Objective: In the course of Alzheimer's disease, the patient becomes increasingly dependent on a caregiver. This not seldom leads to psychological distress in caregivers, some of them seeking psychiatric help. The aim of this study was to evaluate depression and anxiety symptoms as well as caregiver burden in caregivers of patients with Alzheimer's disease. Treatment and monitoring, have beeen carried out both for patients and caregivers.
Design: Thirteen patients of the Dementia Outpatient Unit at the Department of Psychiatry of Uludag University and their 13 caregivers were included in the study.
Materials and Methods: Thirteen patients and their caregivers were included in the study, unfortunately only 8 of them could continue to the thirth treatment. The patient group consisted of 13 patients (5 female, 8 male), with a mean age of 72.6±8.82 years. Mean age of females and males was 72±11.97 years and 73±7.15 years respectively. The caregiver group consisted of 13 caregivers (female=12, male=1)with a mean age of 58±12.1, mean age of females was 57±12.6 and the only one male caregiver was 70 years of age. Caregiver group was categorized into 3 subgroups according to their relationship to the patients; Spouses (n:7, %57 ), children (n:3, %23), and daughters-in-law (n:3, %23). The mean total caregiving duration was 42.6±33.7 months and the mean daily caregiving duration was 12.6±4.8 hours per day. Sociodemographic characteristics of the patients and their caregivers were questioned. Global Deterioration Scale (GDS), Standardized Mini Mental State Examination (S-MMSE) were administered to the patients. Behavioral pathology in Alzheimer’s Disease Frequency Weighted Scale (BEHAVE-AD-FW), Zarit’s Burden Interview (BI), Hamilton Depression Scale (HAM-D), Mongomery and Asberg Depression Rating Scale (MADRS), and Hamilton Anxiety Assesment Scale (HAM-A) were performed to their caregivers. Patients and caregivers were followed up with one by one interviews at two months intervals for a period of six months. During this period, Alzheimer patients received cognitive enhancing therapy, while to the caregivers antidepressant and/or anxiolytic therapy was administered.
Results: The Hamilton anxiety and depression scores of caregivers decreased significantly with therapy. The treatment of anxiety and depression semptoms in caregivers also lead to a decrease in perceived caregiver burden, but this reduction did not reach statistical significance. Evaluation of the disease process in the patients with Alzheimer's Disease showed further increase of symptomatology, as would be expected from the chronicity of the disease.
Conclusion: This study shows that therapy of anxiety and depression in caregivers of patients with Alzheimer's diseases leads to an increase of their tolerance towards the burden of caregiving. It could also be observed that this reduction in perceived burden of the caregivers had a beneficial effect on the therapy process of their respective patients.
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