip to main content
PMC home page
American Journal of Alzheimer's Disease and Other Dementias logoLink to American Journal of Alzheimer's Disease and Other Dementias
. 2001 Nov-Dec;16(6):353–359. doi: 10.1177/153331750101600611

Depression among Alzheimer's caregivers: Identifying risk factors

Joshua R Shua-Haim 1, Todd Haim 2, Yong Shi, Yen-Hong Kuo, Juanita M Smith 3
PMCID: PMC10833864  PMID: 11765860

Abstract

Purpose: The purpose of this study was to reveal risk factors contributing to the development of depression among caregivers of Alzheimer's disease patients.

Methods: In a cross-sectional study, all caregivers of consecutive Alzheimer's disease patients were asked to participate in the study. Patient and caregiver depression was evaluated by using the Yesavage Geriatric Depression Scale (GDS). Information regarding patients' functional status, driving status, and type of behavioral abnormalities was obtained from caregivers. Patients' functional status was evaluated by using the Katz Activity of Daily Living (ADL) scale. The Folstein Mini-Mental Status Examination (MMSE) was used to evaluate cognition. Risk factors for Alzheimer's caregiver depression were assessed by means of logistic regression analysis.

Results: A total of 92 patients and caregivers were evaluated. Fifteen were excluded due to incomplete data. A total of 77 pairs were included in this analysis. The age of caregivers ranged from 28 to 88 years. Mean (standard deviation [SD]) age was 63.1 (SD = 16.3) years old. Husbands and wives (caregivers) accounted for 49.4 percent; daughters or sons (or daughters-or sons-in-law) accounted for 42.9 percent. There were 29 caregivers (38 percent) found to be depressed. By using multivariate analysis, the following factors have been identified as risk factors for depression in Alzheimer's caregivers: depression in the dementia patient; ADL functional scores of 12 or greater; and the presence of hallucinations.

Conclusion: Three risk factors were found to have a strong association with Alzheimer's caregiver depression. Early recognition of such risk factors may help to identify Alzheimer's caregivers with depression.

Full Text

The Full Text of this article is available as a PDF (105.4 KB).

Contributor Information

Joshua R. Shua-Haim, Memory Disorders Institute, Meridian Institute for Aging, Mid Atlantic Geriatric Fellowship Program, Affiliated with Meridian Health System and Jersey Shore Medical Center, Neptune, New Jersey; UMDNJ-SOM, Stratford, New Jersey..

Todd Haim, Rutgers University, New Brunswick, New Jersey..

Juanita M. Smith, Memory Disorders Institute, Meridian Institute for Aging, Mid Atlantic Geriatric Fellowship Program, Affiliated with Meridian Health System and Jersey Shore Medical Center, Neptune, New Jersey..

References

  1. Baumgarten M , Battista RN, Infante-Rivard C, et al.: The psychological and physical health of family members caring for an elderly person with dementia. J Clin Epidemiol. 1992; 45: 61-70. [DOI] [PubMed] [Google Scholar]
  2. Weiler PG : The public health impact of Alzheimer's disease. Am J Public Health. 1987; 77: 1157-1158. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Teusing JP , Mahler S: Helping families cope with Alzheimer's disease. Hosp & Community Psychiatry. 1984; 35: 152-156. [DOI] [PubMed] [Google Scholar]
  4. Rabins PV : Management of dementia in the family context. Psychosomatics. 1984; 25: 369-375. [DOI] [PubMed] [Google Scholar]
  5. Harwood DG , Barker WW, Cantillon, et al.: Depression symptomatology in first-degree family caregivers of Alzheimer disease patients: A cross-ethnic comparison. Alzheimer Disease & Associated Disorders. 1998; 4: 340-346. [DOI] [PubMed] [Google Scholar]
  6. Morris RG , Morris LW, Britton PG: Factors affecting the emotional well-being of the caregivers of dementia sufferers. Br J Psychiatry. 1988; 153: 147-156. [DOI] [PubMed] [Google Scholar]
  7. Becker J , Morrissey E: Difficulties in assessing depressive-like reactions to chronic severe external stress as exemplified by spouse caregivers of Alzheimer patients. Psychol Aging. 1988; 3: 300-306. [DOI] [PubMed] [Google Scholar]
  8. Radloff LS : The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Measure. 1977; 1: 385-401. [Google Scholar]
  9. Schulz R , O'Brien AT, Bookwala J, et al.: Psychiatric and physical morbidity effects of dementia caregiving; prevalence, correlates, and causes. The Gerontologist. 1995; 35: 771-791. [DOI] [PubMed] [Google Scholar]
  10. Zarit SH , Reever KE, Bach-Peterson J: Relatives of impaired eldelry: Correlates of feelings to burden. The Gerontologist. 1980; 20: 649-655. [DOI] [PubMed] [Google Scholar]
  11. Deimling GT , Bass D: Symptoms of mental impairment among elderly adults and their effects on family caregivers. J Gerontology. 1986; 6: 778-784. [DOI] [PubMed] [Google Scholar]
  12. Friedland RP : Alzheimer's disease: Clinical features and differential diagnosis. Neurology. 1993; 43(suppl 4): S45-S51.8264911 [Google Scholar]
  13. Mega Ms , Cummings JL, Fiorello T, Gornbein J: The spectrum of behavioral changes in Alzheimer's disease. Neurology. 1996; 46: 130-135. [DOI] [PubMed] [Google Scholar]
  14. Schultz R , Visintainer, P, Williamson GM: Psychiatric and physical morbidity effects of caregiving. J Gerontology Psychological Sciences. 1990; 45: P181-P191. [DOI] [PubMed] [Google Scholar]
  15. Kiecott-Glaser JK , Dura JR, Speicher CE, et al.: Spousal caregivers of dementia victims: Longitudinal changes in immunity and health. Psychosomatic Medicine. 1991; 53: 345-362. [DOI] [PubMed] [Google Scholar]
  16. Deimling GT , Bass DM: Symptoms of mental impairment among elderly adults and their effects on family caregivers. J Gerontology. 1986; 41: 778-784. [DOI] [PubMed] [Google Scholar]
  17. Folstein MF , Folstein S, McHugh PR: Mini-Mental State: A practical method for grading the cognitive state of patients for the clinician. J Psychatr Res. 1975; 12: 189-198. [DOI] [PubMed] [Google Scholar]
  18. Meshefedjian G , McCusker J, Bellavance F, et al.: Factors associated with symptoms of depression among informal caregivers of demented elderly in the community. The Gerontologist. 1998; 38: 247-253. [DOI] [PubMed] [Google Scholar]
  19. McKhann G , Drachman D, Folstein M, et al.: 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. 1984; 34: 939-944. [DOI] [PubMed] [Google Scholar]
  20. Yesavage JA , Brink TL, Rose TL, et al.: Development and validation of geriatric depression rating scale: Preliminary report. J Psychiatr Res. 1982-1983;17(1): 37-49. [DOI] [PubMed] [Google Scholar]
  21. Shua-Haim JR , Sabo MR, Comsti E, Ross JS: Depression in the elderly. Hospital Medicine. July 1997: 44-58. [Google Scholar]
  22. Shikh JI , Yesavage JA: Geriatric Depression Scale (GDS): Recent evidence and development of a shorter version. Clin Gerontology., 1986; 5: 170-170. [Google Scholar]
  23. Spencer MP , Folstein MF: The Mini-Mental State Examination. In Keller PA, Ritt LG (eds.): Innovation in Clinical Practice: A Source Book. 1985; 4: 305-310. [Google Scholar]
  24. Anthony JC , LeResche L, Niaz U, et al.: Limits of “Mini-Mental State” as a screening test for dementia and delirium among hospitalized patients. Psych Med. 1982; 12: 397-408. [DOI] [PubMed] [Google Scholar]
  25. Katzman R : Alzheimer's disease: NEJM. 1986; 314: 964-964. [DOI] [PubMed] [Google Scholar]
  26. Folstein MF , Anthony JC, Parhad I, et al.: Meaning of cognitive impairment in the elderly. J Am Geriat Soc. 1985; 33(4): 228-235. [DOI] [PubMed] [Google Scholar]
  27. Katz S : Assessing self maintenance: Activity of daily living, mobility, and instrumental activity of daily living. J Am Geriatr Soc. 1983; 31: 721-727. [DOI] [PubMed] [Google Scholar]
  28. Lawton MP : Scale to measure competence in everyday activities. Psychopharm Bull. 1988; 24(4): 609-613. [PubMed] [Google Scholar]
  29. Katz S , Dowens TD, Cash HR: Progress in development of index of ADL. Int J Heath Services. 1976; 6: 493-508. [Google Scholar]
  30. Katz S : A measure of primary sociobiologic function. J Gerontology. 1970; 10(1): 20-30. [Google Scholar]
  31. Lawton MP , Moss M, Fulcomer M, et al.: A research and service oriented multi-level assessment instrument. J Gerontology. 1982; 37: 91-97. [DOI] [PubMed] [Google Scholar]
  32. Rabins PV , Mace NL, Lucas MJ: The impact of dementia on the family. JAMA 1982; 248: 333-335. [PubMed] [Google Scholar]
  33. Dura J , Studenberg K, Kiecolt-Glaser JK: Chronic stress and depressive disorders in older adults. J Abnorm Psychol. 1990; 99: 284-290. [DOI] [PubMed] [Google Scholar]
  34. Fiore J , Becker J, Coppel DB: Social network interactions: A buffer or a stress? Am J Community Psychol. 1983; 11: 423-439. [DOI] [PubMed] [Google Scholar]
  35. Grafstrom M , Fratiglioni L, Sundman PO, et al.: Health and social consequences for relatives of demented and non-demented elderly. A population-based study. J Clin Epidemol. 1992; 45: 861-870. [DOI] [PubMed] [Google Scholar]
  36. Cohen D , Eisdorfer CL: Depression in family members caring for a relative with Alzheimer's disease. J Am Geriatr Soc. 1988;36: 885-889. [DOI] [PubMed] [Google Scholar]
  37. Given CW , Collins CE, Givern BA: Sources of stress among families caring for relatives with Alzheimer's disease. Nurs Clin No Am. 1988; 23: 69-82. [PubMed] [Google Scholar]
  38. Becker J , Morrissey E: Difficulties in assessing depressive-like reactions to chronic severe external stress as exemplified by spouse caregivers of Alzheimer patients. Psychol Aging. 1988; 3: 300-306. [DOI] [PubMed] [Google Scholar]
  39. O'Connor DW , Pollitt PA, Roth M, et al.: Problems reported by relatives in a community study of dementia. Brit J Psychiatry. 1990; 156: 835-841. [DOI] [PubMed] [Google Scholar]

Articles from American Journal of Alzheimer's Disease and Other Dementias are provided here courtesy of SAGE Publications

RESOURCES