The Mental Health Toll of Alzheimer’s Caregiving

November 2, 2022

People who care for a loved one with Alzheimer’s disease are at high risk of developing symptoms of depression that worsen over time, according to a new report. Worsening depression was particularly common among women who cared for a spouse with Alzheimer’s disease.

But anyone who cares for a family member with Alzheimer’s is at high risk of developing symptoms of depression, the study found. In more than half of Alzheimer’s caregivers, mild symptoms of depression are present even before a formal diagnosis of dementia is made.

The findings underscore the toll that caregiving can take on the mental health of family members who care for a spouse, parent or other close relative with Alzheimer’s disease. Alzheimer’s disease is an illness that affects the entire family for prolonged periods, and it is important for caregivers to recognize that the sustained stress of caregiving puts them at increased risk of depression and other health ills over the multi-year course of the disease.

“About one third of family caregivers experience persistent depression when giving family care,” said study author Tarja Valimaki, from the department of nursing science at the University of Eastern Finland. “Assessment and continuous monitoring of family caregivers’ health and well-being should be included in the treatment of memory disorders.”

For the study, published in the journal Clinical Gerontologist, researchers looked at 226 men and women who had been diagnosed with Alzheimer’s disease, along with family members who cared for them, over a five-year period. Family caregivers underwent mental health assessments at the start of the study and at regular intervals after, with researchers focusing on signs of depression and general coping skills. The researchers asked caregivers about such matters as their ability to carry out daily activities, their social functioning, and new sources of distress or concern in their lives.

The researchers found that about 60 percent of caregivers had symptoms of mild depression at the start of the study. In about a third of caregivers, symptoms worsened over the following five years of care. The risk of depression was higher in women than men, and in those who cared for a loved one with behavioral symptoms like aggression, agitation, wandering, hallucinations or poor sleep. Symptoms of depression were particularly pronounced beginning three years after a diagnosis of Alzheimer’s disease. Symptoms of depression eased in fewer than 10 percent of the caregivers studied.

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 stress of caregiving can also increase the risk of heart ailments, falls that may result in broken bones, and other physical ills.

Experts say that it is important for caregivers to seek help early on, and to recognize that their own health affects the care that their partners receive. 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 difficult decision.

A growing number of health and community centers also now offer mindfulness and guided imagery classes, which research suggests may also be helpful for mitigating the stress of caregiving. Such classes may also provide social interaction that can help to counter the forced isolation that comes with caregiving.

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: Tarja Valimaki, PhD; Anne M. Koivisto, PhD, MD; Tumoas Selander, MSc; et al; “Different Trajectories of Depressive Symptoms in Alzheimer’s Disease Caregivers – 5-year follow-up.” Clinical Gerontologist, September 4, 2022


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