title: Depressive symptomatology and associated factors in dementia in Europe: home care versus long-term care.
abstract: BACKGROUND
  This study forms part of a larger European programme investigating the transition from home care to long-term care (LTC) facility in people with dementia (PwD) at the margins of LTC. The aim of this study was to explore the factors associated with depressive symptomatology in PwD in different settings.
  
  
  METHODS
  A total of 1,538 PwD, of which 957 received home care and 581 lived in a LTC facility, and their carers were interviewed. The Cornell Scale for Depression in Dementia (CSDD) measured depressive symptomatology. PwD completed measures of cognition and quality of life (QoL), and informal or formal carers completed measures on the PwD' QoL, neuropsychiatric behavior, activities of daily living, comorbidities, pain, and falls. Logistic regression was used to assess which factors contributed to depressive symptomatology in the two settings.
  
  
  RESULTS
  Those receiving home care, living in Germany, and with severe dementia, showed the highest prevalence of depressive symptomatology. In the home care group, high levels of pain, neuropsychiatric behavior, and comorbidity, as well as low self- and proxy-rated QoL were factors associated with depressive symptomatology. In the LTC group, low proxy-rated QoL, more severe neuropsychiatric behavior, being a male informal carer and living in Germany were associated with depressive symptomatology.
  
  
  CONCLUSIONS
  Evidence highlights the need for targeting different aspects in the management of depression in dementia, including offering improved pain management for those living in the community. Further research needs to explore cultural variations and carer gender factors associated with higher levels of depressive symptomatology.
authors.affiliation: Personal Social Services Research Unit,The University of Manchester,Manchester,UK.
authors.forename: Clarissa
authors.initials: C
authors.lastname: Giebel
authors.affiliation: Personal Social Services Research Unit,The University of Manchester,Manchester,UK.
authors.forename: Caroline
authors.initials: C
authors.lastname: Sutcliffe
authors.affiliation: Department of Health Services Research,Maastricht University,Maastricht,the Netherlands.
authors.forename: Hilde
authors.initials: H
authors.lastname: Verbeek
authors.affiliation: Hospital Clinic of Barcelona,Nursing,Barcelona,Spain.
authors.forename: Adelaida
authors.initials: A
authors.lastname: Zabalegui
authors.affiliation: Department of Geriatric Medicine,Gerontopole,INSERM 1027,University Hospital de Toulouse,Toulouse,France.
authors.forename: Maria
authors.initials: M
authors.lastname: Soto
authors.affiliation: Department of Health Sciences,Lund University,Lund,Sweden.
authors.forename: Ingalill Rahm
authors.initials: IR
authors.lastname: Hallberg
authors.affiliation: Department of Internal Medicine,University of Tartu,Tartu,Estonia.
authors.forename: Kai
authors.initials: K
authors.lastname: Saks
authors.affiliation: School of Nursing Science,Faculty of Health,University of Witten/Herdecke,Germany.
authors.forename: Anna
authors.initials: A
authors.lastname: Renom-Guiteras
authors.affiliation: Department of Nursing Science,University of Turku,Turku,Finland.
authors.forename: Riitta
authors.initials: R
authors.lastname: Suhonen
authors.affiliation: Personal Social Services Research Unit,The University of Manchester,Manchester,UK.
authors.forename: David
authors.initials: D
authors.lastname: Challis
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology; D015897:Comorbidity; D003704:Dementia / Q000453:epidemiology / Q000523:psychology*; D003863:Depression / Q000453:epidemiology* / Q000523:psychology; D005060:Europe / Q000453:epidemiology; D005260:Female; D006699:Home Care Services; D006801:Humans; D008134:Long-Term Care / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D015995:Prevalence; D011788:Quality of Life / Q000523:psychology*; D012720:Severity of Illness Index
keywords: dementia; depression; home care; long-term care; neuropsychiatric behavior; pain