REACH: The Centre for Research in Ageing and Cognitive Health, University of Exeter Medical School, Exeter, UK.
Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Aging Ment Health. 2021 Jan;25(1):38-45. doi: 10.1080/13607863.2019.1671316. Epub 2019 Sep 30.
Depression is a common condition in dementia and has a substantial impact on quality of life and wellbeing. There is limited evidence on how depressive symptoms in the person with dementia impact on the carer, and vice versa. The aim of this study is to investigate dyadic relationships between depressive symptoms and capability to live well in both people with dementia and their carers and to examine whether people with dementia who do not have a carer are more vulnerable to the impact of depressive symptoms than those who have a carer.
Using a large cohort study of 1547 community-dwelling people with mild to moderate dementia and 1283 carers in Great Britain, a Bayesian analysis framework was developed to incorporate dyads ( = 981), people with dementia whose carers did not participate ( = 127), people with dementia who did not have a carer ( = 137), and dyads with missing data ( = 302) and estimate actor and partner relationships between depressive symptoms and capability to live well, which was expressed as a latent factor derived from measures of quality of life, life satisfaction and wellbeing.
Depressive symptoms in people with dementia and carers had negative associations with capability to live well both for the individual and for the partner. Compared to those who had a carer, depressive symptoms had a greater impact on capability to live well in people with dementia who did not had a carer.
The impact of depression may extend beyond the person experiencing the symptoms. Future interventions for depressive symptoms should utilise this potential wider impact to understand and optimise treatment effects.
痴呆患者中常见抑郁症状,对生活质量和幸福感有重大影响。痴呆患者的抑郁症状对照顾者有何影响,反之亦然,这方面的证据有限。本研究旨在调查痴呆患者及其照顾者的抑郁症状和生活能力之间的双向关系,并探讨没有照顾者的痴呆患者是否比有照顾者的患者更容易受到抑郁症状的影响。
利用英国一项针对 1547 名轻度至中度痴呆症的社区居住者和 1283 名照顾者的大型队列研究,开发了一个贝叶斯分析框架,纳入了 981 对(痴呆患者和其未参与的照顾者各 127 对、无照顾者的痴呆患者 137 对和有缺失数据的 302 对),以估计抑郁症状和生活能力之间的个体和伴侣之间的关系,生活能力由生活质量、生活满意度和幸福感的测量结果表示为潜在因素。
痴呆患者和照顾者的抑郁症状与个体和伴侣的生活能力呈负相关。与有照顾者的患者相比,无照顾者的痴呆患者的抑郁症状对生活能力的影响更大。
抑郁的影响可能超出了经历症状的人。未来针对抑郁症状的干预措施应利用这种潜在的广泛影响来理解和优化治疗效果。