Depression, anxiety and quality of life of caregivers of individuals with dementia living in the community in Malta

Abstract

Dementia is one of the most important social and public health challenges affecting the Maltese society. The syndrome is not only characterized by the patient’s loss of independence but also by its impact on the lives of caregivers, who in the majority are relatives of affected individuals. The situation frequently becomes stressful, exposing the caregiver to depression, anxiety and loss in the quality of life. Data of 60 informal caregivers of individuals with dementia (IWD) living in the community were collected using specific data-collection instruments to assess their quality of life, stress and burden levels as well the presence of anxiety and depression. The level of cognitive impairment and activities of daily living were based on the Mini Mental State Examination (MMSE) and Barthel Index (BI) scores. Individuals with dementia had a mean age of 77.0±8.9 years, with 58.3% (n=35) being females. The majority of caregivers were females with a mean age of 63.8±10.8 years. Results indicated that more than half of the caregivers had moderate to severe anxiety and 25% had moderate to severe depression. Anxiety was mostly prevalent in daughters of IWD whereas female spouses were found to be more anxious than male spouses. Analysis of data showed that anxiety/depression and burden of care were negatively correlated with the younger age of the IWD and level of education, and positively correlated with time spent with the care-recipient. No significant correlations were found with the MMSE and the BI scores, demonstrating that anxiety and depression were present irrespective of the extent of cognitive and physical impairment. Emotional distress and burden experienced by caregivers showed a stronger association with caregivers’ quality of life than did the patient-related variables such as gender, MMSE and activities of daily living. The findings demonstrate that caregivers’ depression and anxiety differs among individuals, with the prevailing cause of stress being the ongoing burden that the caregivers’ perceive when caring for a relative with dementia. It is essential for the community professionals and care providers to be aware of the adversities experienced by both the caregiver and the care-recipient in order to support them and facilitate accessibility to services that aid in easing psychological distress.