Burden, anxiety and depression in caregivers of veterans with dementia in Beijing
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.
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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.
References (29)
- et al.
Global prevalence of dementia: A Delphi consensus study
Lancet
(2005) - et al.
Sleep disturbances in caregivers of persons with dementia: Contributing factors and treatment implications
Sleep Medicine Reviews
(2007) - et al.
Dimensionality of somatic complaints: Factor structure and psychometric properties of the Self-Rating Anxiety Scale
Journal of Anxiety Disorders
(2006) - et al.
Factors related to feelings of burden among caregivers looking after impaired elderly in Japan under the long-term care insurance system
Psychiatry and Clinical Neurosciences
(2004) - et al.
Determinants of burden in those who care for someone with dementia
International Journal of Geriatric Psychiatry
(2008) - et al.
The reliability and validity of the Chinese version of the Caregiver Burden Inventory
Nursing Research
(2002) - et al.
The costs of caring: Impact of dementia on family caregivers
Journal of Geriatric Psychiatry and Neurology
(2001) - et al.
Caregiver burden among dementia patient caregivers: A review of the literature
Journal of the American Academy of Nurse Practitioners
(2008) - et al.
Burdens of spouse caregivers of patients with dementia at home
Chinese Mental Health Journal
(2007) - et al.
Immune dysregulation and chronic stress among older adults: A review
Neuroimmunomodulation
(2008)
The stress and psychological morbidity of the Alzheimer patient caregiver
International Journal of Geriatric Psychiatry
Development and validation of the Burden Scale for Family Caregivers
Comprehensive Rehabilitation and Mental Health Services
Study on burdens of family caregivers of patients with dementia and influencing factors
Journal of Navy Medicine
The Zung Self-Rating Depression Scale: Screening for depression among the Hong Kong Chinese elderly
Journal of Geriatric Psychiatry and Neurology
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