March 20, 2016
Spouses and other family members who care for a loved one with Alzheimer’s disease should be screened for depression, a new study suggests. The study found that 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.
As part of an ongoing study at the University of Eastern Finland, researchers looked at 236 men and women who had been diagnosed with Alzheimer’s disease, along with family members who cared for them, over a three-year period. At the start of the study, those with Alzheimer’s were in the earliest stages of the disease, with mild or very mild symptoms; 166 were being cared for primarily by a spouse, while the remaining 70 were being cared for by others.
Family caregivers underwent mental health assessments at the start of the study and at regular intervals after, with researchers looking for signs of depression and general coping skills. The researchers asked caregivers about such matters as their ability carry out daily activities, their social functioning, and new sources of distress or concern in their lives.
Signs of depression include feelings of hopelessness, a loss of interest in social activities or hobbies, changes in appetite and poor sleep. Other symptoms include loss of energy, anger or irritability, and poor concentration.
The researchers found that caregivers who were even mildly depressed at the start of the study experienced the greatest stress levels over the next few years, regardless of how rapidly Alzheimer’s progressed in a loved one. “The occurrence of even mild depressive symptoms predicted a psychological load on the family caregiver irrespective of, for example, the progression of the disease,” said Tarja Valimaki, of the university’s Department of Nursing Science and the lead author of the study.
The researchers also found that compared to other family members, spouses who cared for a loved one with Alzheimer’s were particularly prone to the consequences of depression. Stress levels were higher at the start of the study, and remained high through the years that followed.
The authors suggest that it would be useful for nurses or other professionals involved in a family’s Alzheimer’s care to ask about depression or other sources of stress. “A depression inquiry would make it possible to recognize family caregivers who need enhanced support,” the authors note. “It is not reasonable for spousal caregivers to put their own health at risk due to the caregiving.”
The findings, published in the Journal of Geriatric Psychiatry and Neurology, highlight the importance of considering the mental well-being of anyone caring for someone with Alzheimer’s. Other research has found that up to half of Alzheimer’s caregivers experience symptoms of depression and emotional distress. Caregivers are also at increased risk of heart disease and other life-threatening ailments.
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.
Source: Välimäki TH, Martikainen JA, Hallikainen IT, et al: “Depressed Spousal Caregivers Have Psychological Stress Unrelated to the Progression of Alzheimer Disease: A 3-Year Follow-Up Report, Kuopio ALSOVA Study.” Journal of Geriatric Psychiatry and Neurology. August 6, 2015 (epub ahead of print)