Ornstein Katherine, Gaugler Joseph E, Zahodne Laura, Stern Yaakov
Int J Aging Hum Dev. 2014;78(2):133-48. doi: 10.2190/AG.78.2.c.
Caregiving may be burdensome to caregivers, negatively affecting health and impacting decisions to institutionalize patients. It is unclear how caregiver depression changes over longer periods or whether heterogeneous trajectories for caregivers are apparent. The goals of this article are to characterize the course of depressive symptoms among caregivers over time and to examine the impact of baseline patient and caregiver characteristics on these trajectories. Patients with dementia and their caregivers were followed every 6 months for up to 6 years or until death (n = 133). Growth mixture modeling identified trajectories of caregiver depression over time. Most caregivers had stable trajectories of symptoms, with a smaller subset showing evidence of wear-and-tear. Patient clinical characteristics had no impact on symptom course for caregivers. Future work should utilize a longitudinal perspective and consider that there may be heterogeneous trajectories for caregivers. Those caregivers who follow a wear-and-tear trajectory may require targeted interventions to improve outcomes.
照顾患者可能会给照顾者带来负担,对其健康产生负面影响,并影响将患者送入机构照料的决策。目前尚不清楚照顾者的抑郁症状在较长时期内如何变化,或者照顾者的轨迹是否存在异质性。本文的目的是描述照顾者抑郁症状随时间的变化过程,并研究基线患者和照顾者特征对这些轨迹的影响。对患有痴呆症的患者及其照顾者每6个月进行一次随访,最长随访6年或直至死亡(n = 133)。生长混合模型确定了照顾者抑郁症状随时间的轨迹。大多数照顾者的症状轨迹稳定,一小部分显示出损耗迹象。患者的临床特征对照顾者的症状过程没有影响。未来的研究应采用纵向研究视角,并考虑到照顾者可能存在异质性轨迹。那些遵循损耗轨迹的照顾者可能需要有针对性的干预措施来改善结局。