Friday, 14 January 2005 - 12:00 PM

This presentation is part of: Poster Session I

Differences in Depressive Symptoms of Spouse Dementia Caregivers and a Non-Caregiving Comparison Group

Background and Purpose of Study: Research on the negative effects of dementia caregiving comparing family caregivers (CG) with non-caregivers (NCG) was recently summarized in a meta-analysis of 84 studies (Pinquart & Sorenson, 2003) Mental health outcomes showed the largest between-groups differences. However, very few studies were available comparing depressive symptoms of homogeneous CG groups, such as all spouses, with comparable NCG, and hence only a limited understanding of the effects of caregiving on spouses comes from controlled studies.

The current study utilized data from spouse CG of persons with Alzheimer’s disease or similar dementia, and from NCG older married adults, both recruited by the Case Western Reserve University/University Hospitals of Cleveland Alzheimer’s Disease Research Center. Goals of this study were as follows: 1) To confirm that total depression scores were higher in the CG group, as expected, and 2) To further our understanding of the effects of spousal caregiving by comparing individual subscale and item scores on the Center for Epidemiological Studies-Depression Scale (CES-D) for CG and NCG.

Method. CES-D data from a sample of 431 spousal CG, (mean age of 69.9 +/- 8.78), and 239 married comparison subjects (mean age 72.04 +/- 7.48) were compared using independent student t test for the total score and two-group MANOVA equations with univariate contrasts for the four subscales of the CES-D and separately for the 20 items of the scale. To avoid capitalizing on chance due to multiple comparisons, Bonferroni correction was used so that the desired alpha to establish significance became p < .002 for all contrasts.

Findings. Total CES-D mean score for CG was 11.49, compared with 4.33 for the comparison group (t = 12.9, p < .00001). Hotelling’s T for the four subscales of the CES-D was significant after entering age and gender as covariates (F = 37.6, p < .00001). Univariate contrasts each obtained the significance level specified. The F value was highest for the Positive Affect subscale (F = 137.8, p < .00001). Multivariate F for the 20 items was significant. Univariate contrasts for the individual items revealed sixteen with significant between-group differences. Those with the three highest F values were positive affect items, “Hopeful about future,” “Happy” and “Enjoyed Life.” The other highest F values were for “Sad,” “Bothered by things,” “Lonely” and “Depressed.”

Conclusions and Implications. As expected, spouse dementia CG were found to have more depressive symptoms than NCG. These CG spouses experienced less hope for the future and less positive affect, such as happiness and enjoyment of life. They also exhibited greater degrees of sadness, loneliness and subjective depression than similar-aged married NCG. These findings of the marked lack of hope for the future and lower positive affect have implications for the ways we interpret and intervene with the depression of spouse CG. Psychosocial interventions using active problem-solving, grief facilitation, cognitive restructuring and attempts to find meaning in their roles may assist spousal CG in regaining realistic hopes and personal enjoyment and effectively improve their depression. (Funded by NIA-P50-AG08012.)

See more of Poster Session I
See more of Oral and Poster

See more of Celebrating a Decade of SSWR (January 13 - 16, 2005)