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Cited by 47Dementia and Cognitive Impairment ResearchNursing care and researchFamily Caregiving in Mental Illness

Self-reported symptoms of depression and anxiety among informal caregivers of persons with dementia: a cross-sectional comparative study between Sweden and Italy

Open access
Wulff, Joseba, Fänge, Agneta Malmgren, Lethin, Connie, Chiatti, Carlos·2020·BMC Health Services Research
DOI 10.1186/s12913-020-05964-2PMC PMC7709414
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Abstract

Background: Around 50 million people worldwide are diagnosed with dementia and this number is due to triple by 2050. The majority of persons with dementia receive care and support from their family, friends or neighbours, who are generally known as informal caregivers. These might experience symptoms of depression and anxiety as a consequence of caregiving activities. Due to the different welfare system across European countries, this study aimed to investigate factors associated with self-reported depression and anxiety among informal dementia caregivers both in Sweden and Italy, to ultimately improve their health and well-being. Methods: This comparative cross-sectional study used baseline data from the Italian UP-TECH (n = 317) and the Swedish TECH@HOME (n = 89) studies. Main outcome variables were the severity of self-reported anxiety and depression symptoms, as measured by the Hospital Anxiety and Depression Scale (HADS). HADS scores were investigated using descriptive and bivariate statistics to compare means and standard deviations. Linear regressions were used to test for associations between potential factors and self-reported symptoms of depression and anxiety. Results: Italian informal caregivers reported more severe symptoms of depression and anxiety than Swedish caregivers. In Italy, a higher number of hours of caregiving was associated with anxiety symptoms (β = − 1.205; p = 0.029), being 40–54 years-old with depression symptoms (β = − 1.739; p = 0.003), and being female with symptoms of both depression (β = − 1.793; p < 0.001) and anxiety (β = 1.474; p = 0.005). In Sweden, a higher number of hours of caregiving and being < 39 years-old were associated with depression symptoms (β = 0.286; p < 0.000; β = 3.945; p = 0.014) and a higher number of hours of caregiving, the lack of additional informal caregivers and dementia severity were associated with anxiety symptoms (β = 0.164; p = 0.010; β = − 1.133; p = 0.033; β = − 1.181; p = 0.031). Conclusion: Multiple factors are associated with self-reported symptoms of depression and anxiety among informal caregivers in Sweden and Italy. Factors found in this study partly differ between the two countries, suggesting the important role of cultural and social factors affecting the experience of caregiving. A deeper knowledge of these factors may increase the knowledge on potential protective and risk factors, provide information to policymakers and ultimately improve the psychological well-being of informal caregivers to people with dementia across Europe.

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  • Illness severity and presence of behavioural and psychological symptoms of dementia are known predictors for caregiver burden and depressive and anxiety symptoms.

    “Illness severity and presence of behavioural and psychological symptoms of dementia (BPSD) are known predictors for caregiver burden and depressive and anxiety symptoms [25,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48].”

    From Relationship of Psychological Flexibility and Mindfulness to Caregiver Burden, and Depressive and Anxiety Symptoms in Caregivers of People with Dementia (2023) · cites this paper as [25]

    The Background (page unavailable) says that inappropriate behaviours and increased dementia severity make caregivers more likely to develop symptoms of depression and anxiety. It discusses caregiver burden separately, but does not state that those two factors predict burden. The claim’s burden component is therefore not supported by this paper’s text. (LLM, conf=0.84)

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  • The prevalence of depressive and anxiety symptoms in dementia caregivers ranges from 29.9% to 74% and 7% to 44%, respectively, which is much higher than in the general population.

    “The prevalence of depressive and anxiety symptoms in dementia caregivers ranges from 29.9% to 74% and 7% to 44%, respectively, which is much higher than in the general population [19,20,21,22,23,24,25].”

    From Relationship of Psychological Flexibility and Mindfulness to Caregiver Burden, and Depressive and Anxiety Symptoms in Caregivers of People with Dementia (2023) · cites this paper as [25]

    The Results report depressive symptoms in 74% of the Italian caregiver sample and anxiety symptoms in 7% of the Swedish sample, supporting two endpoints of the cited ranges. They report 39% and 36% for the other endpoints, not 29.9% and 44%. The Background compares dementia caregivers with caregivers of people with other illnesses, not with the general population. (LLM, conf=0.89)

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Research works printed but not linked: 2

  1. [31]Esping-Andersen G Three worlds of welfare state capitalism 1990 Princeton Princeton University Press
  2. [56]Liu L Heart failure: epidemiology and research methods 2018 St. Louis Elsevier Inc 43 82

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Authors
Wulff, J., Fänge, A. M., Lethin, C., & Chiatti, C.
Affiliations
Lund University (SE)
Corresponding author
Lethin, Connie
ORCID
Venue
BMC Health Services Research
Publisher
Springer Science and Business Media LLC
Published
2020-12
Volume
20
Issue
1
Pages
1114-1114
ISSN
1472-6963 (ISSN-L)
DOI
10.1186/s12913-020-05964-2
PMC
PMC7709414
OpenAlex
W3108198145
Cited by
47
References
65
Citations by year
2026: 6 · 2025: 8 · 2024: 12 · 2023: 11 · 2022: 10
FWCI
3.82
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Health Services Research (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Lund University Publications (Lund University) (submittedVersion)
Funders
  • the Italian Ministry of Welfare (DGRM 1335/2011)
  • Forskningsrådet om Hälsa, Arbetsliv och Välfärd (2014–4913)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Health Sciences › Health Professions › Pharmacy › Nursing care and research
  • Social Sciences › Psychology › Clinical Psychology › Family Caregiving in Mental Illness
Keywords
depression, anxiety, informal caregivers, dementia, caregiver burden, caregiving hours, dementia severity, gender differences, cross-national comparison, Sweden, Italy, caregiver well-being
MeSH terms
Adult, Anxiety, Cross-Sectional Studies, Dementia, Depression, Europe, Female, Humans, Italy, Middle Aged, Sweden, Caregivers, Self Report

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