title: Psychological distress in informal caregivers of patients with dementia in primary care: course and determinants.
abstract: The course of psychological distress in informal caregivers of patients with dementia has been investigated in longitudinal studies with conflicting outcomes.
  
  
  
  We investigated the course and determinants of psychological distress in informal caregivers of patients with dementia in primary care.
  
  
  
  In this prospective observational cohort study, data were collected at baseline, after 9 and 18 months. We assessed cognition and neuropsychiatric symptoms (NPS) of the patient (Mini-Mental State Examination and Neuropsychiatric Inventory) and psychological distress (Sense of Competence Questionnaire, Center for Epidemiological Studies Depression scale and General Health Questionnaire 12-tem version) of the informal caregivers. Determinants for the course of psychological distress were caregivers' age, gender and relationship with the patient, patients' cognition and NPS, participation in a care program and admission to long-term care facilities (LTCF). With linear mixed models, the course over time for psychological distress and its determinants were explored.
  
  
  
  We included 117 informal caregivers, of whom 23.1% had a high risk for depression and 41.0% were identified to be likely to have mental problems at baseline. We found a stable pattern of psychological distress over time. Higher frequency of NPS, informal caregivers' age between 50 and 70 years and being female or spouse were associated with higher psychological distress. For patients who were admitted to a LTCF during the study psychological distress of the informal caregivers improved.
  
  
  
  GPs should focus on NPS in patients with dementia and on caregivers' psychological distress and be aware of their risk for depression and mental problems, specifically to those who are spouse, female or between 50 and 70 years of age.
authors.affiliation: Department of Primary and Community Care, Centre for Family Medicine, Geriatric Care and Public Health and Radboud Alzheimer Center, Radboud University Medical Center, Nijmegen, The Netherlands, Thebe, Region South-East, Goirle, The Netherlands, Petra.Borsje@radboudumc.nl.
authors.forename: Petra
authors.initials: P
authors.lastname: Borsje
authors.affiliation: Department of Primary and Community Care, Centre for Family Medicine, Geriatric Care and Public Health and.
authors.forename: Marleen A P
authors.initials: MA
authors.lastname: Hems
authors.affiliation: Department of Primary and Community Care, Centre for Family Medicine, Geriatric Care and Public Health and.
authors.forename: Peter L B J
authors.initials: PL
authors.lastname: Lucassen
authors.affiliation: Department of Primary and Community Care, Centre for Family Medicine, Geriatric Care and Public Health and.
authors.forename: Hans
authors.initials: H
authors.lastname: Bor
authors.affiliation: Department of Primary and Community Care, Centre for Family Medicine, Geriatric Care and Public Health and Radboud Alzheimer Center, Radboud University Medical Center, Nijmegen, The Netherlands, Joachim end Anna, Centre for Specialized Geriatric Care, Nijmegen, The Netherlands.
authors.forename: Raymond T C M
authors.initials: RT
authors.lastname: Koopmans
authors.affiliation: Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands and School of Psychology, The University of Queensland, St Lucia, Australia.
authors.forename: Anne Margriet
authors.initials: AM
authors.lastname: Pot
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology*; D003704:Dementia / Q000451:nursing*; D003863:Depression / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D009426:Netherlands; D009483:Neuropsychological Tests; D011320:Primary Health Care; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012737:Sex Factors; D018454:Spouses / Q000523:psychology*; D013315:Stress, Psychological / Q000453:epidemiology*; D011795:Surveys and Questionnaires
keywords: .; Caregivers; dementia; depression/mood disorder; mental health; primary care