Objective: The majority of people with Alzheimer's Disease (~80%) live at home and are cared for by family members. Currently about 3 million caregivers in the United States are providing care for a family member with AD. It is well recognized that caring for an AD patient places considerable physical, economic, and emotional demands on families and these demands increase as the disease progresses. Prevalence rates of self-reported depression among community dwelling caregivers range from 30% to 83% and caregivers use drugs for depression about 2-3 times as often as the rest of the population. The objectives of this paper are to review the incidence of depression among family caregivers of patients with Alzheimer's Disease; describe known risk factors for caregiver depression and discuss the efficacy of current intervention approaches in reducing depression. Data will be presented from the Miami site of the Resources for Enhancing Alzheimer's Caregiver Health (REACH) program.
Design: Two hundred and twenty five White American and Cuban American caregivers were randomized into a minimal support control (MSC); family therapy condition (SET), or the family therapy augmented by computer integrated telephone system (SET + CTIS) condition. Caregivers were administered the REACH core battery of measures at baseline, six months, 12 months, and 18 months. The core battery included measures of caregiver and care recipient health, service utilization, depression (CESD), anxiety, social support, functional status and medication use.
Results: The data indicated that 64% of the caregivers were at risk for depression (CESD >15) at baseline and that depression was highest among Cuban American wives and daughters. Caregiver health and satisfaction with social support were also significant predictors of depression. The use of anti-depressant medication was fairly low among the caregivers. At the six month follow-up husband caregivers had lower mean depression scores than wives or daughters and depression was highest among Cuban American wives and daughters. However, the data also indicated that Caregivers in the combined family therapy and technology intervention experienced a significant redution in depressive symptoms at 6 months (p<.05). The 18 month follow-up data indicated that the invention was particularly beneficial for Cuban American husbands and daughter caregivers (P<..01).
Conclusions: Depression is common among caregivers of AD patients and the incidence of depression varies according to caregiver characteristics such as relationship to the care recipient, ethnicity and health. However, interventions that include information technology have a promising role in alleviating distress and depression among groups of AD caregivers.
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