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Dementia Caregiving: Recent Research on Negative Health Effects and the Efficacy of Caregiver Interventions

Published online by Cambridge University Press:  07 November 2014

Lynn M. Martire  and
Martica Hall
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Abstract

Provision of care to an older adult with dementia is an important societal resource. This resource may also come at a high cost to informal caregivers, most of whom are family members. In this paper we provide an overview of recent research on dementia caregiving and caregiver interventions. First, we provide background information on the prevalence and costs of Alzheimer's disease and related disorders. Second, we describe the specific stressors and broader mental and physical health outcomes of dementia caregiving. Third, recent evidence of the efficacy of caregiver interventions for both caregiver and patient outcomes is reviewed. Throughout the paper, we describe promising new directions for future research in this area, including assessment and intervention with family caregivers of older patients with comorbid dementia and depression, and the focus on sleep disturbance as a critical health consequence of dementia caregiving.

Type
Feature Article
Information
CNS Spectrums , Volume 7 , Issue 11: Late-life Depression and Dementia , November 2002 , pp. 791 - 796
Copyright
Copyright © Cambridge University Press 2002

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References

REFERENCES

1.McDowell, I. Alzheimer's disease: insights from epidemiology. Aging (Milano). 2001;13:143–162.Google ScholarPubMed
2.Rice, DP, Fillit, HM, Max, W, Knopman, DS, Lloyd, JR, Duttagupta S. Prevalence, costs, and treatment of Alzheimer's disease and related dementia: a managed care perspective. Am J Manag Care. 2001;7:809–818.Google ScholarPubMed
3. National Alliance for Caregiving and the American Association of Retired Persons. Family Caregiving in the U.S.: Findings from a National Survey. Bethesda, MD: National Alliance for Caregiving; 1997.Google Scholar
4.Montgomery, RJ. Gender differences in patterns of child-parent caregiving relationships. In: Dwyer, JW, Coward, RT, eds. Gender, Families, and Elder Care. Newbury Park, CA: Sage Publications; 1992:65–83.Google Scholar
5.Arno, PS, Levine, C, Memmott, MM. The economic value of informal caregiving. Health Aff (Millwood). 1999;18:182–188.CrossRefGoogle ScholarPubMed
6.Meek, PD, McKeithan, K, Schumock, GT. Economic considerations in Alzheimer's disease. Pharmacotherapy. 1998;18:68–73.CrossRefGoogle ScholarPubMed
7.Stommel, M, Collins, CE, Given, BA. The costs of family contributions to the care of persons with dementia. Gerontologist. 1994;34:199–205.CrossRefGoogle Scholar
8.Pearlin, LI, Mullan, JT, Semple, SJ, Skaff, MM. Caregiving and the stress process: an overview of concepts and their measures. Gerontologist. 1990;30:583–594.CrossRefGoogle ScholarPubMed
9.Aneshensel, CS, Pearlin, LI, Mullan, JT, Zarit, SH, Whitlatch, CJ. Profiles in Caregiving: The Unexpected Career. San Diego, CA: Academic Press; 1995.Google Scholar
10.Schulz, R, O'Brien, AT, Bookwala, J, Fleissner, K. Psychiatric and physical morbidity effects of dementia caregiving: prevalence, correlates, and causes. Gerontologist. 1995;35:771–791.CrossRefGoogle ScholarPubMed
11.Neal, MB, Chapman, NJ, Ingersoll-Dayton, B, Emlen, AC. Balancing Work and Caregiving for Children, Adults, and Elders. Newbury Park, CA: Sage; 1993.CrossRefGoogle Scholar
12.Stephens, MA, Franks, MM, Atienza, AA. Where two roles intersect: spillover between parent care and employment. Psychol Aging. 1997;12:30–37.CrossRefGoogle ScholarPubMed
13.Stull, DE, Kosloski, K, Kercher, K. Caregiver burden and generic well-being: opposite sides of the same coin? Gerontologist. 1994;34:88–94.CrossRefGoogle ScholarPubMed
14.Ory, MG, Hoffman, RR 3rd, Yee, JL, Tennstedt, S, Schulz, R. Prevalence and impact of caregiving: a detailed comparison between dementia and nondementia caregivers. Gerontologist. 1999;39:177–185.CrossRefGoogle ScholarPubMed
15.Lyketsos, CG, Steinberg, M, Tschanz, TT, Norton, MC, Steffens, DC, Breitner, JC. Mental and behavioral disturbances in dementia: findings from the Cache County Study on Memory in Aging. Am J Psychiatry. 2000;157:708–714.CrossRefGoogle Scholar
16.Meyers, BS. Depression and dementia: comorbidities, identification and treatment. J Geriatr Psychiatry Neurol. 1998;11:201–205.CrossRefGoogle ScholarPubMed
17.Hinrichsen, GA. Adjustment of caregivers to depressed older adults. Psychol Aging. 1991;6:631–639.CrossRefGoogle ScholarPubMed
18.Hinrichsen, GA, Zweig, R. Family issues in late-life depression. J Long Term Home Health Care. 1994;13:4–15.Google Scholar
19.Teri, L, Logsdon, RG, Uomoto, J, McCurry, SM. Behavioral treatment of depression in dementia patients: a controlled clinical trial. J Gerontol B Psychol Sci Soc Sci. 1997;52:P159–166.CrossRefGoogle ScholarPubMed
20.National Institutes of Health Consensus Conference. Diagnosis and treatment of depression in late life. JAMA. 1992;268:1018–1024.CrossRefGoogle Scholar
21.Wright, LK, Clipp, EC, George, LK. Health consequences of caregiver stress. Medicine, Exercise, Nutrition, and Health. 1993;2:181–195.Google Scholar
22.Dura, JR, Stukenberg, KW, Kiecolt-Glaser, JK. Anxiety and depressive disorders in adult children caring for demented parents. Psychol Aging. 1991;6:467–473.CrossRefGoogle ScholarPubMed
23.Kiecolt-Glaser, JK, Dura, JR, Speicher, CE, Trask, JJ, Glaser, R. Spousal caregivers of dementia victims: longitudinal changes in immunity and health. Psychosom Med. 1991;53:345–362.CrossRefGoogle ScholarPubMed
24.Miller, B, Cafasso, L. Gender differences in caregiving: fact or artifact? Gerontologist. 1992;32:498–507.CrossRefGoogle ScholarPubMed
25.Yee, JL, Schulz, R. Genders differences in psychiatric morbidity among family caregivers: a review and analysis. Gerontologist. 2000;40:147–164.CrossRefGoogle ScholarPubMed
26.Rose-Rego, SK, Straus, ME, Smyth, KA. Differences in the perceived well-being of wives and husbands caring for persons with Alzheimer's disease. Gerontologist. 1998;38:224–230.CrossRefGoogle ScholarPubMed
27.Parmelee, PA. Spouse versus other family caregivers: psychological impact on impaired aged. Am J Community Psychol. 1983;11:337–349.CrossRefGoogle ScholarPubMed
28.Martire, LM, Schulz, R. Informal caregiving to older adults: health effects of providing and receiving care. In: Baum, A, Revenson, T, Singer, J, eds. Handbook of Health Psychology. Mahwah, NJ: Lawrence Erlbaum; 2001:477–493.Google Scholar
29.Burton, LC, Newsom, JT, Schulz, R, Hirsch, CH, German, PS. Preventive health behaviors among spousal caregivers. Prev Med. 1997;26:162–169.CrossRefGoogle ScholarPubMed
30.Ershler, WB. Interleukin-6: a cytokine for gerontologists. J Am Geriatr Soc. 1993;41:176–181.CrossRefGoogle ScholarPubMed
31.Murasko, DM, Bernstein, ED. Effect of age on cytokine production in humans. AGE: The Journal of the American Aging Association. 1998;21:137–151.Google Scholar
32.Murasko, DM, Gold, MF, Hessen, MT, Kaye, D. Immune reactivity, morbidity, and mortality of elderly humans. Aging: Immunology and Infectious Disease. 1990;2:171–179.Google Scholar
33.Castle, S, Wilkins, S, Heck, E, Tanzy, K, Fahey, J. Depression in caregivers of demented patients is associated with altered immunity: impaired proliferative capacity, increased CD8+, and a cytotoxicity marker (CD56+ CD8+). Clin Exp Immunol. 1995;101:487–493.CrossRefGoogle Scholar
34.Esterling, BA, Kiecolt-Glaser, JK, Bodnar, JC, Glaser, R. Chronic stress, social support, and persistent alterations in the natural killer cell response to cytokines in older adults. Health Psychol. 1994;13:291–299.CrossRefGoogle ScholarPubMed
35.Glaser, R, MacCallum, RC, Laskowski, BF, Malarkey, WB, Sheridan, JF, Kiecolt-Glaser, JK. Evidence for a shift in the Th-1 to Th-2 cytokine response associated with chronic stress and aging. J Geronotol A Biol Sci Med Sci. 2000;56:M477–M482.CrossRefGoogle Scholar
36.Kiecolt-Glaser, JK, Glaser, R, Gravenstein, S, Malarkey, SB, Sheridan, J. Chronic stress alters the immune response to influenza virus vaccine in older adults. Proc Natl Acad Sci U S A. 1996;93:3043–3047.CrossRefGoogle ScholarPubMed
37.Kiecolt-Glaser, JK, Marucha, PT, Malarkey, WB, Mercado, AM, Glaser, R. Slowing of wound healing by psychological stress. Lancet. 1995;346:1194–1196.CrossRefGoogle ScholarPubMed
38.Vitaliano, PP, Russo, J, Scanlan, J, Greeno, K. Weight changes in caregivers of Alzheimer's care recipients: psychobehavioral predictors. Psychol Aging. 1996;11:155–163.CrossRefGoogle ScholarPubMed
39.Vitaliano, PP, Scanlan, JM, Krenz, C, Schwartz, RS, Marcovina, SM. Psychological distress, caregiving, and metabolic variables. J Gerontol B Psychol Sci Soc Sci. 1996;51:P290–P297.CrossRefGoogle ScholarPubMed
40.Schulz, R, Beach, SR. Caregiving as a risk factor for mortality: The Caregiver Health Effects Study. JAMA. 1999;282:2215–2219.CrossRefGoogle ScholarPubMed
41.Wilcox, S, King, AC. Sleep complaints in older women who are family caregivers. J Gerontol B Psychol Sci Soc Sci. 1999;54:P189–P198.CrossRefGoogle ScholarPubMed
42.McCurry, SM, Teri, L. Sleep disturbance in elderly caregivers of dementia patients. Clin Gerontol. 1995;16:51–66.CrossRefGoogle Scholar
43.McCurry, SM, Logsdon, RG, Vitiello, MV, Teri, L. Successful behavioral treatment for reported sleep problems in elderly caregivers of dementia patients: a controlled study. J Gerontol B Psychol Sci Soc Sci. 1998;53:P122–P129.CrossRefGoogle ScholarPubMed
44.Hall, M, Dahl, RE, Dew, MA, Reynolds, CF. Sleep patterns following major negative life events. Directions in Psychiatry. 1995;15:1–8.Google Scholar
45.Hall, M, Buysse, DJ, Dew, MA, Prigerson, HG, Kupfer, DJ, Reynolds, CF. Intrusive thoughts and avoidance behaviors are associated with sleep disturbances in bereavement-related depression. Depress Anxiety. 1997;6:106–112.3.0.CO;2-B>CrossRefGoogle ScholarPubMed
46.Hall, M, Buysse, DJ, Nowell, PD, et al.Symptoms of stress and depression as correlates of sleep in primary insomnia. Psychosom Med. 2000;62:227–230.CrossRefGoogle ScholarPubMed
47.Pollak, CP, Perlick, D. Sleep problems and institutionalization of the elderly. J Geriatr Psychiatry Neurol. 1991;4:204–210.CrossRefGoogle ScholarPubMed
48.Bass, DM, Noelker, LS, Rechlin, LR. The moderating influence of service use on negative caregiving consequences. J Gerontol B Psychol Sci Soc Sci. 1996;51:S121–S131.CrossRefGoogle ScholarPubMed
49.Franks, MM, Stephens, MAP. Social support in the context of caregiving: Husbands' provision of support to wives involved in parent care. J Gerontol B Psychol Sci Soc Sci. 1996;51:P43–P52.CrossRefGoogle ScholarPubMed
50.Esterling, BA, Kiecolt-Glaser, JK, Glaser, R. Psychosocial modulation of cytokine-induced natural killer cell activity in older adults. Psychosom Med. 1996;58:264–272.CrossRefGoogle ScholarPubMed
51.Williamson, GM, Shaffer, DR, The Family Relationships in Late Life Project. Relationship quality and potentially harmful behaviors by spousal caregivers: how we were then, how we are now. Psychol Aging. 2001;16:217–226.CrossRefGoogle ScholarPubMed
52.Montgomery, RJV, Kosloski, K. A longitudinal analysis of nursing home placement for dependent elders cared for by spouses vs adult children. J Gerontol B Psychol Sci Soc Sci. 1994;49:S62–S74.Google ScholarPubMed
53.Schulz, R, O'Brien, A, Czaja, S, et al.Dementia caregiver intervention research: in search of clinical significance. Gerontologist. 2002;42:589–602.CrossRefGoogle ScholarPubMed
54.Steffen, AM, Futterman, A, Gallagher-Thompson, D. Depressed caregivers: comparative outcomes of two interventions. Clin Gerontol. 1998;19:3–15.CrossRefGoogle Scholar
55.Schulz, R, ed. Handbook on Dementia Caregiving: Evidence-Based Interventions for Family Caregivers. New York, NY: Springer; 2000.Google Scholar
56.Mittelman, MS, Ferris, SH, Steinberg, G, et al.An intervention that delays institutionalization of Alzheimer's disease patients: treatment of spouse-caregivers. Gerontologist. 1993;33:730–740.CrossRefGoogle ScholarPubMed
57.Mittelman, MS, Ferris, SH, Shulman, E, Steinberg, G, Levin, B. A family intervention to delay nursing home placement of patients with Alzheimer disease: a randomized controlled trial. JAMA. 1996;276:1725–1731.CrossRefGoogle ScholarPubMed
58.Whitlatch, CJ, Zarit, SH, Goodwin, PE, von Eye, A. Influence of the success of psychoeducational interventions on the course of family care. Clin Gerontol. 1995;16:17–30.CrossRefGoogle Scholar