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Anxiety Symptoms in Spouses of Persons with Dementia: Implications for Intervention

This study examines the high prevalence of anxiety symptoms in spouses of persons with dementia and its implications for intervention. Results suggest that anxiety can negatively impact the spouse's capacity to provide care and that interventions should consider both the caregivers' anxiety and the patients' neuropsychiatric symptoms.

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Anxiety Symptoms in Spouses of Persons with Dementia: Implications for Intervention

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  1. High prevalence of anxiety symptoms in spouses of persons suffering from persons IngunUlstein*, Norwegian Centre for Dementia Research, Department of Geriatric Medicine, Oslo University Hospital, Ullevål, Oslo, Norway Kari Kvaal, Oslo University College, Mental Health Programme, Oslo and Institute of Mental Health and Social Sciences, Hedmark University College, Elverum, Norway

  2. Content • Anxiety and older people • The studys • Background • Hypotheses • Material • Methods • Results • Conclusion – implication for intervention

  3. Background • There are few studies concerning anxiety in older people probably due to the high association between anxiety and depression. Flint, 1994; Beekman et al., 2000; Kessler et al., 2002, Kvaal et al., 2002 • Anxiety symptoms are according to several studies prevalent among older people suffering from any chronic physical disorders Balkomet al., 2000; Hocking and Koening, 1995; Yohannes et al., 2000 • In a systematic review of anxiety among carers of people suffering from dementia, anxiety was found to be more common among carers than in matched healthy controls Cooper et al., 2007 • Anxiety influences the capacity of giving care and leads to dysfunctional coping and less emotional support Li et al., 2011

  4. Material • 76 spouses of patients in a mild to moderate stage of dementia recruited from seven memory clinics in Norway • 98 geriatric in-patients acutely admitted to a geriatric ward due to a serious somatic condition • 68 healthy controls recruited from citizen centres in Oslo

  5. Hypotheses • The level of anxiety among patients admitted to a geriatric ward due to an acute somatic illness is higher compared with the two other groups • The spouses of persons suffering from dementia are considered to be healthy, but due to the burden of care we expect them to score higher on the STAI than the healthy controls • Coping failure is associated with anxiety among carers of persons suffering from dementia

  6. Method • Anxiety symptoms were assessed by means of the 12-items version of the State-Trait Anxiety Inventory (STAI-X-1) • Demographics such as age, gender, educational and occupational status of the three groups were collected • Study 1 • The STAI scores of the three groups were compared • Study 2 • Multiple linear regression was used to identify carer and patients characteristics associated with anxiety symptoms • Coping failure were tapped from the GHQ-30

  7. Study 1 Comparison of anxiety in geriatric patients and carers

  8. Background characteristics SD=Standard deviation; a=comparison performed by use of ANOVA; b= comparison with chi-square with linear trend; 1=3 missing

  9. Background characteristics SD=Standard deviation; a=comparison by use of ANOVA; b= comparison with chi-square with linear trend; 1=3 missing

  10. Bivariate associations between STAI and possible explanatory factors

  11. Bivariate associations between STAI and possible explanatory factors

  12. Adjusted associations between STAI- and characteristics of the three groups

  13. Results 1 • No significant differences in reported anxiety according to the STAI between the carers and the geriatric inpatients • The healthy controls scored significantly lower on each STAI-item compared with the two other groups • Females are reporting more anxiety symptoms than males

  14. Study 2 Anxiety and caregiving

  15. Adjusted associations between STAI- and patient characteristics Other patientcharacteristics such as cognitive decline (MMSE), ADL-deficits (DAD), duration of dementia symptoms and ability to stay alone did not contribute

  16. Adjusted associations between STAI- and carer characteristics

  17. Conclusions • Anxiety symptoms are prevalent in elderly people facing stressful events such as • an acute somatic illnesses • living in a household with a partner suffering from dementia • Anxiety may have a negative impact on the spouse’s capacity of giving care to the demented partner due to coping failure • Distress associated with neuropsychiatric symptoms increases anxiety in the carers • Anxiety as well as the neurospychiatric symptoms of the patients has to be taken into account when creating interventions for carers

  18. Thanks for your attention!

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