Social and depressive stress suffered by spouses of patients with mild dementia

Abstract

Objective - To identify stressors and their correlates in spouses of patients with mild dementia. Design - Retrospective study of patient records. Setting - Patients attending a Memory Clinic at Ullevaal Hospital in Oslo. Subjects - 92 mildly demented patients living at home (mean age 75.7 years, 51% women, mean MMSE score 22.3) and their spouses. Main outcome measures - Frequency and types of stress suffered by spouses using validated and factor-analyzed instruments as measures. Results - Twenty-five per cent or more of the spouses reported often/always having problems with the following: being depressed by the situation, having difficulties getting away on holiday, social life being affected, household routines being upset, and sleep being interrupted. Factor analysis of the Greene Caregiver Stress Scale (15 items) identified two factors; 'Social stress' and 'Depressive stress'. Social stress was associated with the patient's I-ADL level, and depressive stress with mood and behaviour of the patient. The depressive symptomatology of the patient as expressed by the spouses was related to both depressive and social stress, whereas cognitive function, as measured by the MMSE, was not an independent predictor of carer strain. Conclusion - Even in mildly demented patients, symptoms of carer stress are frequent. Supportive strategies such as early diagnosis, information for carers and intervention strategies are discussed.