Elsevier

Archives of Gerontology and Geriatrics

Volume 55, Issue 3, November–December 2012, Pages 560-563
Archives of Gerontology and Geriatrics

Burden, anxiety and depression in caregivers of veterans with dementia in Beijing

https://doi.org/10.1016/j.archger.2012.05.014Get rights and content

Abstract

Dementia is the most common neurodegenerative disease in the elderly. The number of Chinese dementia patients reached 5 million in 2001 and will grow rapidly by 314–336% in 2040. Caring for patients with dementia is a stressful experience, which can cause the physical and mental problems in caregivers. According to the protocol, we evaluated the burden, depression and anxiety of caregivers by Clinical Dementia Rating (CDR) Scale, Caregiver Burden Inventory (CBI), Self-Rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS). 90 caregivers of dementia patients and 90 caregivers of nondementia patients with other chronic diseases from 24 military communities in Beijing were enrolled in this investigation. The scores of burden, depression and anxiety increased from nondementia to severe dementia groups. There were associations between patient's CDR score and CBI score, as well as the average daily care time and CBI score. In addition, the scores of SDS and SAS were both positive correlated to CBI score. Comparing to general community, the caregivers of dementia veterans had lower scores in SDS and SAS. Therefore, we should pay more attentions to the caregivers of severe dementia patients. Reduction of daily care time is a possible way to releasing the burden of caregivers. Better general supports are beneficial to reducing depression and anxiety when caregivers confront the heavy burden.

Introduction

The proportion of Chinese aged 65 and over will increase from 4% in overall population in the year 2000 to 14% by 2025, amounting to 200 million elderly people (The International Institute for Applied Systems Analysis, 2008). Dementia is the most common neurodegenerative disease in the elderly, which leads to the decrease in the cognitive, mental and physical abilities of the affected seniors. Therefore, it is considered as one of the most compelling problems of social and public health in the future of China. It has been estimated that the number of 5 million people with dementia in China in the year 2001 and will grow rapidly by 314–336% in 2040 (Ferri et al., 2005). Caregivers as an important aspect of dementia will be required with a large number.

Caring for dementia patients is complex and requires considerable adaptive behavior (Connell et al., 2001, Etters et al., 2008). The heavy burden of caregivers is usually attributed to patient's symptoms, such as cognitive deficits, disorientation and changes in personality and behavior (Gräßel, Chiu, & Oliver, 2003). Moreover, it is also influenced by other factors such as psychological or emotional health and physical morbidity, social life, ethnicity and income of the caregivers (Campbell et al., 2008, Molyneux et al., 2008). Actually, caregiving is believed as a risk factor for mortality (Schulz & Beach, 1999). Many disorders are reported to be associated with caregivers of dementia patients, e.g. immune dysregulation, sleep disturbances and cognitive decrease during the course of caregiving (Gonin et al., 2008, McCurry et al., 2007, Vugt de et al., 2005). In China, 90% of dementia patients are cared for at home by their spouses and children. Of these caregivers, 50% suffer from anxiety and depression (Zhang et al., 2004).

Veterans in China form a distinct group living in a military environment with unified management and lower population mobility, which ensures the stability of response rate. In addition, there is a higher medical standard and better general support with specific physicians, nurses and support personnel in the military environment (Wu, 2008), which can be considered as a positive condition for the patients and caregivers. There is no investigation in the literature that focuses on the caregivers of Chinese veterans with dementia. In this study, we evaluated the burden, anxiety and depression of them within military community in Beijing.

Section snippets

Subjects

The participants were primary caregivers caring for the veterans who mainly suffering from either dementia or other nondementia chronic diseases (hypertension, diabetes, chronic renal failure, osteoarthritis, etc.). Ninety caregivers of dementia patients and 90 caregivers of nondementia patients were recruited from 24 military communities in Beijing based on random selection. Diagnoses were confirmed by medical records according to DSM-IV criteria. Caregivers were excluded if the duration of

Results

All the enrolled participants completed the investigation without any withdrawal. In dementia patients, the average age was 85.27 ± 5.09, and the proportion of male was 91.1%. Classified by the CDR score, mild dementia was 45.7%, moderate dementia was 23.5%, and severe dementia was 30.8%. In comparison group, the average age of patients reached 83.28 ± 4.86, and male was also 91.1%. The characteristics of caregivers were outlined in Table 1. In dementia group, 53.3% caregivers were spouses with an

Discussion

In our study, elderly spouses mainly served as primary caregivers (53.3%) for dementia veterans. The previous investigations in Chinese demonstrated that the proportion of family care pattern for dementia elders in China was around 90%. The primary caregivers were their spouses and children (Wu and Zhang, 2005, Zhang et al., 2004). Therefore, we can conclude that spouse plays a key role in Chinese dementia care, both in military and general community. That is, elders take care of very elders,

Conflict of interest

We declare that we have no conflict of interest.

Acknowledgment

This work was supported by the Special Grant for Chinese Military Health-Care (no. 07BJZ04). The sponsors had no role in the design, methods, subject recruitment, data collections, analysis, or preparation of the manuscript.

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