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Identifying target groups for the prevention of depression among caregivers of dementia patients

Published online by Cambridge University Press:  01 September 2011

Karlijn J. Joling ,
Filip Smit ,
Harm W. J. van Marwijk ,
Henriëtte E. van der Horst ,
Philip Scheltens ,
Richard Schulz  and
Hein P. J. van Hout
Karlijn J. Joling*
Affiliation:
Department of General Practice, EMGO Institute for Health and Health Care Research, VU University Medical Centre, Amsterdam, The Netherlands
Filip Smit
Affiliation:
Department of Epidemiology and Biostatistics, EMGO Institute for Health and Health Care Research, VU University Medical Centre, Amsterdam, The Netherlands Trimbos Institute (Netherlands Institute for Mental Health and Addiction), Utrecht, The Netherlands
Harm W. J. van Marwijk
Affiliation:
Department of General Practice, EMGO Institute for Health and Health Care Research, VU University Medical Centre, Amsterdam, The Netherlands
Henriëtte E. van der Horst
Affiliation:
Department of General Practice, EMGO Institute for Health and Health Care Research, VU University Medical Centre, Amsterdam, The Netherlands
Philip Scheltens
Affiliation:
Department of Neurology, Alzheimer Centre, VU University Medical Centre, Amsterdam, The Netherlands
Richard Schulz
Affiliation:
Department of Psychiatry, University of Pittsburgh and Center for Social and Urban Research, Pittsburgh, PA, USA
Hein P. J. van Hout
Affiliation:
Department of General Practice, EMGO Institute for Health and Health Care Research, VU University Medical Centre, Amsterdam, The Netherlands
*
Correspondence should be addressed to: Karlijn J. Joling, Department of General Practice, EMGO Institute for Health and Health Care Research, van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands. Phone.: +31 20 444 8199; Fax: +31 20 444 8163. Email: [email protected].
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Abstract

Background: Depression in informal caregivers of persons with dementia is a major, costly and growing problem. However, it is not yet clear which caregivers are at increased risk of developing depression. With this knowledge preventive strategies could focus on these groups to maximize health gain and minimize effort.

Methods: The onset of clinically relevant depression was measured with the Center for Epidemiologic Studies - Depression Scale in 725 caregivers who were not depressed at baseline and who were providing care for a relative with dementia. Caregivers were followed over 18 months. The indices calculated to identify the most important risk indicators were: odds ratio, attributable fraction, exposure rate and number needing to be treated.

Results: The following significant indicators of depression onset were identified: increased initial depressive symptoms, poor self-rated health status and white or Hispanic race/ethnicity. The incidence of depression would decrease by 72.3% (attributive fraction) if these risk indicators together are targeted by a completely effective intervention. Race/ethnicity was not a significant predictor if caregivers of patients who died or were institutionalized were left out of the analyses.

Conclusion: Detection of only a few characteristics makes it possible to identify high-risk groups in an efficient way. Focusing on these easy-to-assess characteristics might contribute to a cost-effective prevention of depression in caregivers.

Keywords

incidencehigh-risk groupsrisk factorscarersAlzheimer's disease
Type
Research Article
Information
International Psychogeriatrics , Volume 24 , Issue 2 , February 2012 , pp. 298 - 306
Copyright
Copyright © International Psychogeriatric Association 2011

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