Purpose: The increase of stressors such as behavior problems and functional limitations is frequently reported among dementia patients. This increase of stressors may lead to the increase of depressive symptoms among family caregivers. Whether caregiver intervention may moderate the negative effects of the increase of stressors on caregiver depression has not been examined. In this study, I will examine 1) whether caregiver interventions affect longitudinal changes of caregiver depression, and 2) whether intervention may moderate the negative effects of the increase of stressors on longitudinal changes of caregiver depression.

Method: The current study includes caregiver participants (n=622) from three sites of the REACH (Resources for Enhancing Alzheimer's Caregiver Health) caregiver intervention project, which randomly assigned caregiver either to a psychosocial intervention, or a minimal support condition. Caregiver depression was measured by the twenty CES-D items. Stressors include behavior problems and functional limitations of dementia patients. Behavior problems were assessed by the Revised Memory and Behavior Problems Checklist, and functional limitations were measured by the number of limitations in performing activities of daily living and instrumental activities of daily living. The instruments were administered through caregiver interviews at baseline, 6, 12, and 18 month follow-ups. A caregiver's longitudinal changes of caregiver depression will be expressed as a slope in individual growth modeling.

Results: Individual growth models indicate that longitudinal changes of caregiver depression do not vary by intervention membership. Nonetheless, caregiver interventions are effective in reducing caregiver depression when dementia patients exhibit an increase of behavior problems over time. In contrast, caregiver interventions are less effective in reducing caregiver depression when dementia patients exhibit an increase of functional limitations over time.

Implications: These findings illustrate that intervention may be effective for subgroups of caregivers. Findings indicate that intervention may moderate the negative effects of an increase of behavior problems on longitudinal changes of caregiver depression. On the other hand, findings fail to indicate that intervention may moderate the negative effects of an increase of functional limitations on longitudinal changes of caregiver depression. These findings may result from the emphasis of caregiver intervention on teaching behavior problem management skills, compared to coping with deterioration of dementia patients' functional capabilities. These findings highlight that interventions need to be tailored to meet emerging caregiving needs of caregivers when dementia patients demonstrate the increase of behavior problems and functional limitations over time.