Increased hours of care and depressive symptoms are detectable in caregivers at least 10 years before their partner is diagnosed with cognitive impairment, a new study finds. Clinicians should note the need for earlier detection and family support, according to the investigators.
The researchers analyzed household survey data from the 2000-2016 waves of the Health and Retirement Study. Caregivers’ depressive symptoms and weekly hours of care were assessed for the 10 years before and after the partner’s diagnosis of dementia.
Depressive symptoms were measured using the Center for Epidemiological Studies Abbreviated Depression Scale. Weekly caregiving hours were self-reported.
Prior to the onset of a partner’s dementia, each measure increased every two years by 3% and 9%, respectively. Both measures then fell — by 2% and 1% — every two years after the partner was clinically diagnosed, Melissa Harris, PhD, RN, of Duke University, and colleagues reported.
Cognitive changes and associated disabilities occur over years, even decades, before reaching a threshold at which dementia is diagnosed, Harris said. She and her colleagues, however, were surprised to find that depressive symptoms and caregiver hours of care decreased after the onset of a partner’s dementia.
“Caregivers may be accessing support and services when the level of disability reaches that threshold of onset,” or they may be reaching a point in their care journey where they have adjusted to the changes, he said. she declared.
The findings run counter to mainstream wisdom that received spikes in care right after dementia onset, according to lead researcher Geoffrey Hoffman, PhD, MPH, of the University of Michigan School of Nursing. Instead, it appears that early referral to specialist services is key to alleviating the emotional burden and high demands of care faced by caregivers, the authors said.
Clinicians may want to view dementia as a journey that begins before diagnosis to better identify needs and solutions, Harris concluded.
The study was published in the magazine Medical care.