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Caregiver Health: Health of Caregivers of Alzheimer’s and Other Dementia Patients

  • Geriatric Disorders (H Lavretsky, Section Editor)
  • Published:
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Abstract

Alzheimer’s disease (AD) is the most common type of dementia and is a significant public health problem that will intensify as the population ages. The behavioral and psychological symptoms of dementia (BPSD) present a significant burden to patients, their families, and their caregivers. The majority of care is provided at home by family caregivers. Caring for a person with AD and other dementias is associated with significant risk to the caregiver’s health and well-being. Healthcare providers must recognize that family caregivers often present as secondary patients. Given the importance of these caregivers to patients with AD and other dementias, it is vital to understand the risk factors that impact caregiver health and well-being. Non-pharmacological interventions can reduce the negative impact of caregiver burden on caregiver health, reduce premature institutionalization of patients, and improve quality of life for patients, their families, and their caregivers. This article summarizes recent relevant research concerning AD and dementia caregiver health and psychosocial interventions.

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References

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  1. Herbert LE, Weuve J, Scherr PA, Evens DA. Alzheimer disease in the United States (2010–2050) estimated using the 2010 census. Neurology. 2013. doi:10.1212/WNL.0b013e31828726f5.

    Google Scholar 

  2. Prince M, Bryce R, Albanese E, et al. The global prevalence of dementia: a systematic review and metaanalysis. Alzheimers Dement. 2013;9(1):63–75.

    Article  PubMed  Google Scholar 

  3. • Alzheimer's Association. 2012 Alzheimer's disease facts and figures. Alzheimers Dement. 2012;8(2):131–68. This reference provides the latest and most comprehensive statistics on prevalence of Alzheimers disease.

    Article  Google Scholar 

  4. Bouldin E, Andresen E. Caregiving across the United States: caregivers of persons with Alzheimer’s disease or dementia in Illinois, Louisiana, Ohio and the District of Columbia. Florida Office on Disability and Health, University of Florida-Gainesville. 2009. http://act.alz.org/site/DocServer/BRFSS_Caregiver_Report.pdf?docID=2201. Accessed 02 Feb 2013.

  5. Giovannetti ER, Wolff JL. Cross-survey differences in national estimates of numbers of caregivers of disabled older adults. Milbank Q. 2010;88(3):310–49.

    Article  PubMed  Google Scholar 

  6. MetLife Mature Market Institute. The Metlife study of Alzheimer’s disease: the caregiving experience. 2006. https://www.metlife.com/assets/cao/mmi/publications/studies/mmi-alzheimers-disease-caregiving-experience-study.pdf. Accessed 02 Feb 2013.

  7. Nikzad-Terhune KA, Anderson KA, Newcomer R, Gaugler JE. Do trajectories of at-home dementia caregiving account for burden after nursing home placement? A growth curve analysis. Soc Work Health Care. 2010;49(8):734–52.

    Article  PubMed  Google Scholar 

  8. Werner S, Auslander GK, Shoval N, et al. Caregiving burden and out-of-home mobility of cognitively impaired care-recipients based on GPS tracking. Int Psychogeriatr. 2012;24(11):1836–45.

    Article  PubMed  Google Scholar 

  9. Ankri J, Andrieu S, Beaufils B, et al. Beyond the global score of the Zarit Burden Interview: useful dimensions for clinicians. Int J Geriatr Psychiatry. 2005;20(3):254–60.

    Article  PubMed  Google Scholar 

  10. Savundranayagam MY, Montgomery RJ, Kosloski K. A dimensional analysis of caregiver burden among spouses and adult children. Gerontologist. 2011;51(3):321–31.

    Article  PubMed  Google Scholar 

  11. Werner P, Mittelman MS, Goldstein D, Heinik J. Family stigma and caregiver burden in Alzheimer’s disease. Gerontologist. 2012;52(1):89–97.

    Article  PubMed  Google Scholar 

  12. Quinn C, Clare L, McGuinness T, Woods RT. The impact of relationships, motivations, and meanings on dementia caregiving outcomes. Int Psychogeriatr. 2012;24(11):1816–26.

    Article  PubMed  Google Scholar 

  13. Shahly V, Chatterji S, Gruber MJ, et al. Cross-national differences in the prevalence and correlates of burden among older family caregivers in the World Health Organization World Mental Health (WMH) Surveys. Psychol Med. 2013;43(4):865–79.

    Article  PubMed  CAS  Google Scholar 

  14. Lautenschlager NT, Kurz AF, Loi S, Cramer B. Personality of mental health caregivers. Curr Opin Psychiatry. 2013;26(1):97–101.

    Article  PubMed  Google Scholar 

  15. Wolfs CA, Kessels A, Severens JL, et al. Predictive factors for the objective burden of informal care in people with dementia: a systematic review. Alzheimer Dis Assoc Disord. 2012;26(3):197–204.

    Article  PubMed  Google Scholar 

  16. Mohamed S, Rosenheck R, Lyketsos CG, Schneider LS. Caregiver burden in Alzheimer disease: cross-sectional and longitudinal patient correlates. Am J Geriatr Psychiatry. 2010;18(10):917–27.

    Article  PubMed  Google Scholar 

  17. Zarit SH, Reever KE, Bach-Peterson J. Relatives of the impaired elderly: correlates of feelings of burden. Gerontologist. 1980;20(6):649–55.

    Article  PubMed  CAS  Google Scholar 

  18. Bédard M, Molloy DW, Squire L, et al. The zarit burden interview: a new short version and screening version. Gerontologist. 2001;41(5):652–7.

    Article  PubMed  Google Scholar 

  19. Flynn Longmire CV, Knight BG. Confirmatory factor analysis of a brief version of the Zarit Burden Interview in Black and White dementia caregivers. Gerontologist. 2011;51(4):453–62.

    Article  PubMed  Google Scholar 

  20. Knight B, Fox L, Chou C-P. Factor structure of the burden interview. J Clin Geropsychol. 2000;6(4):249–58.

    Article  Google Scholar 

  21. Montgomery RJ, Borgatta EF, Borgatta ML. Societal and family change in the burden of care. In: Liu W, Kendig H, editors. Who should care for the elderly? An east–west value divide. NJ: World Scientific: River Edge; 2000. p. 27–54.

    Chapter  Google Scholar 

  22. Berg-Weger M, Rubio DM, Tebb SS. The caregiver well-being scale revisited. Health Soc Work. 2000;25(4):255–63.

    Article  PubMed  CAS  Google Scholar 

  23. Tebb S. An aid to empowerment: a caregiver well-being scale. Health Soc Work. 1995;20(2):87–92.

    PubMed  CAS  Google Scholar 

  24. Tebb SS, Berg-Weger M, Rubio DM. The caregiver well-being scale: developing a short-form rapid assessment instrument. Health Soc Work. 2013, In Press.

  25. Pinquart M, Sorensen S. Correlates of physical health of informal caregivers: a meta-analysis. J Gerontol B Psychol Sci Soc Sci. 2007;62(2):126–37.

    Article  Google Scholar 

  26. von Kanel R, Mills PJ, Mausbach BT, et al. Effect of Alzheimer caregiving on circulating levels of C-reactive protein and other biomarkers relevant to cardiovascular disease risk: a longitudinal study. Gerontology. 2012;58(4):354–65.

    Article  Google Scholar 

  27. Gouin JP, Glaser R, Malarkey WB, et al. Chronic stress, daily stressors, and circulating inflammatory markers. Health Psychol. 2012;31(2):264–8.

    Article  PubMed  Google Scholar 

  28. Vitaliano PP, Murphy M, Young HM, et al. Does caring for a spouse with dementia promote cognitive decline? A hypothesis and proposed mechanisms. J Am Geriatr Soc. 2011;59(5):900–8.

    Article  PubMed  Google Scholar 

  29. Löckenhoff CE, Duberstein PR, Friedman B, Costa Jr PT. Five-factor personality traits and subjective health among caregivers: the role of caregiver strain and self-efficacy. Psychol Aging. 2011;26(3):592–604.

    Article  PubMed  Google Scholar 

  30. Riffin C, Lockenhoff CE, Pillemer K, et al. Care recipient agreeableness is associated with caregiver subjective physical health status. J Gerontol B Psychol Sci Soc Sci. 2012. doi:10.1093/geronb/gbs114.

    PubMed  Google Scholar 

  31. Roepke SK, Mausbach BT, Patterson TL, et al. Effects of Alzheimer caregiving on allostatic load. J Health Psychol. 2011;16(1):58–69.

    Article  PubMed  Google Scholar 

  32. Vitaliano PP, Zhang J, Scanlan JM. Is caregiving hazardous to one’s physical health? A meta-analysis. Psychol Bull. 2003;129(6):946–72.

    Article  PubMed  Google Scholar 

  33. Mausbach BT, Roepke SK, Ziegler MG, et al. Association between chronic caregiving stress and impaired endothelial function in the elderly. J Am Coll Cardiol. 2010;55(23):2599–606.

    Article  PubMed  Google Scholar 

  34. Schulz R, Beach SR. Caregiving as a risk factor for mortality: the caregiver health effects study. JAMA. 1999;282(23):2215–9.

    Article  PubMed  CAS  Google Scholar 

  35. Christakis NA, Allison PD. Mortality after the hospitalization of a spouse. N Engl J Med. 2006;354(7):719–30.

    Article  PubMed  CAS  Google Scholar 

  36. Fredman L, Cauley JA, Hochberg M, et al. Mortality associated with caregiving, general stress, and caregiving-related stress in elderly women: results of caregiver-study of osteoporotic fractures. J Am Geriatr Soc. 2010;58(5):937–43.

    Article  PubMed  Google Scholar 

  37. Rahrig Jenkins K, Kabeto MU, Langa KM. Does caring for your spouse harm one’s health? Evidence from a United States nationally-representative sample of older adults. Age Soc. 2009;29(02):277.

    Article  Google Scholar 

  38. O’Reilly D, Connolly S, Rosato M, Patterson C. Is caring associated with an increased risk of mortality? A longitudinal study. Soc Sci Med. 2008;67(8):1282–90.

    Article  PubMed  Google Scholar 

  39. Brown SL, Smith DM, Schulz R, et al. Caregiving behavior is associated with decreased mortality risk. Psych Sci. 2009;20(4):488–94.

    Article  Google Scholar 

  40. Perkins M, Howard VJ, Wadley VG, et al. Caregiving strain and all-cause mortality: evidence from the REGARDS study. J Gerontol B Psychol Sci Soc Sci. 2012. doi:10.1093/geronb/gbs084.

    Google Scholar 

  41. Joling KJ, van Hout HPJ, Schellevis FG, et al. Incidence of depression and anxiety in the spouses of patients with dmentia: a naturalistic cohort study of recorded morbidity with a 6-year follow-up. Am J Geriatr Psychiatry. 2010;18(2):146–53.

    Article  PubMed  Google Scholar 

  42. Wimo A, Jonsson L, Bond J, et al. The worldwide economic impact of dementia 2010. Alzheimers Dement. 2013;9(1):1–11.

    Article  PubMed  Google Scholar 

  43. Joling KJ, Smit F, van Marwijk HW, et al. Identifying target groups for the prevention of depression among caregivers of dementia patients. Int Psychogeriatr. 2012;24(2):298–306.

    Article  PubMed  Google Scholar 

  44. Epstein-Lubow G, Gaudiano B, Darling E, et al. Differences in depression severity in family caregivers of hospitalized individuals with dementia and family caregivers of outpatients with dementia. Am J Geriatr Psychiatry. 2012;20(9):815–9.

    Article  PubMed  Google Scholar 

  45. Romero-Moreno R, Marquez-Gonzalez M, Mausbach BT, Losada A. Variables modulating depression in dementia caregivers: a longitudinal study. Int Psychogeriatr. 2012;24(8):1316–24.

    Article  PubMed  CAS  Google Scholar 

  46. Lopez J, Romero-Moreno R, Marquez-Gonzalez M, Losada A. Spirituality and self-efficacy in dementia family caregiving: trust in God and in yourself. Int Psychogeriatr. 2012;24(12):1943–52.

    Article  PubMed  CAS  Google Scholar 

  47. Norton MC, Smith KR, Ostbye T, et al. Greater risk of dementia when spouse has dementia? The Cache County study. J Am Geriatr Soc. 2010;58(5):895–900.

    Article  PubMed  Google Scholar 

  48. Oken BS, Fonareva I, Wahbeh H. Stress-related cognitive dysfunction in dementia caregivers. J Geriatr Psychiatry Neurol. 2011;24(4):191–8.

    Article  PubMed  Google Scholar 

  49. Cupidi C, Realmuto S, Lo Coco G, et al. Sleep quality in caregivers of patients with Alzheimer’s disease and Parkinson’s disease and its relationship to quality of life. Int Psychogeriatr. 2012;24(11):1827–35.

    Article  PubMed  Google Scholar 

  50. von Känel R, Mausbach BT, Ancoli-Israel S, et al. Sleep in spousal Alzheimer caregivers: a longitudinal study with a focus on the effects of major patient transitions on sleep. Sleep. 2012;35(2):247–55.

    Google Scholar 

  51. von Kanel R, Ancoli-Israel S, Dimsdale JE, et al. Sleep and biomarkers of atherosclerosis in elderly Alzheimer caregivers and controls. Gerontology. 2010;56(1):41–50.

    Article  Google Scholar 

  52. Gaugler JE, Mittelman MS, Hepburn K, Newcomer R. Clinically significant changes in burden and depression among dementia caregivers following nursing home admission. BMC Med. 2010;8(1):85.

    Article  PubMed  Google Scholar 

  53. Smit D, te Boekhorst S, de Lange J, et al. The long-term effect of group living homes versus regular nursing homes for people with dementia on psychological distress of informal caregivers. Aging Ment Health. 2011;15(5):557–61.

    Article  PubMed  Google Scholar 

  54. Givens JL, Lopez RP, Mazor KM, Mitchell SL. Sources of stress for family members of nursing home residents with advanced dementia. Alzheimer Dis Assoc Disord. 2012;26(3):254–9.

    Article  PubMed  Google Scholar 

  55. McLennon SM, Habermann B, Rice M. Finding meaning as a mediator of burden on the health of caregivers of spouses with dementia. Aging Ment Health. 2011;15(4):522–30.

    Article  PubMed  Google Scholar 

  56. Sörensen S, Pinquart M, Duberstein D. How effective are interventions with caregivers? An updated meta-analysis. Gerontologist. 2002;42(3):356–72.

    Article  PubMed  Google Scholar 

  57. Schulz R, O’Brien A, Czaja S, et al. Dementia caregiver intervention research: in search of clinical significance. Gerontologist. 2002;42(5):589–602.

    Article  PubMed  Google Scholar 

  58. Gallagher-Thompson D, Coon DW. Evidence-based psychological treatments for distress in family caregivers of older adults. Psychol Aging. 2007;22(1):37–51.

    Article  PubMed  Google Scholar 

  59. •• Elvish R, Lever S-J, Johnstone J, et al. Psychological interventions for carers of people with dementia: A systematic review of quantitative and qualitative evidence. Counsell Psychother Res. 2012. doi:10.1080/14733145.2012.739632:1–20. Excellent review of the most recent literature on the efficacy of psychosocial interventions for dementia caregivers.

    Google Scholar 

  60. Parker D, Mills S, Abbey J. Effectiveness of interventions that assist caregivers to support people with dementia living in the community: a systematic review. Int J Evid Based Healthc. 2008;6(2):137–72.

    Article  PubMed  Google Scholar 

  61. Savundranayagam MY, Montgomery RJ, Kosloski K, Little TD. Impact of a psychoeducational program on three types of caregiver burden among spouses. Int J Geriatr Psychiatry. 2011;26(4):388–96.

    Article  PubMed  Google Scholar 

  62. Hayden LJ, Glynn SM, Hahn TJ, et al. The use of Internet technology for psychoeducation and support with dementia caregivers. Psychol Serv. 2012;9(2):215–8.

    Article  PubMed  Google Scholar 

  63. Marriott A, Donaldson C, Tarrier N, Burns A. Effectiveness of cognitive-behavioural family intervention in reducing the burden of care in carers of patients with Alzheimer’s disease. Br J Psychiatry. 2000;176(6):557–62.

    Article  PubMed  CAS  Google Scholar 

  64. Akkerman RL, Ostwald SK. Reducing anxiety in Alzheimer’s disease family caregivers: the effectiveness of a nine-week cognitive-behavioral intervention. Am J Alzheimers Dis Other Demen. 2004;19(2):117–23.

    Article  PubMed  Google Scholar 

  65. Glueckauf RL, Davis WS, Willis F, et al. Telephone-based, cognitive-behavioral therapy for African American dementia caregivers with depression: initial findings. Rehabil Psychol. 2012;57(2):124–39.

    Article  PubMed  Google Scholar 

  66. • Napoles AM, Chadiha L, Eversley R, Moreno-John G. Reviews: developing culturally sensitive dementia caregiver interventions: are we there yet? Am J Alzheimers Dis Other Demen. 2010;25(5):389–406. An excellent review of the liturature on culturally sensitive dementia caregiver interventions.

    Article  PubMed  Google Scholar 

  67. Olazaran J, Reisberg B, Clare L, et al. Nonpharmacological therapies in Alzheimer’s disease: a systematic review of efficacy. Dement Geriatr Cogn Disord. 2010;30(2):161–78.

    Article  PubMed  Google Scholar 

  68. Whitebird RR, Kreitzer M, Crain AL, et al. Mindfulness-based stress reduction for family caregivers: a randomized controlled trial. Gerontologist. 2012. doi:10.1093/geront/gns126.

    PubMed  Google Scholar 

  69. Lavretsky H, Epel ES, Siddarth P, et al. A pilot study of yogic meditation for family dementia caregivers with depressive symptoms: effects on mental health, cognition, and telomerase activity. Int J Geriatr Psychiatry. 2013;28(1):57–65.

    Article  PubMed  CAS  Google Scholar 

  70. Mittelman MS, Brodaty H, Wallen AS, Burns A. A three-country randomized controlled trial of a psychosocial intervention for caregivers combined with pharmacological treatment for patients with Alzheimer’s disease: effects on caregiver depression. Am J Geriatr Psychiatry. 2008;16(11):893–904.

    Article  PubMed  Google Scholar 

  71. Lavretsky H, Siddarth P, Irwin MR. Improving depression and enhancing resilience in family dementia caregivers: a pilot randomized placebo-controlled trial of escitalopram. Am J Geriatr Psychiatry. 2010;18(2):154.

    Article  PubMed  Google Scholar 

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Conflict of Interest

Todd J. Richardson declares that he has no conflict of interest.

Soo J. Lee declares that he has no conflict of interest.

Marla Berg-Weger declares that she has no conflict of interest.

George T. Grossberg declares that he has no conflict of interest.

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Correspondence to Todd J. Richardson.

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This article is part of Topical Collection on Geriatric Disorders

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Richardson, T.J., Lee, S.J., Berg-Weger, M. et al. Caregiver Health: Health of Caregivers of Alzheimer’s and Other Dementia Patients. Curr Psychiatry Rep 15, 367 (2013). https://doi.org/10.1007/s11920-013-0367-2

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