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Anxiety and depression are associated with coping strategies in caregivers of Alzheimer's disease patients: results from the MÁLAGA-AD study

Published online by Cambridge University Press:  16 February 2012

José María García-Alberca ,
Belén Cruz ,
José Pablo Lara ,
Victoria Garrido ,
Almudena Lara  and
Esther Gris
José María García-Alberca*
Affiliation:
Memory and Alzheimer's Disease Unit, Instituto Andaluz de Neurociencia y Conducta, Málaga, Spain Cognitive Neurophysiology Unit, Centro de Investigaciones Médico-Sanitarias, University of Málaga, Málaga, Spain
Belén Cruz
Affiliation:
Memory and Alzheimer's Disease Unit, Instituto Andaluz de Neurociencia y Conducta, Málaga, Spain
José Pablo Lara
Affiliation:
Cognitive Neurophysiology Unit, Centro de Investigaciones Médico-Sanitarias, University of Málaga, Málaga, Spain
Victoria Garrido
Affiliation:
Memory and Alzheimer's Disease Unit, Instituto Andaluz de Neurociencia y Conducta, Málaga, Spain
Almudena Lara
Affiliation:
Asociación Criptana de Enfermos de Alzheimer, Campo de Criptana, Spain
Esther Gris
Affiliation:
Memory and Alzheimer's Disease Unit, Instituto Andaluz de Neurociencia y Conducta, Málaga, Spain
*
Correspondence should be addressed to: José María García-Alberca, Instituto Andaluz de Neurociencia y Conducta, Alamos, 17. 29012, Malaga, Spain. Phone: +34 952 13 75 46; Fax: + 34 952 21 20 22. Email: jmgalberca@ianec.com.
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Abstract

Background: Caregiving for people with Alzheimer's disease (AD) is highly stressful and has significant negative consequences, such as anxiety and depression. Previous research offers conflicting findings as to whether coping strategies are associated with greater psychological distress or not. We conducted this study with a view to obtaining new data regarding the association of coping strategies and psychological distress in AD caregivers.

Methods: Eighty people with AD and their primary caregivers living in the community were recruited from local health services. Purposive recruitment was carried out to ensure that the sample was representative of people living with dementia in terms of dementia severity, gender, and care setting. We used the State-Trait Anxiety Inventory to measure anxiety, the Beck Depression Inventory to measure depression, and the Coping Strategies Inventory to measure coping strategies.

Results: Most caregivers reported higher anxiety and depression levels. Use of disengagement coping strategies (Wald = 3.35, p = 0.01) and higher caregiver burden (Wald = 4.83, p = 0.02) predicted anxiety on logistic regression. In turn, use of disengagement coping strategies (Wald = 12.48, p = 0.001) and higher caregiver burden (Wald = 6.91, p = 0.009) predicted depression on logistic regression.

Conclusion: These results may be useful for designing treatment interventions that aim to modify the use of coping strategies and thus reduces caregiver anxiety and depression.

Keywords

Alzheimer's diseasecopinganxietydepressioncaregiver burden
Type
Research Article
Information
International Psychogeriatrics , Volume 24 , Special Issue 8: Focus on late life depression , August 2012 , pp. 1325 - 1334
Copyright
Copyright © International Psychogeriatric Association 2012

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References

Almberg, B., Jansson, W., Grafstrom, M. and Winblad, B. (1998). Differences between and within genders in caregiving strain: a comparison between caregivers of demented and non-caregivers of non-demented elderly people. Journal of Advanced Nursing, 28, 840–858.CrossRefGoogle Scholar
Beck, A. T., Steer, R. A. and Garbin, M. G. (1988). Psychometrics properties of the Beck's Depression Inventory. Twenty-five years of evaluation. Clinical Psychology Review, 8, 77–100.CrossRefGoogle Scholar
Blesa, R., Pujol, M., Aguilar, M., Santacruz, P., Bertrán-Serra, A. and Hernández, G. (2001). Clinical validity of the “Mini-Mental State” for Spanish speaking communities. Neuropsychologia, 39, 1150–1157.CrossRefGoogle ScholarPubMed
Cano-García, F. J., Rodríguez-Franco, L. and García-Martínez, J. (2007). Spanish version of the Coping Strategies Inventory. Actas Españolas de Psiquiatría, 35, 29–39.Google ScholarPubMed
Conde, C. and Useros, E. (1975). Spanish version of the Beck Depression Inventory. Revista de Psiquiatría y Psicología Médica de Europa y América Latina, 12, 217–236.Google Scholar
Cooper, C., Katona, C., Orrell, M. and Livingston, G. (2006). Coping strategies and anxiety in caregivers of people with Alzheimer's disease: the LASER-AD study. Journal of Affective Disorders, 90, 15–20.CrossRefGoogle ScholarPubMed
Cooper, C., Katona, C., Orrell, M. and Livingston, G. (2008). Coping strategies, anxiety and depression in caregivers of people with Alzheimer's disease. International Journal of Geriatric Psychiatry, 23, 929–936.CrossRefGoogle ScholarPubMed
Covinsky, K. H. et al. . (2003). Patient and caregiver characteristics associated with depression in caregivers of patients with dementia. Journal of General Internal Medicine, 18, 1006–1014.CrossRefGoogle ScholarPubMed
Crespo, M., Lopez, J. and Zarit, S. H. (2005). Depression and anxiety in primary caregivers: a comparative study of caregivers of demented and nondemented older persons. International Journal of Geriatric Psychiatry, 20, 591–592.CrossRefGoogle ScholarPubMed
Cummings, J. L., Mega, M., Gray, K., Rosenberg-Thompson, S., Carusi, D. A. and Gornbein, J. (1994). The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology, 44, 2308–2314.CrossRefGoogle ScholarPubMed
Di Mattei, V. E., Prunas, A., Novella, L., Marcone, A., Cappa, S. F. and Sarno, L. (2008). The burden of distress in caregivers of elderly demented patients and its relationship with coping strategies. Neurological Sciences, 29, 383–389.CrossRefGoogle ScholarPubMed
Domenech, J. M. (1999). Statistics for Health Sciences. Barcelona: Signo.Google Scholar
Erzigkeit, H., Lehfeld, H., Peña-Casanova, J., Bieber, F., Yekrangi-Hartmann, C. and Rupp, M. (2001). The Bayer-Activities of Daily Living Scale (B-ADL): results from a validation study in three European countries. Dementia and Geriatric Cognitive Disorders, 12, 348–358.CrossRefGoogle ScholarPubMed
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-Mental State”: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.CrossRefGoogle ScholarPubMed
Gallicchio, L., Siddiqi, N., Langenberg, P. and Baumgarten, M. (2002). Gender differences in burden and depression among informal caregivers of demented elders in the community. International Journal of Geriatric Psychiatry, 17, 154–163.CrossRefGoogle ScholarPubMed
García-Alberca, J. M., Lara, J. P. and Berthier, M. L. (2011). Anxiety and depression in caregivers are associated with patients’ and caregivers’ characteristics in Alzheimer's disease. International Journal of Psychiatry in Medicine, 41, 57–69.CrossRefGoogle ScholarPubMed
Gelmini, G., Morabito, B. and Braidi, G. (2009). Educational and formative training reduce stress in the caregivers of demented patients. Archives of Gerontology and Geriatrics, 49 (Suppl. 1), 119–124.CrossRefGoogle ScholarPubMed
Jones, F. and Bright, J. (2001). Stress: Myth, Theory and Research. Edinburgh Gate: Prentice Hall.Google Scholar
Hindmarch, I., Lehfeld, H., De Jong, P. and Erzigkeit, H. (1998). The Bayer Activities of Daily Living Scale (B-ADL). Dementia and Geriatric Cognitive Disorders, 9 (Suppl. 2), 20–26.CrossRefGoogle ScholarPubMed
Kendall, P. C., Hollon, S. D., Beck, A. T., Hammen, C. L. and Ingram, R. E. (1987). Issues and recommendations regarding use of the Beck Depression Inventory. Cognitive Therapy and Research, 11, 289–299.CrossRefGoogle Scholar
Kneebone, I. I. and Martin, P. R. (2003). Coping and caregivers of people with dementia. British Journal of Health Psychology, 8, 1–17.CrossRefGoogle ScholarPubMed
Kuzu, N. et al. (2005). Effects of a comprehensive educational program on quality of life and emotional issues of dementia patient caregivers. Geriatric Nursing, 26, 378–386.CrossRefGoogle ScholarPubMed
Lazarus, R. S. (1999). Stress and Emotion: A New Synthesis. New York: Springer.Google Scholar
Lazarus, R. S. and Folkman, S. (1984). Stress, Appraisal and Coping. New York: Springer.Google Scholar
Maddi, S. R. (1980). Personality as a resource in stress resistance. Paper presented at the meeting of the American Psychological Association, Montreal.Google Scholar
Mahoney, R., Regan, C., Katona, C. and Livingston, G. (2005). Anxiety and depression in family caregivers of people with Alzheimer's disease — the LASER-AD study. American Journal of Geriatric Psychiatry, 13, 795–801.CrossRefGoogle ScholarPubMed
Martín Carrasco, M., Salvadó, I., Nadal, S., Miji, L. C., Rico, J. M. and Lanz, P. (1996). Spanish version of the Zarit Caregiver Burden Interview. Revista de Gerontolología, 6, 338–345.Google Scholar
McKhann, G., Drachman, D. and Folstein, M. (1984). Clinical diagnosis of Alzheimer's disease: report of the NINADS-ADRDA Work Group under the auspices of Department of Health and Human services task force on Alzheimer's disease. Neurology, 34, 939–944.CrossRefGoogle ScholarPubMed
Morano, C. L. (2003). Appraisal and coping: moderators or mediators of stress in Alzheimer's disease caregivers? Social Work Research, 27, 116–128.CrossRefGoogle Scholar
Pinquart, M. and Soerensen, S. (2003). Differences between caregivers and noncaregivers in psychological health and physical health: a meta-analysis. Psychology and Aging, 18, 250–267.CrossRefGoogle ScholarPubMed
Reisberg, B., Ferris, S. H., De Leon, M. D. and Crook, T. (1982). The Global Deterioration Scale for assessment of primary degenerative dementia. American Journal of Psychiatry, 139, 1136–1139.Google ScholarPubMed
Schulz, R., Boerner, K., Shear, K., Zhang, S. and Gitlin, L. (2006). Predictors of complicated grief among dementia caregivers: a prospective study of bereavement. American Journal of Geriatric Psychiatry, 14, 650–658.CrossRefGoogle ScholarPubMed
Seisdedos, N. (1982). Spanish Adaptation of the State Trait Anxiety Inventory (STAI). Madrid: Tea Ediciones.Google Scholar
Soper, D. (2011). The Free Statistics Calculators Website. Online software; www.danielsoper.com/statcalel3/default.aspx; ast accessed September 2011.Google Scholar
Spielberger, C. D., Gorsuch, R. L. and Lushene, R. E. (1970). Manual for the State-Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologist Press.Google Scholar
Takai, M. et al. (2009). The experience of burnout among home caregivers of patients with dementia: relations to depression and quality of life. Archives of Gerontology and Geriatrics, 49, e1–e5.CrossRefGoogle ScholarPubMed
Tobin, D. L., Holroyd, K. A., Reynolds, R. V. and Wigal, J. K. (1989). The hierarchical factor structure of the coping strategies inventory. Cognitive Therapy and Research, 13, 343–361.CrossRefGoogle Scholar
Vedhara, K., Shanks, N., Wilcock, G. and Lightman, S. L. (2001). Correlates and predictors of self-reported psychological and physical morbidity in chronic caregiver stress. Journal of Health Psychology, 6, 101–119.CrossRefGoogle ScholarPubMed
Vilalta-Franch, J., Lozano-Gallego, M., Hernández-Ferrándiz, M., Llinás-Reglá, J., López-Pousa, S. and López, O. (1999). Neuropsychiatric Inventory: the psychometric properties of its adaptation to Spanish. Revista de Neurología, 2, 15–19.Google Scholar
Zarit, S. H., Reever, K. E. and Bach-Peterson, J. (1980). Relatives of the impaired elderly: correlates of feelings of burden. Gerontologist, 20, 649–655.CrossRefGoogle ScholarPubMed
Zeitlin, S. (1980). Assessing coping behavior. American Journal of Orthopsychiatry, 50, 139–144.CrossRefGoogle ScholarPubMed
Zucchella, C., Michelangelo, B., Pasotti, C., Chiapella, L. and Sinforiani, E. (2011). Caregiver burden and coping in early-stage Alzheimer disease. Alzheimer Disease and Associated Disorders, Epub ahead of print, April 2011.Google Scholar