Defining "early dementia" and monitoring intervention: what measures are useful in family caregiving?

Full Abstract

Measures of cognition are often used to define and measure the progress of dementia and outcomes of intervention. This paper examines whether measures of psychosocial disability used with those of cognition are more useful than measures of cognition alone, particularly in early dementia. A measure of cognition and two instruments of caregiver burden, used as routine clinical outcome measures of three types of Old Age Psychiatry dementia services, were examined. All cases with dementia in a memory clinic (MC; n = 149), a community mental health service for older people (CMHT; n = 120) and a specialist dementia day hospital (DH; n = 118), in one NHS district were followed up at 12 months. Measures of cognition (MMSE), behaviour, caregiver coping (Problem Checklist; PC) and caregiver mood (Hospital Anxiety and Depression Scale; HAD) were taken at baseline (MC, n = 48; CMHT, n = 113; DH, n = 55) and at follow-up (MC, n = 35; CMHT, n = 34; DH, n = 23). At baseline, all three groups had an average MMSE score of "mild impairment" but measures of behaviour and caregiver burden showed subtle between-group differences. At the 12-month follow-up, cognition remained stable in all groups, but the frequency of day-to-day problems increased and caregiver mood deteriorated in families receiving DH support. The use of psychosocial measures of disability in conjunction with those of cognition, are important in the definition and longitudinal measurement of intervention and support in early dementia.

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Author information

Author/s: Richards, K (K); Moniz-Cook, E (E); Duggan, P (P); Carr, I (I); Wang, M (M);

Affiliation: Hull & East Riding Community NHS Trust, Hull, UK.

Journal and publication information

Publication Type: Comparative Study; Journal Article

Journal: Aging & mental health (Aging Ment Health), published in England. (Language: eng)

Reference: 2003-Jan; vol 7 (issue 1) : pp 7-14

Dates: Created 2003/01/29; Completed 2003/05/28; Revised 2006/11/15;

PMID: 12554309, status: MEDLINE (last retrieval date: 11/6/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

Comments and Corrections

CommentIn: Aging Ment Health. 2003 Jan;7(1):5-6. (PMID: 12607561)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adaptation, Psychological
Aged
Anxiety Disorders - epidemiology; psychology
Caregivers - psychology
Cognition Disorders - diagnosis; epidemiology
Community Mental Health Services - statistics & numerical data
Cost of Illness
Dementia - rehabilitation; therapy
Disability Evaluation

Disability Evaluation
Family Health
Follow-Up Studies
Hospitalization - statistics & numerical data
Humans
Mental Disorders - epidemiology
Mood Disorders - epidemiology; psychology
Neuropsychological Tests
Severity of Illness Index

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