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Depressive symptomatology and associated factors in dementia in Europe: home care versus long-term care

Published online by Cambridge University Press:  11 December 2015

Clarissa Giebel*
Affiliation:
Personal Social Services Research Unit, The University of Manchester, Manchester, UK
Caroline Sutcliffe
Affiliation:
Personal Social Services Research Unit, The University of Manchester, Manchester, UK
Hilde Verbeek
Affiliation:
Department of Health Services Research, Maastricht University, Maastricht, the Netherlands
Adelaida Zabalegui
Affiliation:
Hospital Clinic of Barcelona, Nursing, Barcelona, Spain
Maria Soto
Affiliation:
Department of Geriatric Medicine, Gerontopole, INSERM 1027, University Hospital de Toulouse, Toulouse, France
Ingalill Rahm Hallberg
Affiliation:
Department of Health Sciences, Lund University, Lund, Sweden
Kai Saks
Affiliation:
Department of Internal Medicine, University of Tartu, Tartu, Estonia
Anna Renom-Guiteras
Affiliation:
School of Nursing Science, Faculty of Health, University of Witten/Herdecke, Germany
Riitta Suhonen
Affiliation:
Department of Nursing Science, University of Turku, Turku, Finland
David Challis
Affiliation:
Personal Social Services Research Unit, The University of Manchester, Manchester, UK
*
Correspondence should be addressed to: Clarissa Giebel, PSSRU, Second Floor Crawford House, The University of Manchester, Booth Street East, Manchester, M13 9QS, UK. Phone: +44 161 275 5652. Email: clarissa.giebel@manchester.ac.uk.

Abstract

Background:

This study forms part of a larger European programme investigating the transition from home care to long-term care (LTC) facility in people with dementia (PwD) at the margins of LTC. The aim of this study was to explore the factors associated with depressive symptomatology in PwD in different settings.

Methods:

A total of 1,538 PwD, of which 957 received home care and 581 lived in a LTC facility, and their carers were interviewed. The Cornell Scale for Depression in Dementia (CSDD) measured depressive symptomatology. PwD completed measures of cognition and quality of life (QoL), and informal or formal carers completed measures on the PwD’ QoL, neuropsychiatric behavior, activities of daily living, comorbidities, pain, and falls. Logistic regression was used to assess which factors contributed to depressive symptomatology in the two settings.

Results:

Those receiving home care, living in Germany, and with severe dementia, showed the highest prevalence of depressive symptomatology. In the home care group, high levels of pain, neuropsychiatric behavior, and comorbidity, as well as low self- and proxy-rated QoL were factors associated with depressive symptomatology. In the LTC group, low proxy-rated QoL, more severe neuropsychiatric behavior, being a male informal carer and living in Germany were associated with depressive symptomatology.

Conclusions:

Evidence highlights the need for targeting different aspects in the management of depression in dementia, including offering improved pain management for those living in the community. Further research needs to explore cultural variations and carer gender factors associated with higher levels of depressive symptomatology.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2015 

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References

Alexopoulos, G. S. (1988). The Cornell Scale for Depression in Dementia: Administration & Scoring Guidelines. NY: Cornell Institute of Geriatric Psychiatry.CrossRefGoogle Scholar
Alexopoulus, G. S., Abrams, R. S., Young, R. C. and Shamoian, A. C. (1988). Cornell scale for depression in dementia. Biological Psychiatry, 23, 271284.CrossRefGoogle Scholar
Alzheimer's Disease International (ADI) (2014). World Alzheimer Report 2014. London: Alzheimer's Disease International.Google Scholar
Beerens, H. et al. (2014). Quality of life and quality of care for people with dementia receiving long term institutional care or professional home care: the European RightTimePlaceCare study. Journal of the American Medical Directors Association, 15, 5461.CrossRefGoogle ScholarPubMed
Bielinski, K. and Lawlor, B. (2006). Depression in severe dementia. In Burns, A. and Winblad, B. (eds.), Severe Dementia (pp. 6374). Chichester: Wiley.CrossRefGoogle Scholar
Borza, T., Engedal, K., Bergh, S., Barca, M. L., Benth, J. S. and Selbaek, G. (2015). The course of depressive symptoms as measured by the Cornell scale for depression in dementia over 74 months in 1158 nursing home residents. Journal of Affective Disorders, 175, 209216.CrossRefGoogle ScholarPubMed
Charlson, M. E., Pompei, P., Ales, K. L. and MacKenzie, C. R. (1987). A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. Journal of Chronic Diseases, 40, 373383.CrossRefGoogle ScholarPubMed
Chou, K. L. (2007). Reciprocal relationship between pain and depression in older adults: evidence from the English longitudinal study of ageing. Journal of Affective Disorders, 102, 115123.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, 23082314.CrossRefGoogle ScholarPubMed
Donaldson, C., Tarrier, N. and Burns, A. (1998). Determinants of carer stress in Alzheimer's disease. International Journal of Geriatric Psychiatry, 13, 248256.3.0.CO;2-0>CrossRefGoogle ScholarPubMed
Dunn, J. and Clare, L. (2007). Learning face-name associations in early-stage dementia: comparing the effects of errorless learning and effortful processing. Neuropsychological Rehabilitation, 17, 735754.CrossRefGoogle ScholarPubMed
Folstein, M., Folstein, S. and McHugh, P. (1975). “Mini-mental state.” A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189198.CrossRefGoogle ScholarPubMed
Giebel, C. M., Challis, D. and Montaldi, D. (2014a). A revised interview for deterioration in daily living activities in dementia reveals the relationship between social activities and well-being. Dementia, doi: 10.1177/1471301214553614. Google ScholarPubMed
Giebel, C. M. et al. (2014b). Deterioration of basic activities of daily living and their impact on quality of life across different cognitive stages of dementia: a European study. International Psychogeriatrics, 26, 12831293.CrossRefGoogle ScholarPubMed
Giebel, C. M. et al. (2015). Depressive symptomatology in severe dementia in a European sample: prevalence, associated factors and prescription rate of antidepressants. International Psychogeriatrics, 27, 657667.CrossRefGoogle Scholar
Gruber-Baldini, A. L., Zimmerman, S., Boustani, M., Watson, L. C., Williams, C. S. and Reed, P. S. (2005). Characteristics associated with depression in long-term care residents with dementia. Gerontologist, 45, 5055.CrossRefGoogle ScholarPubMed
Hoe, J., Hancock, G., Livingston, G. and Orrell, M. (2006). Quality of life of people with dementia in residential care homes. British Journal of Psychiatry, 188, 460464.CrossRefGoogle ScholarPubMed
Hutchinson, A. M. et al. (2010). The Resident Assessment Instrument – Minimum Data Set 2.0 quality indicators: a systematic review. BMC Health Services Research, 10, 166179.CrossRefGoogle ScholarPubMed
Katz, S., Ford, A. B., Moskowitz, R. W., Jackson, B. A. and Jaffee, M. W. (1963). Studies of illness in the aged: the index of ADL: a standardized measure of biological and psychosocial function. JAMA, 85, 914919.CrossRefGoogle Scholar
Kaufer, D. I. et al. (2000). Validation of the NPI-Q, a brief clinical form of the neuropsychiatric inventory. Journal of Neuropsychiatry and Clinical Neuroscience, 12, 233239.CrossRefGoogle ScholarPubMed
Knapskog, A. B., Barca, M. L. and Engedal, K. (2013). Prevalence of depression among memory clinic patients as measured by the cornell scale of depression in Dementia. Aging and Mental Health, 18, 579587.CrossRefGoogle ScholarPubMed
Kosteniuk, J. G. et al. (2014). Prevalence and covariates of elevated depressive symptoms in rural memory clinic patients with mild cognitive impairment or dementia. Dementia and Geriatric Cognitive Disorders, 4, 209220.CrossRefGoogle ScholarPubMed
Logsdon, R. G., Gibbons, L. E., McCurry, S. M. and Teri, L. (1999). Quality of life in Alzheimer's disease: patient and caregiver reports. Journal of Mental Health and Aging, 5, 2132.Google Scholar
Majic, T., Pluta, J. P., Mell, T., Treusch, Y., Gutzmann, H. and Rapp, M. A. (2012). Correlates of agitation and depression in nursing home residents with dementia. International Psychogeriatrics, 24, 17791789.CrossRefGoogle ScholarPubMed
Mioshi, E. et al. (2013). The impact of dementia severity on caregiver burden in frontotemporal dementia and Alzheimer disease. Alzheimers Disease and Associated Disorders, 27, 6873.CrossRefGoogle ScholarPubMed
Molloy, D. W. and Standish, T. I. M. (1997). A guide to the standardized mini-mental state examination. International Psychogeriatrics, 9, 8794.CrossRefGoogle Scholar
National Institute for Health and Clinical Excellence (NICE) (2006). Final Appraisal Determination: Donepezil, Galantamine, Rivastagmine (Review) and Memantine for the Treatment of Alzheimer's Disease. London: Department of Health.Google Scholar
Robinson, M. J., Edwards, S. E., Iyengar, S., Bymaster, F., Clark, M. and Katon, W. (2009). Depression and pain. Frontiers Bioscience, 14, 50315051.CrossRefGoogle ScholarPubMed
Snowden, M. B. et al. (2015). Longitudinal association of dementia and depression. American Journal of Geriatric Psychiatry, 23, 897905.CrossRefGoogle ScholarPubMed
Starkstein, S. E., Jorge, R., Mizrahi, R. and Robinson, R. G. (2005). The construct of minor and major depression in Alzheimer's disease. American Journal of Psychiatry, 162, 20862093.CrossRefGoogle ScholarPubMed
Steinberg, M. et al. (2008). Point and 5-year period prevalence of neuropsychiatric symptoms in dementia: the cache county study. International Journal of Geriatric Psychiatry, 23, 170177.CrossRefGoogle ScholarPubMed
Stopford, C. L., Thompson, J. C., Neary, D., Richardson, A. and Snowden, J. (2012). Working memory, attention, and executive function in Alzheimer's disease and frontotemporal dementia. Cortex, 48, 429446.CrossRefGoogle ScholarPubMed
Tombaugh, T. N. and Mclntyre, N. J. (1992).The mini-mental state examination: a comprehensive review. Journal of the American Geriatrics Society, 40, 922935.CrossRefGoogle ScholarPubMed
Van der Mussele, S. et al. (2013). Prevalence and associated behavioral symptoms of depression in mildcognitive impairment and dementia due to Alzheimer's disease. International Journal of Geriatric Psychiatry, 28, 947958.CrossRefGoogle Scholar
Verbeek, H. et al. (2012). A European study investigating patterns of transition from home care towards institutional dementia care: the protocol of a RightTimePlaceCare study. BMC Public Health, 12, 68.CrossRefGoogle ScholarPubMed
Wimo, A., Wetterholm, A. L., Mastey, V. and Winblad, B. (1998). Evaluation of the resource utilization and caregiver time in Anti-dementia drug trials – a quantitative battery. In Wimo, A., Jonsson, B., Karlsson, G. and Winblad, B (eds.), The Health Economics of Dementia (pp. 465499). London: John Wiley and Sons.Google ScholarPubMed
Zarit, S. H., Reever, K. E. and Bach-Peterson, J. (1980). Relatives of the impaired elderly: correlates of feelings of burden. Gerontologist, 20, 649655.CrossRefGoogle ScholarPubMed
Zwakhalen, S., Koopmans, R., Geels, P., Berger, M. P. and Hamers, J. P. (2009). The prevalence of pain in nursing home residents with dementia using an observational pain scale. European Journal of Pain, 13, 8993.CrossRefGoogle ScholarPubMed