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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*
Personal Social Services Research Unit, The University of Manchester, Manchester, UK
Caroline Sutcliffe
Personal Social Services Research Unit, The University of Manchester, Manchester, UK
Hilde Verbeek
Department of Health Services Research, Maastricht University, Maastricht, the Netherlands
Adelaida Zabalegui
Hospital Clinic of Barcelona, Nursing, Barcelona, Spain
Maria Soto
Department of Geriatric Medicine, Gerontopole, INSERM 1027, University Hospital de Toulouse, Toulouse, France
Ingalill Rahm Hallberg
Department of Health Sciences, Lund University, Lund, Sweden
Kai Saks
Department of Internal Medicine, University of Tartu, Tartu, Estonia
Anna Renom-Guiteras
School of Nursing Science, Faculty of Health, University of Witten/Herdecke, Germany
Riitta Suhonen
Department of Nursing Science, University of Turku, Turku, Finland
David Challis
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:



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.


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.


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.


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.

Research Article
Copyright © International Psychogeriatric Association 2015 

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