title: Identifying target groups for the prevention of depression among caregivers of dementia patients.
abstract: BACKGROUND
  Depression in informal caregivers of persons with dementia is a major, costly and growing problem. However, it is not yet clear which caregivers are at increased risk of developing depression. With this knowledge preventive strategies could focus on these groups to maximize health gain and minimize effort.
  
  
  METHODS
  The onset of clinically relevant depression was measured with the Center for Epidemiologic Studies - Depression Scale in 725 caregivers who were not depressed at baseline and who were providing care for a relative with dementia. Caregivers were followed over 18 months. The indices calculated to identify the most important risk indicators were: odds ratio, attributable fraction, exposure rate and number needing to be treated.
  
  
  RESULTS
  The following significant indicators of depression onset were identified: increased initial depressive symptoms, poor self-rated health status and white or Hispanic race/ethnicity. The incidence of depression would decrease by 72.3% (attributive fraction) if these risk indicators together are targeted by a completely effective intervention. Race/ethnicity was not a significant predictor if caregivers of patients who died or were institutionalized were left out of the analyses.
  
  
  CONCLUSIONS
  Detection of only a few characteristics makes it possible to identify high-risk groups in an efficient way. Focusing on these easy-to-assess characteristics might contribute to a cost-effective prevention of depression in caregivers.
authors: Department of General Practice, EMGO Institute for Health and Health Care Research, VU University Medical Centre, Amsterdam, The Netherlands. k.joling@vumc.nl
authors: Karlijn J
authors: KJ
authors: Joling
authors: Filip
authors: F
authors: Smit
authors: Harm W J
authors: HW
authors: van Marwijk
authors: Henriëtte E
authors: HE
authors: van der Horst
authors: Philip
authors: P
authors: Scheltens
authors: Richard
authors: R
authors: Schulz
authors: Hein P J
authors: HP
authors: van Hout
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology* / Q000706:statistics & numerical data; D003704:Dementia / Q000523:psychology* / Q000628:therapy; D003863:Depression / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D006304:Health Status; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors