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Acculturation and depressive symptoms in latino caregivers of cognitively impaired older adults

Published online by Cambridge University Press:  09 April 2014

Oanh L. Meyer*
Affiliation:
Department of Neurology, University of California, Davis, California, USA
Sue Geller
Affiliation:
Department of Mathematics, Texas A&M University, Texas, USA
Emily He
Affiliation:
Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York, USA
Hector M. González
Affiliation:
Department of Epidemiology and Biostatistics, Michigan State University, Michigan, USA
Ladson Hinton
Affiliation:
Department of Psychiatry and Behavioral Sciences, University of California, Davis, California, USA
*
Correspondence should be addressed to: Dr. Oanh Meyer, PhD, Department of Neurology, University of California, Davis, School of Medicine, 4860 Y Street, Sacramento, CA 95817. Phone: +(916) 734-5218; Fax: +(916) 703-5290. Email: [email protected].
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Abstract

Background:

Caregiving for older adults is a growing public health concern because of the negative psychological effects it has on caregivers. Despite the growing Latino caregiver population, little is known regarding how the effects of acculturation on caregiver depressive symptoms might vary by caregiver age. This study aimed to examine the relationship between language acculturation and depressive symptoms in Latino caregivers, and to test whether this relationship was moderated by age.

Methods:

Ninety-four Latino caregivers of cognitively impaired older adults with and without dementia were identified through an ongoing epidemiological cohort study. Caregivers were interviewed in their homes, in either Spanish or English. A Poisson regression was used to analyze the caregiver characteristics associated with caregiver depressive symptoms.

Results:

Language acculturation was positively associated with caregiver depressive symptoms, as was age, female gender, and being married or living with someone. Those with excellent or good health and who had spent more than one year caregiving had lower depressive symptoms. Finally, the positive relationship between language acculturation and depressive symptoms was increased in older caregivers.

Conclusions:

Language acculturation appears to be a risk factor for depressive symptoms in Latino caregivers of cognitively impaired older adults. The relationship between language acculturation and depressive symptoms is complex such that caregiver age and health status further nuance this relationship. Future research should explore the independent and interactive effects of these variables on depressive symptoms.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2014 

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References

Adams, K. B. (2006). The transition to caregiving: the experience of family members embarking on the dementia caregiving career. Journal of Gerontological Social Work, 47, 329. doi:10.1300/J083v47n03_02.CrossRefGoogle ScholarPubMed
Administration on Aging. (2013, May 8) Aging Statistics. Available at: http://www.aoa.gov/AoARoot/Aging_Statistics/index.aspx; last accessed 8 May 2013.Google Scholar
Alegria, M. et al. (2008). Prevalence of mental illness in immigrant and non-immigrant U.S. Latino groups. American Journal of Psychiatry, 165, 359369. doi:10.1176/appi.ajp.2007.07040704.CrossRefGoogle ScholarPubMed
Alegria, M., Canino, G., Stinson, F. S. and Grant, B. F. (2006). Nativity and DSM-IV psychiatric disorders among Puerto Ricans, Cuban Americans, and non-Latino Whites in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Journal of Clinical Psychiatry, 67, 5665. doi:10.4088/JCP.v67n0109.CrossRefGoogle ScholarPubMed
Alegria, M., Sribney, W., Woo, M., Torres, M. and Guarnaccia, P. (2007). Looking beyond nativity: the relation of age of immigration, length of residence, and birth cohorts to the risk of onset of psychiatric disorders for Latinos. Research in Human Development, 4, 1947. doi:10.1080/15427600701480980.CrossRefGoogle Scholar
Aranda, M. P. and Knight, B. G. (1997). The influence of ethnicity and culture on the caregiver stress and coping process: a sociocultural review and analysis. The Gerontologist, 37, 342354. doi:10.1093/geront/37.3.342.CrossRefGoogle Scholar
Arean, P. A. et al. (2005). Improving depression care for older, minority patients in primary care. Medical Care, 43, 381390.CrossRefGoogle ScholarPubMed
Alzheimer's Association. (2011). 2011 Alzheimer's Disease Facts and Figures. http://www.alz.org/downloads/facts_figures_2011.pdf; last accessed 8 May 2013.Google Scholar
Black, S. A., Markides, K. S. and Miller, T. Q. (1998). Correlates of depressive symptomatology among older community-dwelling Mexican Americans: the Hispanic EPESE. The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 53, S198208. doi:10.1093/geronb/53B.4.S198.CrossRefGoogle ScholarPubMed
Centers for Disease Control and Prevention (2013, May 10). Self-reported increased confusion or memory loss and associated functional difficulties among adults aged ≥60 years — 21 states, 2011. Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6218a1.htm; last accessed 10 May 2013.Google Scholar
Coon, D. W. et al. (2004). Well-being, appraisal, and coping in Latina and Caucasian female dementia caregivers: findings from the REACH study. Aging & Mental Health, 8, 330345. doi:10.1080/13607860410001709683.CrossRefGoogle ScholarPubMed
Covinsky, K. E. et al. (2003). Patient and caregiver characteristics associated with depression in caregivers of patients with dementia. Journal of General Internal Medicine, 18, 10061014. doi:10.1111/j.1525-1497.2003.30103.x.CrossRefGoogle ScholarPubMed
Cox, C. and Monk, A. (1990). Minority caregivers of dementia victims: a comparison of Black and Hispanic families. Journal of Applied Gerontology, 9, 340354. doi:10.1177/073346489000900308.CrossRefGoogle Scholar
Cuellar, I., Arnold, B. and Maldonado, R. (1995). Acculturation Rating Scale for Mexican-Americans-II: a revision of the original ARSMA scale. Hispanic Journal of Behavioral Sciences, 17, 275304. doi: 10.1177/07399863950173001.CrossRefGoogle Scholar
Cuellar, I. and Roberts, R. E. (1997). Relations of depression, acculturation, and socioeconomic status in a Latino sample. Hispanic Journal of Behavioral Sciences, 19, 230238. doi: 10.1177/07399863970192009.CrossRefGoogle Scholar
Gallagher-Thompson, D., Coon, D. W., Solano, N., Ambler, C., Rabinowitz, Y. and Thompson, L. W. (2003). Change in indices of distress among Latino and Anglo female caregivers of elderly relatives with dementia: site-specific results from the REACH national collaborative study. The Gerontologist, 43, 580591. doi:10.1093/geront/43.4.580.CrossRefGoogle ScholarPubMed
Gallicchio, L., Siddiqi, N., Langenberg, P. and Baumgarten, M. (2002). Gender differences in burden and depression among informal caregivers of demented elders in the community. International Journal of Geriatric Psychiatry, 17, 154163. doi: 10.1002/gps.538.CrossRefGoogle ScholarPubMed
Garcia, M. and Marks, G. (1989). Depressive symptomatology among Mexican American adults: an examination with the CES-D scale. Psychiatry Research, 27, 137148. doi:10.1016/0165-1781(89)90129-7.CrossRefGoogle ScholarPubMed
González, H. M., Ceballos, M., Tarraf, W., West, B. T., Bowen, M. E. and Vega, W. (2009). The health of older Mexican Americans in the long run. American Journal of Public Health, 10, 18791885. doi:10.2105/AJPH.2008.133744.CrossRefGoogle Scholar
González, H. M., Haan, M. N. and Hinton, L. (2001). Acculturation and the prevalence of depression in older Mexican Americans: baseline results of the Sacramento Area Latino Study on Aging. Journal of the American Geriatrics Society, 49, 948953. doi:10.1046/j.1532-5415.2001.49186.x.CrossRefGoogle Scholar
González, H. M., Tarraf, W., Whitfield, K. E. and Vega, W. A. (2010). The epidemiology of major depression and ethnicity in the United States. Journal of Psychiatric Research, 44, 10431051. doi:10.1016/j.jpsychires.2010.03.017.CrossRefGoogle ScholarPubMed
Grant, B. F., Stinson, F. S., Dawson, D. A., Chou, S. P., Ruan, W. J. and Pickering, R. P. (2004a). Co-occurrence of 12-month alcohol and drug use disorders and personality disorders in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Archives of General Psychiatry, 61, 361368. doi:10.1001/archpsyc.61.4.361.CrossRefGoogle ScholarPubMed
Grant, B. F., Stinson, F. S., Hasin, D. S., Dawson, D. A., Chou, S. P. and Anderson, K. (2004b). Immigration and lifetime prevalence of DSM-IV psychiatric disorders among Mexican Americans and non-Hispanic whites in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Archives of General Psychiatry, 61, 12261233. doi:10.1001/archpsyc.61.12.1226.CrossRefGoogle ScholarPubMed
Guarnaccia, P. J., Angel, R. and Worobey, J. L. (1989). The factor structure of the CES-D in the Hispanic Health and Nutrition Examination Survey: the influences of ethnicity, gender and language. Social Science and Medicine, 29, 8594. doi:10.1016/0277-9536(89)90131-7.CrossRefGoogle ScholarPubMed
Haan, M. N., Mungas, D. M., González, H. M., Ortiz, T. A., Acharya, A. and Jagust, W. J. (2003). Prevalence of dementia in older Latinos: the influence of type 2 diabetes mellitus, stroke and genetic factors. Journal of the American Geriatrics Society, 51, 169177. doi:10.1046/j.1532-5415.2003.51054.x.CrossRefGoogle ScholarPubMed
Hahn, E. A., Kim, G. and Chiriboga, D. A. (2011). Acculturation and depressive symptoms among Mexican American elders new to the caregiving role: results from the Hispanic-EPESE. Journal of Aging and Health, 23, 417432. doi:10.1177/0898264310380454.CrossRefGoogle Scholar
Harwood, D. G., Barker, W. W., Cantillon, M., Loewenstein, D. A., Ownby, R. and Duara, R. (1998). Depressive symptomatology in first-degree family caregivers of Alzheimer disease patients: a cross-ethnic comparison. Alzheimer Disease & Associated Disorders, 12, 340346.CrossRefGoogle ScholarPubMed
Harwood, D. G., Barker, W. W., Ownby, R. L., Bravo, M., Aguero, H. and Duara, R. (2000). Predictors of positive and negative appraisal among Cuban American caregivers of Alzheimer's disease patients. International Journal of Geriatric Psychiatry, 15, 481487. doi:10.1002/1099-1166(200006)15:6<481::AID-GPS984>3.0.CO;2-J.3.0.CO;2-J>CrossRefGoogle ScholarPubMed
Hazuda, H. P., Haffner, S. and Stern, M. (1988). Acculturation and assimilation among Mexican Americans: scales and population-based data. Social Science Quarterly, 69, 687705.Google Scholar
Hinton, L., Haan, M., Geller, S. and Mungas, D. (2003). Neuropsychiatric symptoms in Latino Elders with dementia or cognitive impairment without dementia and factors that modify their association with caregiver depression. The Gerontologist, 43, 669677. doi:10.1093/geront/43.5.669.CrossRefGoogle ScholarPubMed
Kessler, R. C. et al. (1994). Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey. Archives of General Psychiatry, 51, 819. doi:10.1001/archpsyc.1994.03950010008002.CrossRefGoogle ScholarPubMed
Kikman-Liff, B. and Mondragón, D. (1991). Language of interview: relevance for research of Southwest Hispanics. American Journal of Public Health, 81, 13991404.CrossRefGoogle Scholar
Knight, B. G. and Sayegh, P. (2010). Cultural values and caregiving: the updated sociocultural stress and coping model. The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 65B, 513. doi:10.1093/geronb/gbp096.CrossRefGoogle ScholarPubMed
Lee, S., Nguyen, H. A. and Tsui, J. (2011). Interview language as a proxy measure for acculturation among Asian Americans in a population-based survey. Journal of Immigrant and Minority Health, 13, 244252. doi:10.1007/s10903-009-9278-z.CrossRefGoogle Scholar
Liang, K. Y. and Zeger, S. L. (1986). Longitudinal data analysis for discrete and continuous outcomes. Biometrika, 73, 1222. doi:10.1093/biomet/73.1.13.Google Scholar
Mahoney, R., Regan, C., Katona, C. and Livingston, G. (2005). Anxiety and depression in family caregivers of people with Alzheimer disease: the LASER-AD study. The American Journal of Geriatric Psychiatry, 13, 795801. doi:10.1097/00019442-200509000-00008.CrossRefGoogle ScholarPubMed
Marín, G. and Gamba, R. J. (1996). A new measurement of acculturation for Hispanics: the Bidimensional Acculturation Scale for Hispanics (BAS). Hispanic Journal of Behavioral Sciences, 18, 297316. doi:10.1177/07399863960183002.CrossRefGoogle Scholar
Markides, K. S. and Farrell, J. (1985). Marital status and depression among Mexican Americans. Social psychiatry, 20, 8691. doi: 10.1007/BF00594985.CrossRefGoogle ScholarPubMed
McConaghy, R. and Caltabiano, M. L. (2005). Caring for a person with dementia: Exploring relationships between perceived burden, depression, coping and well being. Nursing and Health Sciences, 7, 8191. doi:10.1111/j.1442-2018.2005.00213.x.CrossRefGoogle ScholarPubMed
Miranda, P. Y. and González, H. M. (2011) Pathways between acculturation and health: does the measure matter? Hispanic Journal of Behavioral Science, 33, 524537. doi:10.1177/0739986311423901.CrossRefGoogle Scholar
Moscicki, E., Locke, B. Z., Rae, D. and Boyd, J. (1989). Depressive symptoms among Mexican Americans: the Hispanic Health and Nutrition Examination Survey. American Journal of Epidemiology, 130, 348360.CrossRefGoogle ScholarPubMed
Napoles, A. M., Chadiha, L., Eversley, R. and Moreno-John, G. (2010). Reviews: developing culturally sensitive dementia caregiver interventions: are we there yet? American Journal of Alzheimer's Disease and Other Dementias, 25, 389406. doi:10.1177/1533317510370957.CrossRefGoogle ScholarPubMed
Padilla, A. M. and Perez, W. (2003). Acculturation, social identity, and social cognition: a new perspective. Hispanic Journal of Behavioral Sciences, 25, 3555. doi:10.1177/0739986303251694.CrossRefGoogle Scholar
Pearlin, L. L., 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, 583594.CrossRefGoogle ScholarPubMed
Pinquart, M. and Sörensen, S. (2007). Correlates of physical health of informal caregivers: a meta-analysis. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 62, P126137.CrossRefGoogle ScholarPubMed
Polich, T. and Gallagher-Thompson, D. (1997). Preliminary study investigating psychological distress among female Latino caregivers. Journal of Clinical Geropsychology, 3, 115.Google Scholar
R Core Team (2013). R: A Language and Environment for Statistical Computing. Vienna, Austria: R Foundation for Statistical Computing. Available at: http://www.R-project.org/; last accessed 7 January 2013.Google Scholar
Rabins, P. V., Fitting, M. D., Eastham, J. and Zabora, J. (1990). Emotional adaptation over time in caregivers for chronically ill elderly people. Age Ageing, 19, 185190.Google ScholarPubMed
Radloff, L. S. (1977). The CES-D scale: a self report depression scale for research in the general population. Applied Psychological Measurement, 1, 385401. doi:10.1177/014662167700100306.CrossRefGoogle Scholar
Rivera, F. I. (2007). Contextualizing the experience of young Latino adults: acculturation, social support, and depression. Journal of Immigrant and Minority Health, 9, 237244. doi:10.1007/s10903-006-9034-6.CrossRefGoogle ScholarPubMed
Roberts, R. E. (1980). Reliability of the CES-D Scale in different ethnic contexts. Psychiatry Research, 2, 125134. doi: 10.1016/0165-1781(80)90069-4.CrossRefGoogle ScholarPubMed
Schulz, R. and Beach, S. R. (1999). Caregiving as a risk factor for mortality: the Caregiver Health Effects Study. The Journal of the American Medical Association, 282, 22152219. doi:10.1001/jama.282.23.2215.CrossRefGoogle ScholarPubMed
Schulz, R. and Martire, L. M. (2004). Family caregiving of persons with dementia: prevalence, health effects, and support strategies. The American Journal of Geriatric Psychiatry: Official Journal of the American Association for Geriatric Psychiatry, 12, 240249. doi:10.1097/00019442-200405000-00002.CrossRefGoogle ScholarPubMed
Schulz, R. et al. (2008). Dementia patient suffering and caregiver depression. Alzheimer Disease and Associated Disorders, 22, 170176. doi:10.1097/WAD.0b013e31816653cc.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, 771791. doi: 10.1093/geront/35.6.771.CrossRefGoogle ScholarPubMed
Sentell, T., Shumway, M. and Snowden, L. (2007). Access to mental health treatment by English language proficiency and race/ethnicity. Journal of General Internal Medicine, 22 (Suppl 2), 289293. doi:10.1007/s11606-007-0345-7.CrossRefGoogle ScholarPubMed
Shurgot, G. R. and Knight, B. G. (2005). Preliminary study investigating acculturation, cultural values, and psychological distress in Latino caregivers of dementia patients. Journal of Mental Health and Aging, 3, 3744.Google Scholar
Sörensen, S. and Pinquart, M. (2005). Racial and ethnic differences in the relationship of caregiving stressors, resources, and sociodemographic variables to caregiver depression and perceived physical health. Aging & Mental Health, 9, 482495. doi:10.1080/13607860500142796.CrossRefGoogle ScholarPubMed
STATA Corp. (2011). Stata Statistical Software: Release 12.1. 2011. College Station, Texas: Stata Corporation.Google Scholar
Tang, M. X. et al. (1998). The APOE-epsilon4 allele and the risk of Alzheimer disease among African Americans, Whites, and Hispanics. JAMA: The Journal of the American Medical Association, 279, 751755.CrossRefGoogle ScholarPubMed
Tennstedt, S., Cafferata, G. L. and Sullivan, L. (1992). Depression among caregivers of impaired elders. Journal of Aging and Health, 4, 5876. doi: 10.1177/089826439200400104.CrossRefGoogle ScholarPubMed
Vega, W. A., Kolody, B., Aguilar-Gaxiola, S., Alderete, E., Catalano, R. and Caraveo-Anduaga, J. (1998). Lifetime prevalence of DSM-III-R psychiatric disorders among urban and rural Mexican Americans in California. Archives of General Psychiatry, 55, 771778. doi:10.1001/archpsyc.55.9.771.CrossRefGoogle Scholar
Vega, W. A., Kolody, B. and Warheit, G. (1985). Psychoneuroses among Mexican Americans and other Whites: prevalence and caseness. American Journal of Public Health, 75, 523527.CrossRefGoogle ScholarPubMed
Vega, W. A., Sribney, W. M. and Achara-Abrahams, I. (2003). Co-occurring alcohol, drug, and other psychiatric disorders among Mexican-origin people in the United States. American Journal of Public Health, 93, 10571064.CrossRefGoogle ScholarPubMed
Vitaliano, P. P., Zhang, J., Young, H. M., Caswell, L. W., Scanlan, J. M. and Echeverria, D. (2009). Depressed mood mediates decline in cognitive processing speed in caregivers. The Gerontologist, 49, 1222. doi:10.1093/geront/gnp004.CrossRefGoogle ScholarPubMed
Yu, S. M., Nyman, R. M., Kogan, M. D., Huang, Z. J. and Schwalberg, R. H. (2004). Parent's language of interview and access to care for children with special health care needs. Ambulatory Pediatrics, 4, 181187. doi:10.1367/A03-094R.1.CrossRefGoogle ScholarPubMed