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

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.