title: Depression in informal caregivers of persons with dementia.
abstract: BACKGROUND
  Worldwide, there are more than 35 million individuals diagnosed with Alzheimer's disease. Many of these individuals are cared for at home by unpaid caregivers who often report high levels of depressive symptoms and depression. The majority of studies conducted to predict which caregivers are at risk for depression have examined non-modifiable risk factors. Therefore, it is important to discover modifiable factors that may be associated with risk for depression in caregivers.
  
  
  OBJECTIVE
  The aims of this research were to identify a set of factors that are modifiable and known to be associated with high levels of depression/depressive symptomology (D/DS) in other populations and to determine whether these factors are predictive of D/DS after controlling for non-modifiable, demographic, and clinical factors.
  
  
  METHODS
  Secondary data analysis.
  
  
  METHODS
  Fifty-three participants provided direct care to a person with dementia with night-time activity. Inclusion criteria included not undergoing treatment for sleep disorders; living with the care recipient; and a Mini-Mental Status Exam score > 27. Baseline data collected by questionnaires, sleep diary and actigraphy.
  
  
  RESULTS
  In multivariate analyses of the modifiable factors, only high levels of negative affect predicted higher levels of depressive symptomatology. When non-modifiable factors were included in the model, negative affect and high levels of perceived caregiver burden predicted 52.6% of the variance in depressive symptomology. In secondary analyses, wake after sleep onset misperception was associated with higher depression scores.
  
  
  CONCLUSIONS
  While negative affect had a moderate effect on depressive symptoms, modifiable factors often associated with depressive symptoms in other studies were not associated with caregiver depression in this study. Possibly caregivers' overall poor sleep causes a floor effect and masks a potential relationship.
  
  
  CONCLUSIONS
  Both caregivers' affect and perceived burden are strongly related to depressive symptoms, so healthcare practitioners need to frequently assess both so as to provide timely interventions.
authors.affiliation: College of Nursing, University of South Florida, Tampa, FL, USA.
authors.forename: Rita F
authors.initials: RF
authors.lastname: D'Aoust
authors.forename: Glenna
authors.initials: G
authors.lastname: Brewster
authors.forename: Meredeth A
authors.initials: MA
authors.lastname: Rowe
mesh_terms: D056044:Actigraphy; D000328:Adult; D000339:Affect; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology*; D003704:Dementia / Q000451:nursing*; D003863:Depression / Q000453:epidemiology*; D006801:Humans; D008875:Middle Aged; D012307:Risk Factors; D012890:Sleep; D011795:Surveys and Questionnaires
keywords: Alzheimer's disease; affect; carers; dementia; depression; sleep