Evaluation of depressive symptoms in older caregivers

Luchesi, Bruna Moretti; Degani, Gláucia Costa; Brígola, Allan Gustavo; Pavarini, Sofia Cristina Iost; Marques, Sueli

doi:10.1590/0101-60830000000047

Review articles • Arch. Clin. Psychiatry (São Saulo) 42 (2) • Mar-Apr 2015 • https://doi.org/10.1590/0101-60830000000047 linkcopy

Evaluation of depressive symptoms in older caregivers

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Background The number of older caregivers is getting bigger and it is important to know if they experience depressive symptoms because there can be consequences for both caregiver and care recipient.

Objective To analyze the recent publications related to the assessment of depressive symptoms in elderly caregivers.

Methods Lilacs and PubMed databases were reviewed associating the descriptors “caregivers” AND “aged” AND “depression”. Inclusion criteria were texts including primary data in Portuguese, Spanish or English, published between 2009-2013, also data which evaluated elderly caregivers (≥ 60) and depression or depressive symptoms. There were found n = 1129 texts and after applying the inclusion criteria n = 17 were selected and analyzed.

Results Geriatric Depressive Scale (-30 and -15 items) and Center for Epidemiologic Studies Depression scale were the most used scales to evaluate depressive symptoms in older caregivers. Caregivers were in the most of the cases female and cared for a family member with dementia. The majority of the texts that compared older caregivers to older non-caregivers found that caregivers had more depressive symptoms.

Discussion Early identification of depressive symptoms can help professionals to minimize damage in caregivers and in care recipient and to plan interventions focusing on improving quality of life of this specific caregiver group.

Older; depression; caregiver; review

Title	Journal/Publication Year	University/Country of corresponding author	Aim	Measure used and how the results were shown
Chronic psychosocial stress: does it modulate immunity to the influenza vaccine in Hong Kong Chinese elderly caregivers?¹⁷	AGE 2013	The Chinese University of Hong Kong – China	“Determine whether chronic stress is associated with poorer influenza-specific immune responses to influenza vaccines in Hong Kong Chinese elderly people”^17:1479	GDS-15 Chinese version, mean punctuation in a range of 0-15
Positive affect as associated with fewer sleep problems in older caregivers but not noncaregivers¹⁸	Gerontologist 2013	University School of Public Health – USA	Examined “whether the associations of positive affect and depressive symptoms with sleep problems differed between caregivers and noncaregivers”^18:61	CES-D 20 items, cutoff > 15
Psychosocial and cognitive health differences by caregiver status among older Mexican Americans¹⁹	Community Mental Health 2013	University of California – USA	Identify “the risk and protective factors associated with informal caregiving by older (≥ 70 years) Mexican Americans and profile caregiving arrangements”^19:61	CES-D 20 items, cutoff > 15
Influence of gender, age and income on the well-being of elderly caregivers²⁰	Brazilian Journal of Geriatrics and Gerontology 2013	State University of Campinas – Brazil	“Compare elderly caregivers with non-caregivers regarding their health psychosocial and functional status, and to investigate the influence of socioeconomic variables on these conditions in both groups”^20:664	GDS-15 Brazilian version, cutoff > 5
Relationships between gender, age, family conditions, physical and mental health, and social isolation of elderly caregivers²¹	International Psychogeriatrics 2012	State University of Campinas – Brazil	“Investigate the relationship between caregivers’ gender, age, family income, living arrangements and social support as independent variables, and depressive symptoms, comorbidities, level of frailty, grip strength, walking speed and social isolation, as dependent variables”^21:472	GDS-15 Brazilian version, cutoff > 5
Modeling trajectories and transitions: results from the New York University caregiver intervention²²	Nursing Research 2011	University of Minnesota – USA	“Estimate the effects of comprehensive psychosocial support on trajectories of spouse caregivers’ well-being related to the nursing home placement transition”^22:S28	GDS-30 items, mean punctuation in a range of 0-30
Acculturation and depressive symptoms among Mexican American elders new to the caregiving role: results from the Hispanic-EPESE²³	Journal of Aging and Health 2011	University of South Florida – USA	“Identify characteristics associated with becoming a caregiver among Mexican American (MA) elders and to examine predictors of depressive symptoms among the new caregivers 2 years later”^23:467	CES-D 20 items, cutoff > 15
The relation of pain and caregiver burden in informal older adult caregivers²⁴	Pain Medicine 2011	University of Regina – Canada	“Study the associations between caregiver pain, depression, and caregiver burden in a sample of older adult caregivers”^24:51	GDS-30 items, cutoff > 10
Childhood Adversity Heightens the Impact of Later-Life Caregiving Stress on Telomere Length and Inflammation²⁵	Psychosomatic Medicine 2011	The Ohio State University College of Medicine – USA	Evaluate “whether childhood abuse and other adversities have lasting, detectable consequences for inflammation and cell aging late in life, and whether the effects are large enough to be discernible beyond that of a major chronic stressor, dementia family caregiving”^25:16	CES-D 20 items, did not show the results in numbers
Factors that explain the poorer mental health of caregivers: Results from a community survey of older Australians²⁶	Australian & New Zealand Journal of Psychiatry 2010	The Autralian National University – Australia	“Identify mediating factors that could provide a basis for intervention and policy options to better support older Australian caregivers”^26:617	Goldberg anxiety and depression scales – 18 items, mean punctuation in a range of 0-18
An evaluation of a wellness guide for older carers living in the community²⁷	Public Health Nursing 2010	Deakin University – Australia	“Assess the usefulness and effectiveness of a wellness guide and to identify whether its use by a group of older ‘‘new’’ carers would make them healthier and knowledgeable of community resources”^27:302	DASS short version, mean punctuation in a range of 0-63
Depression among older Mexican American caregivers²⁸	Cultural Diversity & Ethnic Minority Psychology 2010	Indiana University-Purdue University Indianapolis – USA	“Compare depression levels between older Mexican American caregivers and noncaregivers while controlling for confounds identified but not controlled in past research”^28:50	CES-D 20 items, cutoff > 15
Depression and anxiety in primary caregivers of elderly adults with Alzheimer dementia: case studies²⁹	Interdisciplinary Studies on Aging 2010	Pontifical Catholic University of Rio Grande do Sul – Brazil	“Investigate the occurrence of depression and anxiety in primary caregivers of elderly adults with Alzheimer Dementia”^29:214	BDI 21 items, did not show the results in numbers
Collaborative memory intervention in dementia: caregiver participation matters³⁰	Neuropsychological Rehabilitation 2009	University of Umea – Sweden	“Examine the effectiveness of a collaborative memory intervention for persons with dementia and their spousal caregivers, where the couple acquired and practised memory supportive strategies (spaced-retrieval and hierarchical cuing) to learn a face – name association and to set a table for coffee/tea”^30:696	BDI 21 items, mean punctuation in a range of 0-63
Quality of life among older grandparent caregivers: a pilot study³¹	Journal of Advanced Nursing 2009	National Cheng Kung University – Taiwan	“Compare quality of life and levels of depressive symptoms among older grandparent caregivers and noncaregivers in Taiwan”^31:1475	GDS-30 items, did not show the results in numbers
Effects of cranial electrical stimulation on sleep disturbances, depressive symptoms, and caregiving appraisal in spousal caregivers of persons with Alzheimer’s disease³²	Applied Nursing Research 2009	University of Virginia – USA	“Investigate the short-term use of the AlphaStim^® CES device on sleep disturbance, depressive symptoms, and subjective appraisal in elderly persons who are the primary caregivers for their spouses with AD”^32:120	GDS-30 items, cutoff > 10
Positive affect and incidence of frailty in elderly women caregivers and noncaregivers: results of Caregiver-Study of Osteoporotic Fractures³³	Journal of the American Geriatrics Society 2009	University of Maryland – USA	“Determine whether positive affect is associated with a lower incidence of frailty over 2 years in elderly community-dwelling women and to test the stress-buffering hypothesis by evaluating whether these associations differed in caregivers and noncaregivers”^33:627	CES-D 20 items, cutoff > 15

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[TFN1] GDS: Geriatric Depressive Scale; CES-D: Center for Epidemiological Studies Scale; DASS: Depression Anxiety Stress Scale; BDI: Beck Depression Inventory.