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Martis CS, Bhandary RP, Chandrababu R, Lakshmi R V, Bhandary PV, Noronha JA, Chakrabarty J, Tolson D, Devi ES. Caring burden and quality of life among the caregivers of people living with dementia - a cross-sectional study in Udupi district of Karnataka. Home Health Care Serv Q 2024; 43:191-204. [PMID: 38190733 DOI: 10.1080/01621424.2023.2301417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Abstract
Dementia is a chronic disorder of the brain that affects cognitive performance. The caregivers of individuals with dementia experience a greater burden that affects their Quality of Life (QoL). This cross-sectional study conducted in India was designed to assess the caring burden and QoL among the caregivers of people with dementia, as well as to ascertain the relationship between QoL scores and burden. Our sample included 80 caregivers of people with dementia. Most of the caregivers (n = 59, 73.8%) had a higher level of caregiver burden. There was a negative correlation between caregiver burden scores and QoL. A higher level of caregiver stress and low QoL were experienced by caregivers of dementia patients. In developing countries like India, counseling, and education on home health care for people with dementia should be provided to reduce the burden and enhance the QoL of caregivers.
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Affiliation(s)
- Clarita Shynal Martis
- Department of Medical Surgical Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, India
| | | | - Ramesh Chandrababu
- Department of Medical Surgical Nursing, Sri Ramachandra Faculty of Nursing, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, India
| | - Vani Lakshmi R
- Department of Data Science, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India
| | | | - Judith Angelitta Noronha
- Department of Obstetrics and gynaecological nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, India
| | - Jyothi Chakrabarty
- Department of Medical Surgical Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, India
| | - Debbie Tolson
- Alzheimer Scotland Centre for Policy and Practice, University of West of Scotland, Scotland, UK
| | - Elsa Sanatombi Devi
- Department of Medical Surgical Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, India
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Shen WC, Chang LH, Huang YC, Wang JJ. Psychological Distress, Multicare Needs and Social Resource Utilisation of Family Caregivers of People With Dementia: A Descriptive-Correlational Study. Int J Older People Nurs 2024; 19:e12624. [PMID: 38895917 DOI: 10.1111/opn.12624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 04/08/2024] [Accepted: 05/30/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND The population of people with dementia increases yearly, imposing a growing burden on family caregivers. Psychological distress impacts the mental health of family caregivers of people with dementia. Caregiver psychological distress can result in increased social resource utilisation and unmet multicare needs. PURPOSE The study explored the psychological distress of family caregivers of people with dementia and examined the impact on social resource utilisation and multicare needs. METHODS A descriptive-correlational study collected data in Taiwan from a cross-sectional sample of family caregivers of people with dementia using a self-report questionnaire. Data were analysed using linear and logistic regression. RESULTS A total of 301 caregivers provided data for analysis. Nearly two-thirds of caregivers were female with a mean age of 57 years old (SD = 12). Over half of the family caregivers of people with dementia experienced mild-to-moderate psychological distress. The greater the psychological distress, the greater the probability of using social resources (1.09 times per 1-point increase, p = 0.002). Psychological distress was positively associated with the number of caregivers' care needs (β = 0.371, p < 0.001). CONCLUSIONS Findings of this study can assist healthcare professionals in better understanding the psychological distress and care needs of caregivers. Services designed to meet the needs of family caregivers will improve psychological distress.
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Affiliation(s)
- Wan-Ching Shen
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
| | - Ling-Hui Chang
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
| | - Ying-Che Huang
- Department of Neurology, Tainan Hospital, Ministry of Health and Welfare, Tainan City, Taiwan
| | - Jing-Jy Wang
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
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Huang YY, Gan YH, Yang L, Cheng W, Yu JT. Depression in Alzheimer's Disease: Epidemiology, Mechanisms, and Treatment. Biol Psychiatry 2024; 95:992-1005. [PMID: 37866486 DOI: 10.1016/j.biopsych.2023.10.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 09/13/2023] [Accepted: 10/07/2023] [Indexed: 10/24/2023]
Abstract
Depression and Alzheimer's disease (AD) are substantial public health concerns. In the past decades, a link between the 2 disease entities has received extensive acknowledgment, yet the complex nature of this relationship demands further clarification. Some evidence indicates that midlife depression may be an AD risk factor, while a chronic course of depression in late life may be a precursor to or symptom of dementia. Recently, multiple pathophysiological mechanisms have been proposed to underlie the bidirectional relationship between depression and AD, including genetic predisposition, immune dysregulation, accumulation of AD-related biomarkers (e.g., amyloid-β and tau), and alterations in brain structure. Accordingly, numerous therapeutic approaches, such as pharmacology treatments, psychotherapy, and lifestyle interventions, have been suggested as potential means of interfering with these pathways. However, the current literature on this topic remains fragmented and lacks a comprehensive review characterizing the association between depression and AD. In this review, we aim to address these gaps by providing an overview of the co-occurrence and temporal relationship between depression and AD, as well as exploring their underlying mechanisms. We also examine the current therapeutic regimens for depression and their implications for AD management and outline key challenges facing the field.
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Affiliation(s)
- Yu-Yuan Huang
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and Ministry of Education Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yi-Han Gan
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and Ministry of Education Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Liu Yang
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and Ministry of Education Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Wei Cheng
- Institute of Science and Technology for Brain-Inspired Intelligence, Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China
| | - Jin-Tai Yu
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and Ministry of Education Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China.
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vom Hofe I, Stricker BH, Vernooij MW, Ikram MK, Ikram MA, Wolters FJ. Antidepressant use in relation to dementia risk, cognitive decline, and brain atrophy. Alzheimers Dement 2024; 20:3378-3387. [PMID: 38561253 PMCID: PMC11095425 DOI: 10.1002/alz.13807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 02/01/2024] [Accepted: 02/26/2024] [Indexed: 04/04/2024]
Abstract
INTRODUCTION We aimed to assess the effect of antidepressant use on dementia risk, cognitive decline, and brain atrophy. METHODS In this prospective cohort study, we included 5511 dementia-free participants (Mini-Mental State Examination [MMSE] > 25) of the Rotterdam study (57.5% women, mean age 70.6 years). Antidepressant use was extracted from pharmacy records from 1991 until baseline (2002-2008). Incident dementia was monitored from baseline until 2018, with repeated cognitive assessment and magnetic resonance imaging (MRI) every 4 years. RESULTS Compared to never use, any antidepressant use was not associated with dementia risk (hazard ratio [HR] 1.14, 95% confidence interval [CI] 0.92-1.41), or with accelerated cognitive decline or atrophy of white and gray matter. Compared to never use, dementia risk was somewhat higher with tricyclic antidepressants (HR 1.36, 95% CI 1.01-1.83) than with selective serotonin reuptake inhibitors (HR 1.12, 95% CI 0.81-1.54), but without dose-response relationships, accelerated cognitive decline, or atrophy in either group. DISCUSSION Antidepressant medication in adults without indication of cognitive impairment was not consistently associated with long-term adverse cognitive effects. HIGHLIGHTS Antidepressant medications are frequently prescribed, especially among older adults. In this study, antidepressant use was not associated with long-term dementia risk. Antidepressant use was not associated with cognitive decline or brain atrophy. Our results support safe prescription in an older, cognitively healthy population.
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Affiliation(s)
- Ilse vom Hofe
- Department of EpidemiologyErasmus University Medical CenterRotterdamThe Netherlands
| | - Bruno H. Stricker
- Department of EpidemiologyErasmus University Medical CenterRotterdamThe Netherlands
| | - Meike W. Vernooij
- Department of EpidemiologyErasmus University Medical CenterRotterdamThe Netherlands
- Department of Radiology & Nuclear Medicine and Alzheimer Centre Erasmus MCErasmus University Medical CenterRotterdamThe Netherlands
| | - M. Kamran Ikram
- Department of EpidemiologyErasmus University Medical CenterRotterdamThe Netherlands
- Department of NeurologyErasmus University Medical CenterRotterdamThe Netherlands
| | - M. Arfan Ikram
- Department of EpidemiologyErasmus University Medical CenterRotterdamThe Netherlands
| | - Frank J. Wolters
- Department of EpidemiologyErasmus University Medical CenterRotterdamThe Netherlands
- Department of Radiology & Nuclear Medicine and Alzheimer Centre Erasmus MCErasmus University Medical CenterRotterdamThe Netherlands
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Lin PH, Fu SH, Lee YC, Yang SY, Li YL. Examining the effects of binaural beat music on sleep quality, heart rate variability, and depression in older people with poor sleep quality in a long-term care institution: A randomized controlled trial. Geriatr Gerontol Int 2024; 24:297-304. [PMID: 38319068 DOI: 10.1111/ggi.14827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 11/16/2023] [Accepted: 01/23/2024] [Indexed: 02/07/2024]
Abstract
OBJECTIVE This study aimed to examine the effects of binaural beat music (BBM) on sleep quality, heart rate variability, and depression in older people with poor sleep quality in a long-term care institution. METHODS A single-blind randomized controlled trial design was employed, and 64 older participants with poor sleep quality were recruited from a long-term care institution in Taiwan. Participants were randomized into the BBM group or control group and received 14 days of intervention. During the intervention period, participants in the experimental group listened to 20 min of Taiwanese Hokkien oldies embedded with BBM once in the morning and afternoon three times a week. Participants in the control group only listened to Taiwanese Hokkien oldies. Questionnaires and heart rate variability analysis were used to assess participants' sleep quality, heart rate variability, and depressive symptoms. RESULTS Significant improvements were observed in sleep quality, along with an increase in heart rate variability means of heart rate and normal sinus beats, and a decrease in low-frequency normalized units and depression severity in the BBM group after the intervention. In the control group, effects on sleep quality were inconsistent, heart rate variability showed significant improvements in some autonomic nervous function regulation, and depression severity was significantly decreased. Furthermore, the BBM group showed a significant improvement in sleep quality and a significant reduction in sympathetic nervous activity compared with the control group. CONCLUSION This study demonstrates that 14 days of BBM intervention, a non-invasive intervention, could improve sleep quality and depression in older people with poor sleep quality in long-term care institutions. Geriatr Gerontol Int 2024; 24: 297-304.
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Affiliation(s)
- Pin-Hsuan Lin
- Department of Health and Beauty, Shu Zen Junior College of Medicine and Management, Kaohsiung, Taiwan
| | - Shih-Hau Fu
- Department of Acupressure Technology, Chung Hwa University of Medical Technology, Tainan, Taiwan
| | - Ya-Chen Lee
- Department of Occupational Therapy, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Shang-Yu Yang
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Yi-Lin Li
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
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Zheng G, Zhou B, Fang Z, Jing C, Zhu S, Liu M, Chen X, Zuo L, Chen H, Hao G. Living alone and the risk of depressive symptoms: a cross-sectional and cohort analysis based on the China Health and Retirement Longitudinal Study. BMC Psychiatry 2023; 23:853. [PMID: 37978367 PMCID: PMC10655346 DOI: 10.1186/s12888-023-05370-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 11/10/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND There were a few studies that examined the longitudinal association between living alone and depressive symptoms, and the vast majority of them were conducted in patients with certain diseases, such as heart failure, cancer, and glaucoma. This study aimed to examine the association between living alone and depressive symptoms in a large representative older Chinese population. METHODS The China Health and Retirement Longitudinal Study (CHARLS) data from 2015 to 2018 were used. Living alone was defined as participants who did not live with others ever or more than 11 months in the past year at baseline. Depressive symptoms were measured using the 10-item Center for Epidemiological Studies-Depression Scale (CES-D10). The multivariate logistic regression was used to estimate the relationship between living alone and depressive symptoms. RESULTS There were 5,311 and 2,696 participants ≥ 60 years old included in the cross-sectional and cohort analysis, respectively. The risk of depressive symptoms in participants who lived alone was significantly higher than those who lived with others in both cross-sectional (OR:1.33; 95%CI:1.14,1.54) and cohort analysis (OR:1.23; 95%CI:0.97,1.55). There was a significant interaction between financial support and living alone (Pinteraction = 0.008) on the risk of depressive symptoms. Stratified analyses showed that, compared to those who lived with others, the risk of depressive symptoms in participants who lived alone increased by 83% (OR:1.83; 95%CI:1.26,2.65) in participants receiving lower financial support. However, we did not find statistically significant associations in participants with medium (OR:1.10; 95%CI: 0.74,1.63) and higher financial support (OR: 0.87; 95%CI: 0.53,1.41). CONCLUSION Living alone was associated with a higher risk of depressive symptoms in the Chinese older population, and this association was moderated by the receipt of financial support. Living alone may be an effective and easy predictor for early identification of high-risk populations of depression in the older population.
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Affiliation(s)
- Guangjun Zheng
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Biying Zhou
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Zhenger Fang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Chunxia Jing
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
- Guangdong Key Laboratory of Environmental Exposure and Health, Jinan University, Guangzhou, China
| | - Sui Zhu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Mingliang Liu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Xia Chen
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Lei Zuo
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Haiyan Chen
- Department of Parasitic Disease and Endemic Disease Control and Prevention, Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Guang Hao
- Guangdong Provincial Engineering Research Center of Public Health Detection and Assessment, School of Public Health, Guangdong Pharmaceutical University, No. 283 Jianghai Avenue, Guangzhou, 510632, Guangdong, China.
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Wang GHM, Li P, Wang Y, Guo J, Wilson DL, Lo-Ciganic WH. Association between Antidepressants and Dementia Risk in Older Adults with Depression: A Systematic Review and Meta-Analysis. J Clin Med 2023; 12:6342. [PMID: 37834986 PMCID: PMC10573169 DOI: 10.3390/jcm12196342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 09/27/2023] [Accepted: 10/01/2023] [Indexed: 10/15/2023] Open
Abstract
Depression, commonly treated with antidepressants, is associated with an increased risk of dementia, especially in older adults. However, the association between antidepressant use and dementia risk is unclear. We searched for randomized controlled trials and observational studies from PubMed, Embase, and Cochrane on 1 February 2022, restricting to full texts in English. Since dementia is a chronic disease requiring a long induction time, we restricted studies with ≥1 year follow-up. We extracted the relative risk (RR) adjusted for the most variables from each study and evaluated the heterogeneity using I square (I2). The protocol was registered in the PROSPERO International Register of Systematic Reviews (CRD42022338038). We included six articles in the systematic review, of which the sample size ranged from 716 to 141,740, and the median length of follow-up was 5 years. The pooled RR was 1.21 (95% CI = 1.12-1.29) with an I2 of 71%. Our findings suggest that antidepressant use was associated with an increased risk of dementia in older adults with depression, yet moderate to high heterogeneity existed across studies. Future work accounting for the depression progression is needed to differentiate the effect of depression and antidepressants on dementia risk.
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Affiliation(s)
- Grace Hsin-Min Wang
- Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, FL 32610, USA; (G.H.-M.W.); (P.L.); (Y.W.); (J.G.); (D.L.W.)
| | - Piaopiao Li
- Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, FL 32610, USA; (G.H.-M.W.); (P.L.); (Y.W.); (J.G.); (D.L.W.)
| | - Yehua Wang
- Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, FL 32610, USA; (G.H.-M.W.); (P.L.); (Y.W.); (J.G.); (D.L.W.)
| | - Jingchuan Guo
- Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, FL 32610, USA; (G.H.-M.W.); (P.L.); (Y.W.); (J.G.); (D.L.W.)
- Center for Drug Evaluation and Safety, College of Pharmacy, University of Florida, Gainesville, FL 32610, USA
| | - Debbie L. Wilson
- Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, FL 32610, USA; (G.H.-M.W.); (P.L.); (Y.W.); (J.G.); (D.L.W.)
| | - Wei-Hsuan Lo-Ciganic
- Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, FL 32610, USA; (G.H.-M.W.); (P.L.); (Y.W.); (J.G.); (D.L.W.)
- Center for Drug Evaluation and Safety, College of Pharmacy, University of Florida, Gainesville, FL 32610, USA
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Chang TY, Liao SC, Chang CM, Wu CS, Huang WL, Hwang JJ, Hsu CC. Barriers to depression care among middle-aged and older adults in Taiwan's universal healthcare system. THE LANCET REGIONAL HEALTH - WESTERN PACIFIC 2022; 26:100501. [PMID: 36213135 PMCID: PMC9535419 DOI: 10.1016/j.lanwpc.2022.100501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Li J, Gao G, Zeng Y, Wu Y, Zhu X, Xu H. Perceived social support in Chinese family caregivers of patients with dementia. Int J Nurs Pract 2021; 28:e12945. [PMID: 33870622 DOI: 10.1111/ijn.12945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 03/01/2021] [Accepted: 03/20/2021] [Indexed: 11/30/2022]
Abstract
AIM This study aimed to describe levels of social support and explore the factors predictive of social support for Chinese family caregivers of patients with dementia. BACKGROUND Social support levels and their predictive factors in Chinese dementia caregivers have not been well documented, which need to be further clarified to provide a basis for creating effective social support strategies. METHODS This was a cross-sectional study with 91 participants who completed a demographic questionnaire and the Social Support Rating Scale from 2015 to 2016. RESULTS Chinese family caregivers of patients with dementia received moderate social support. Caregivers' subjective support domain scores and support utilization domain scores were significantly lower than those of the normal Chinese population, whereas caregivers' total social support scores were higher than those of the normal Chinese population. Family caregivers' monthly household income, educational level and place of residence were predictors of their own social support. CONCLUSION Social support in Chinese caregivers of patients with dementia needs to be improved, especially the subjective support and support utilization. Healthcare professionals should pay special attention to caregivers with a lower monthly household income and educational level and caregivers who lived in the suburban area. SUMMARY STATEMENT What is already known about this topic? Social support is important for family caregivers of patients with dementia. Social support levels and their predictive factors in Chinese dementia caregivers have not been well documented. What this paper adds? Caregivers' subjective support and support utilization were significantly lower than the normal Chinese population; caregivers' total social support was significantly higher than the normal Chinese population. The best predictors of caregivers' social support were the monthly household income, educational level and place of residence of the caregivers. The implications of this paper: Healthcare professionals should pay special attention to caregivers with a lower monthly household income and educational level and caregivers who lived in the suburban area. Future research is needed to create effective nursing regimes, paying attention to caregivers with a lower educational level and caregivers who lived in the suburban area.
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Affiliation(s)
- Jufang Li
- School of Nursing, Wenzhou Medical University, Wenzhou, Wenzhou, China
| | - Gexin Gao
- School of Nursing, Wenzhou Medical University, Wenzhou, Wenzhou, China
| | - Yawei Zeng
- School of Nursing, Wenzhou Medical University, Wenzhou, Wenzhou, China
| | - Yuping Wu
- School of Nursing, Wenzhou Medical University, Wenzhou, Wenzhou, China
| | - Xiaoling Zhu
- School of Nursing, Wenzhou Medical University, Wenzhou, Wenzhou, China
| | - Hongbo Xu
- School of Nursing, Wenzhou Medical University, Wenzhou, Wenzhou, China
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