title: Caregiver depression is associated with a low sense of coherence and health-related quality of life.
abstract: OBJECTIVE
  The main objective is to examine the sense of coherence (SOC) of spouse caregivers. The aim was further investigate the association of SOC, health-related quality of life (HRQoL), depressive symptoms, distress and how severity of Alzheimer's disease (AD) affects SOC.
  
  
  METHODS
  17O patient-spouse caregiver dyads in which the patient has recently diagnosed mild AD. Caregivers completed SOC scale (SOC-29), HRQoL (15D), Beck depression and general health questionnaire scale. The assessment of AD-related symptoms was made using mini mental state examination, clinical dementia rating, neuropsychiatric inventory and functional performance using activities of daily living (ADCS-ADL) scale.
  
  
  RESULTS
  Male caregivers' SOC was significantly higher than female caregivers. The main predictor for low SOC was depression, with 37% of spousal caregivers reporting depressive symptoms. Women reported more depressive symptoms and distress. Caregivers' HRQoL was as high as 0.8714, and a significant correlation was found between SOC and depression, r = -0.632 and distress r = -0.579. Furthermore, significant correlations were found between HRQoL and depression (r = -0.572) and distress (r = -0.568). The main predictors for high HRQoL were female gender and low distress.
  
  
  CONCLUSIONS
  Spouse caregivers with low SOC seem to be a vulnerable group of caregivers. The many negative effects of perceived health accumulate in these caregivers during the very early phases of the caregiving process. Vulnerable caregivers need to be recognized at the time of AD diagnosis so that they can receive psychological support and counselling in addition to prevent morbidity in these caregivers.
authors.affiliation: Department of Nursing Science, University of Kuopio, 70211 Kuopio, Finland. tarja.valimaki@uku.fi
authors.forename: Tarja H
authors.initials: TH
authors.lastname: Välimäki
authors.forename: Katri M
authors.initials: KM
authors.lastname: Vehviläinen-Julkunen
authors.forename: Anna-Maija K
authors.initials: AM
authors.lastname: Pietilä
authors.forename: Tuula A
authors.initials: TA
authors.lastname: Pirttilä
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D000544:Alzheimer Disease / Q000453:epidemiology*; D001294:Attitude to Health; D017028:Caregivers / Q000523:psychology* / Q000706:statistics & numerical data; D003071:Cognition; D015331:Cohort Studies; D003866:Depressive Disorder / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011788:Quality of Life / Q000523:psychology*; D012720:Severity of Illness Index; D017678:Sex Distribution; D018454:Spouses / Q000523:psychology / Q000706:statistics & numerical data; D013315:Stress, Psychological / Q000453:epidemiology; D011795:Surveys and Questionnaires