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Alzheimer’s Caregivers at Risk for Depression

September 15, 2020

Caring for a loved one with Alzheimer’s disease can increase the risk of depression in caregivers, and symptoms of depression typically persist over time. Those are the findings of a new study from the University of Michigan that found that caring for a partner or spouse who is newly diagnosed with Alzheimer’s disease is associated with a 30 percent increased risk of developing symptoms of depression, compared to peers who do not have to care for a spouse with Alzheimer’s.

And unlike the spike in depressive symptoms that can follow the death of a loved one, a cancer diagnosis or other traumatic event, in which people may bounce back after a year or two, symptoms of depression tied to caring for a loved one with Alzheimer’s may persist for many years, the researchers found.

The findings underscore the importance of recognizing Alzheimer’s disease is an illness that affects the entire family for prolonged periods. Caregivers must recognize that the sustained stress of caregiving puts them at increased risk of depression, anxiety and other health ills over the multi-year course of the disease, and take measures to care for and protect themselves.

“We have seen that family members deeply affect each other’s health, so clinical and supportive care must orient more around the needs of the family,” said Melissa Harris, a doctoral student in the University of Michigan School of Nursing and the study’s lead author. “It’s so important to ask for advice and support early on. Caregivers should remember that their health is just as important as their partner’s and substantially impacts the health of the person with dementia.”

The social isolation caused by the coronavirus pandemic only adds to the caregiver’s burden, she notes. “The pandemic is adversely affecting family caregivers because of social isolation, and also because resources have been canceled or now have limited access,” Ms. Harris said. “Many caregivers have said they already felt socially isolated and that the pandemic has just amplified those feelings.”

For the study, published in the Journal of Applied Gerontology, the researchers divided 16,650 older men and women into three groups. Some had a spouse or partner who had been diagnosed with Alzheimer’s disease in the previous two years. Others had been caring for a spouse with Alzheimer’s for at least two years, and often for many years. The others were not caring for a loved one with Alzheimer’s.

They tracked participants not just for a diagnosis of major depression, but also for symptoms of milder depression. The stress of caring for someone with dementia can be particularly overwhelming for someone with symptoms of even mild depression, jeopardizing the health of both patients and caregivers.

Such symptoms can include irritability, restlessness or anger; feelings of hopelessness, guilt, worthlessness or despair; a loss of interest in activities you previously enjoyed; difficulty thinking or concentrating; pulling away from social interactions; lack of motivation and energy; bodily aches and pains; poor sleep; changes in weight or eating habits; or turning to alcohol or drugs.

The older adults who were not caring for a partner with dementia had, on average, 1.2 of such symptoms. Those who had been caring for a partner with Alzheimer’s in the past two years had, on average, a 27 percent increase in symptoms. Those who had been caring for a loved one with dementia had a 33 percent increase in depressive symptoms.

“This may not seem like a huge increase in depressive symptoms, but think about feeling depressed or feeling restless every day,” Ms. Harris said. “That can mean a lot in the life of a caregiver.”

An increase in depressive symptoms is tied to an increased risk of other health problems. Earlier research the group had done found that it was also tied to a 30 percent increased risk that the caregiver would suffer a disabling fall. “We know that falls are another common debilitating outcome for this group, so the change in depressive symptoms we saw could also imply changes in a caregiver’s physical and functional health,” Ms. Harris said.

“Caregivers should remember that their health is just as important as their partner’s and substantially impacts the health of the person with dementia” she said. Depression can be effectively treated with medications, therapy and support, and the earlier treatment begins, the earlier you’ll feel better.

Counseling and support services can be very helpful for easing stress in anyone caring for a loved one with Alzheimer’s. Such support may also boost physical health in caregivers and help keep people with Alzheimer’s out of nursing homes, a costly and emotionally wrenching decision.

By ALZinfo.org, The Alzheimer’s Information Site. Reviewed by Marc Flajolet, Ph.D., Fisher Center for Alzheimer’s Research Foundation at The Rockefeller University.

Source: Melissa L. Harris, Marita G. Titler, Geoffrey J. Hoffman, et al: “Associations Between Alzheimer’s Disease and Related Dementias and Depressive Symptoms of Partner Caregivers.” Journal of Applied Gerontology, August 29, 2020

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