POSTER TEMPLATE BY: Abstract In this longitudinal study of 185 spouses of persons with dementia, we examined whether use of cholinesterase inhibitor (ChEIs) positively affect caregiver burden. After controlling for age and cognitive loss, results suggest that dementia drugs prescribed at baseline do not predict caregiver burden one year thereafter (β =.02, p =.77). In contrast, depressive symptoms (β =.28, p <.01) and the absence of life satisfaction (β = -.30, p <.01) emerged as significantly associated with burden ( R² =.24, p <.01). This finding is in accord with Pearlins stress process model (Pearlin et al., 1990). Abstract In this longitudinal study of 185 spouses of persons with dementia, we examined whether use of cholinesterase inhibitor (ChEIs) positively affect caregiver burden. After controlling for age and cognitive loss, results suggest that dementia drugs prescribed at baseline do not predict caregiver burden one year thereafter (β =.02, p =.77). In contrast, depressive symptoms (β =.28, p <.01) and the absence of life satisfaction (β = -.30, p <.01) emerged as significantly associated with burden ( R² =.24, p <.01). This finding is in accord with Pearlins stress process model (Pearlin et al., 1990). Bonni Devlin a*, Charisse Pagarigan a* and Norm ORourke b a Department of Gerontology, b Faculty of Art and Social Sciences, Simon Fraser University, Burnaby (BC) * Co-First Authors | Bonni Devlin a*, Charisse Pagarigan a* and Norm ORourke b a Department of Gerontology, b Faculty of Art and Social Sciences, Simon Fraser University, Burnaby (BC) * Co-First Authors | Methods Spouses of persons with dementia, living together in the community, were recruited at the Clinic for Alzheimer Disease and Related Disorders (UBC Hospital, Vancouver). A total of 185 spouses were recruited over a 14 month period. Sixty-two percent (n = 115) of the care recipients were diagnosed with possible or probable Alzheimer disease. The average age of patients was years (SD = 7.86; range = 49-90) and couples had been married years on average (SD = 14.05; range = 1- 66). The vast majority of carers were Caucasian (94%; n = 174). Participants completed the Satisfaction with Life Scale (SWLS), Center for Epidemiological Studies – Depression Scale (CES-D) and Zarit Burden Interview (ZBI). Hierarchical multiple regression was performed to determine if ChEI use predicts lower caregiver burden one year later. Analyses were conducted using SPSS version Methods Spouses of persons with dementia, living together in the community, were recruited at the Clinic for Alzheimer Disease and Related Disorders (UBC Hospital, Vancouver). A total of 185 spouses were recruited over a 14 month period. Sixty-two percent (n = 115) of the care recipients were diagnosed with possible or probable Alzheimer disease. The average age of patients was years (SD = 7.86; range = 49-90) and couples had been married years on average (SD = 14.05; range = 1- 66). The vast majority of carers were Caucasian (94%; n = 174). Participants completed the Satisfaction with Life Scale (SWLS), Center for Epidemiological Studies – Depression Scale (CES-D) and Zarit Burden Interview (ZBI). Hierarchical multiple regression was performed to determine if ChEI use predicts lower caregiver burden one year later. Analyses were conducted using SPSS version Summary The results of this longitudinal study do not support the current (albeit sparse) research on ChEI use and caregiver burden which indicates a small, but significant positive relationship (Lingler et al., 2005; Hashimoto et al., 2009). Our results do support current findings of the association between caregiver burden and factors of psychological well-being such as life satisfaction and depressive symptoms (Cuijpers, 2005; Vitaliano, 2003; Broadty & Green, 2002). Furthermore, life satisfaction is inversely associated with caregiver burden and depressive symptoms are positively associated with caregiver burden. Our findings also support Pearlin and colleagues (1990) assertion that intra-psychic variables are generally more important than contextual and illness-related variables. We should note, however, that we did not confirm that ChEI dosage levels were within therapeutic range or taken as prescribed. Also, our sample was composed mostly of Caucasian women with higher education and socioeconomic status compared to the general population. Future research should be undertaken with other informal caregivers and from other regions of Canada. Summary The results of this longitudinal study do not support the current (albeit sparse) research on ChEI use and caregiver burden which indicates a small, but significant positive relationship (Lingler et al., 2005; Hashimoto et al., 2009). Our results do support current findings of the association between caregiver burden and factors of psychological well-being such as life satisfaction and depressive symptoms (Cuijpers, 2005; Vitaliano, 2003; Broadty & Green, 2002). Furthermore, life satisfaction is inversely associated with caregiver burden and depressive symptoms are positively associated with caregiver burden. Our findings also support Pearlin and colleagues (1990) assertion that intra-psychic variables are generally more important than contextual and illness-related variables. We should note, however, that we did not confirm that ChEI dosage levels were within therapeutic range or taken as prescribed. Also, our sample was composed mostly of Caucasian women with higher education and socioeconomic status compared to the general population. Future research should be undertaken with other informal caregivers and from other regions of Canada. Introduction Today, treatment for dementia commonly includes use of cholinesterase inhibitors. Some research suggests that ChEIs not only slow cognitive decline but also reduces caregiver burden, delayed institutionalization and lowers healthcare costs (Hsiung & Loy-English, 2004; Messinger-Rapport, McCallum & Hujer, 2006). The current study was undertaken with spouses of persons with dementia; 71% of whom were prescribed ChEIs at the time of recruitment. The objective of this study was to determine whether ChEIs predict lower caregiver burden one year later. Introduction Today, treatment for dementia commonly includes use of cholinesterase inhibitors. Some research suggests that ChEIs not only slow cognitive decline but also reduces caregiver burden, delayed institutionalization and lowers healthcare costs (Hsiung & Loy-English, 2004; Messinger-Rapport, McCallum & Hujer, 2006). The current study was undertaken with spouses of persons with dementia; 71% of whom were prescribed ChEIs at the time of recruitment. The objective of this study was to determine whether ChEIs predict lower caregiver burden one year later. Results Multiple regression analyses indicated that dementia-related factors accounted just 10% of the variability in caregiver burden (R 2 =.10, p <.01). Moreover, ChEI use did not emerge as a statistically significant predictor (β =.02, p =.77). Our hypothesis was not supported. In contrast, both depressive symptoms (β =.28, p <.01) and reduced levels of life satisfaction (β = -.30, p <.01) measured at recruitment both significantly predicted caregiver burden 1-year later after controlling for dementia- related factors (i.e., dementia symptom severity, patient age and ChEI use). Almost one-quarter of burden variance is explained by life satisfaction and depressive symptoms ( R² =.24, p <.01). Results Multiple regression analyses indicated that dementia-related factors accounted just 10% of the variability in caregiver burden (R 2 =.10, p <.01). Moreover, ChEI use did not emerge as a statistically significant predictor (β =.02, p =.77). Our hypothesis was not supported. In contrast, both depressive symptoms (β =.28, p <.01) and reduced levels of life satisfaction (β = -.30, p <.01) measured at recruitment both significantly predicted caregiver burden 1-year later after controlling for dementia- related factors (i.e., dementia symptom severity, patient age and ChEI use). Almost one-quarter of burden variance is explained by life satisfaction and depressive symptoms ( R² =.24, p <.01). References Brodaty, H., & Green, A. (2002). Defining the role of the caregiver in Alzheimer's disease treatment. Drugs Aging, 19, Cuijpers, P. (2005). Depressive disorders in caregivers of dementia patients: A systematic review. Aging and Mental Health, 9, Hashimoto, M., Yatabe, Y., Kaneda, K., Honda, K., & Ikeda, M. (2009). Impact of donepezil hydrochloride on the care burden of family caregivers of patients with Alzheimers disease. Psychogeriatrics, 9, 196–203. Hsiung, G.Y.R., Loy-English, I. (2004). Current therapy: A review of the cholinesterase inhibitors. BC Medical Journal, 46, Lingler, J. H., Martire, L. M. & Schulz, R. (2005). Caregiver-specific outcomes in anti- dementia clinical drug trials: a systematic review and meta-analysis. Journal of the American Geriatrics Society. 53, Messinger-Rapport, B., McCallum, T., & Hujer, M. (2006). Impact of dementia caregiving on the caregiver in the continuum of care. Long-Term Care: Clinical Care & Aging, 14 (1), Pearlin, L.I., Mullan, J.T., Semple, S.J., & Skaff, M.M. (1990). Caregiving and the stress process: An overview of concepts and their measures. Gerontologist, 30, 583–594. Public Health Agency of Canada (2008). Canadian best practices portal for health promotion and chronic disease prevention (Catalogue No. HP35-10/2008). Ottawa, ON: Government of Canada Publications. Vitaliano, P.P. (1990). A model of burden in caregivers of DAT patients. In E. Light & B.D. Lebowitz (Eds.), Alzheimer's disease treatment and family stress (pp. 267–291). New York, Hemisphere Publishing. References Brodaty, H., & Green, A. (2002). Defining the role of the caregiver in Alzheimer's disease treatment. Drugs Aging, 19, Cuijpers, P. (2005). Depressive disorders in caregivers of dementia patients: A systematic review. Aging and Mental Health, 9, Hashimoto, M., Yatabe, Y., Kaneda, K., Honda, K., & Ikeda, M. (2009). Impact of donepezil hydrochloride on the care burden of family caregivers of patients with Alzheimers disease. Psychogeriatrics, 9, 196–203. Hsiung, G.Y.R., Loy-English, I. (2004). Current therapy: A review of the cholinesterase inhibitors. BC Medical Journal, 46, Lingler, J. H., Martire, L. M. & Schulz, R. (2005). Caregiver-specific outcomes in anti- dementia clinical drug trials: a systematic review and meta-analysis. Journal of the American Geriatrics Society. 53, Messinger-Rapport, B., McCallum, T., & Hujer, M. (2006). Impact of dementia caregiving on the caregiver in the continuum of care. Long-Term Care: Clinical Care & Aging, 14 (1), Pearlin, L.I., Mullan, J.T., Semple, S.J., & Skaff, M.M. (1990). Caregiving and the stress process: An overview of concepts and their measures. Gerontologist, 30, 583–594. Public Health Agency of Canada (2008). Canadian best practices portal for health promotion and chronic disease prevention (Catalogue No. HP35-10/2008). Ottawa, ON: Government of Canada Publications. Vitaliano, P.P. (1990). A model of burden in caregivers of DAT patients. In E. Light & B.D. Lebowitz (Eds.), Alzheimer's disease treatment and family stress (pp. 267–291). New York, Hemisphere Publishing. Acknowledgement. Support for this study was provided by the North Shore Health Research Foundation and from the Canadian Institutes of Health Research (CIHR #136727) both awarded to Dr. ORourke. Hierarchical Regression Analysis of Caregiver Burden One Year Later Note. R² =.10, (p <.05) with the inclusion of dementia-related factors; R² =.24 (p <.01) subsequent to entry of caregiver psychological well- being variables. Hierarchical Regression Analysis of Caregiver Burden One Year Later Note. R² =.10, (p <.05) with the inclusion of dementia-related factors; R² =.24 (p <.01) subsequent to entry of caregiver psychological well- being variables. * p <.01