Abstract WP463: Moderator Role of Preparedness on the Association Between Depression and Quality of Life in Stroke Survivor-Caregiver Dyads

Background: Although several studies have clearly shown that depressive symptoms in stroke survivors and caregivers decreases their quality of life (QOL), previous research has not yet analyzed the role of potential moderators in the relationship between the above two variables. Aims: To examine the moderating effect of caregiver preparedness between depressive symptoms and QOL in stroke survivor and caregiver dyads. Methods: Longitudinal design with 222 stroke survivor-caregiver dyads enrolled at survivor discharge from rehabilitation hospitals. Data collection was performed over 12 months. We measured survivor and caregiver QOL dimensions (physical, psychological, social and environmental), depression and preparedness. Hierarchical Linear Modeling was used to test four longitudinal dyadic moderation models (one for each QOL domain). Results: Survivors (50% males) and caregivers (65% females) were 70.8 (SD=11.9) and 52.5 (SD=13.1) years old, respectively. Controlling for baseline covariates, caregiver preparedness significantly moderated the association between survivor depressive symptoms and survivor psychological (B = 0.56, p < .01) and environmental (B = 0.58, p < .01) QOL at baseline and social QOL over time (B = 0.24, p < .05). In each case, higher levels of caregiver preparedness were protective and buffered the influence of survivor depressive symptoms on survivor QOL. Similarly, caregiver preparedness significantly moderated the association between caregiver depressive symptoms and caregiver physical (B = 0.25, p < .01) and environmental (B = 0.18, p < .05) QOL over time. Conclusions: Caregiver preparedness is a positive variable for both members of the dyad and the paper highlights the importance of implementing tailored intervention which could improve caregivers’ preparedness already during the rehabilitation period.

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Protective Role of Caregiver Preparedness on the Relationship Between Depression and Quality of Life in Stroke Dyads

Stroke ◽

10.1161/strokeaha.120.034029 ◽

2021 ◽

Author(s):

Gianluca Pucciarelli ◽

Karen S. Lyons ◽

Antonello Petrizzo ◽

Rossella Ambrosca ◽

Silvio Simeone ◽

...

Keyword(s):

Quality Of Life ◽

Hierarchical Linear Modeling ◽

Longitudinal Design ◽

Stroke Survivor ◽

High Educational Level ◽

Stroke Survivors ◽

Linear Modeling ◽

Over Time

Background and Purpose: Depression and quality of life (QOL) have an interdependent and transactional nature in stroke survivor-caregiver dyads. While the strong relationship between depression and physical and emotional QOL in stroke survivor-caregiver dyads is well known, it is less clear if this relationship is moderated by caregiver preparedness, which could easily be targeted with interventions. In this study, we examined the moderating role of caregiver preparedness on the association between depression and QOL in stroke survivor-caregiver dyads. Methods: We used a longitudinal design with follow-ups every 3 months over a 1-year period. Considering the nonindependent nature of the data (survivors and their caregivers), we used multilevel modeling to analyze data at the dyad level. We implemented 4 longitudinal dyadic moderation models (one for each QOL domain: physical, psychological, social, and environmental) using hierarchical linear modeling. Results: A sample of 222 stroke survivor-caregiver dyads was analyzed. Stroke survivors were older ( M =70.8, SD=11.9) than their caregivers ( M =52.4, SD=13.1). Stroke survivors predominantly had an ischemic stroke, equally distributed by site. Caregivers were primarily female (66%), with a medium to high educational level (57%). Caregiver preparedness significantly moderated the association between survivor depression and survivor psychological ( B =0.56, P <0.01) and environmental ( B =0.58, P <0.01) QOL at baseline and social QOL over time ( B =0.24, P <0.05). Similarly, caregiver preparedness significantly moderated the association between caregiver depression and caregiver physical ( B =0.25, P <0.01) and environmental ( B =0.18, P <0.05) QOL over time. Conclusions: Caregiver preparedness has a positive influence on both members of the dyad. Assessment of stroke-caregiver preparedness could be helpful to motivate clinicians to develop and implement interventions for stroke survivor-caregiver dyads.

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Biopsychosocial Patterning of Multimorbidity and Its Consequences

The Oxford Handbook of Integrative Health Science ◽

10.1093/oxfordhb/9780190676384.013.14 ◽

2018 ◽

pp. 220-236

Author(s):

Elliot Friedman ◽

Beth LeBreton ◽

Lindsay Fuzzell ◽

Elizabeth Wehrpsann

Keyword(s):

Quality Of Life ◽

Older Adults ◽

Functional Outcomes ◽

The United States ◽

Chronic Medical Conditions ◽

Quality Of Life Research ◽

Increased Risk ◽

Over Time

By many estimates the majority of adults over age 65 have two or more chronic medical conditions (multimorbidity) and are consequently at increased risk of adverse functional outcomes. Nonetheless, many older adults with multimorbidity are able to maintain high levels of function and retain good quality of life. Research presented here is designed to understand the influences that help ensure better functional outcomes in these older adults. This chapter presents findings that draw on data from the Midlife in the United States study. The independent and interactive contributions of diverse factors to multimorbidity and changes in multimorbidity over time are reviewed. The degree that multimorbidity increases risk of cognitive impairment and disability is examined. The role of inflammation as a mediator is considered. Multimorbidity is increasingly the norm for older adults, so better understanding of factors contributing to variability in multimorbidity-related outcomes can lead to improved quality of life.

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Quality of life in individuals with attenuated psychotic symptoms: Possible role of anxiety, depressive symptoms, and socio-cognitive impairments

Psychiatry Research ◽

10.1016/j.psychres.2017.08.024 ◽

2017 ◽

Vol 257 ◽

pp. 431-437 ◽

Cited By ~ 12

Author(s):

Tsutomu Takahashi ◽

Yuko Higuchi ◽

Yuko Komori ◽

Shimako Nishiyama ◽

Mihoko Nakamura ◽

...

Keyword(s):

Quality Of Life ◽

Depressive Symptoms ◽

Cognitive Impairments ◽

Psychotic Symptoms

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Burden, quality of life, anxiety, and depressive symptoms among caregivers of hemodialysis patients: The role of social support

The International Journal of Psychiatry in Medicine ◽

10.1177/0091217420913388 ◽

2020 ◽

Vol 55 (6) ◽

pp. 397-407

Author(s):

Madihah Shukri ◽

Mohd Azman Mustofai ◽

Md Aris Safree Md Yasin ◽

Tuan Sharipah Tuan Hadi

Keyword(s):

Quality Of Life ◽

Social Support ◽

Depressive Symptoms ◽

Cross Sectional Study ◽

Hemodialysis Patients ◽

Cross Sectional ◽

Caregiving Burden ◽

Low Levels

Objective The purpose of this study was to determine how burden and quality of life predict anxiety and depressive symptoms among caregivers of hemodialysis patients. Social support was included in the model as a proposed moderator in the above relationships. Methods This cross-sectional study involved 340 caregivers of chronic kidney patients undergoing hemodialysis. The setting was in Terengganu, Malaysia. The caregivers completed the measures of caregiving burden, quality of life, social support, and symptoms of anxiety and depression. Results About 28.8% and 52.4% of caregivers showed clinically moderate levels of anxiety and depressive symptoms, respectively. Furthermore, 35.9% and 3.8% of them showed clinically high levels of anxiety and depressive symptoms, respectively. Analyses showed that general quality of life was a significant predictor of both anxiety and depressive symptoms. Burden and psychological domains of quality of life significantly predicted anxiety. In addition, a lack of social support was a determinant of depressive symptoms. Evidence suggested that social support moderated the burden–anxiety relationship. Specifically, caregivers with low levels of social support showed more elevated levels of anxiety symptoms when their burden was higher. Conclusion There is an urgent need for early detection to initiate prompt treatment in this population. The study provides some important insights into offering comprehensive intervention to help caregivers cope more effectively through the provision of sufficient social support to buffer the effects of caregiving burden and improve mental health.

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The Role of Cognitive Appraisal in Quality of Life Over Time in Patients With Cancer

Oncology Nursing Forum ◽

10.1188/20.onf.292-304 ◽

2020 ◽

Vol 47 (3) ◽

pp. 292-304

Author(s):

Theresa Kessler

Keyword(s):

Quality Of Life ◽

Cognitive Appraisal ◽

Patients With Cancer ◽

Over Time

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Comorbid cognitive impairment and depression is a significant predictor of poor outcomes in hip fracture rehabilitation

International Psychogeriatrics ◽

10.1017/s1041610209991487 ◽

2009 ◽

Vol 22 (2) ◽

pp. 246-253 ◽

Cited By ~ 43

Author(s):

Liang Feng ◽

Samuel C Scherer ◽

Boon Yeow Tan ◽

Gribson Chan ◽

Ngan Phoon Fong ◽

...

Keyword(s):

Quality Of Life ◽

Cognitive Impairment ◽

Depressive Symptoms ◽

Hip Fracture ◽

Life Outcomes ◽

Ambulatory Status ◽

Quality Of Life Outcomes ◽

Mood And Cognition ◽

Over Time

ABSTRACTBackground: The effects of depression and cognitive impairment on hip fracture rehabilitation outcomes are not well established. We aimed to evaluate the associations of depressive symptoms and cognitive impairment (individually and combined) with ambulatory, living activities and quality of life outcomes in hip fracture rehabilitation patients.Methods: A cohort of 146 patients were assessed on depressive symptoms (Geriatric Depression Scale, GDS ≥ 5), cognitive impairment (Mini-mental State Examination, MMSE ≤ 23), and other variables at baseline, and on ambulatory status, Modified Barthel Index (MBI), and SF-12 PCS and MCS quality of life on follow ups at discharge, 6 months and 12 months post fracture.Results: In these patients (mean age 70.8 years, SD 10.8), 7.5% had depressive symptoms alone, 28.8% had cognitive impairment alone, 50% had both, and 13.7% had neither (reference). Ambulatory status showed improvement over time in all mood and cognition groups ((β = 0.008, P = 0.0001). Patients who had cognitive impairment alone (β = −0.060, P = 0.001) and patients who had combined cognitive impairment with depressive symptoms β = −0.62, P = 0.0003), showed significantly less improvement in ambulatory status than reference patients. In the latter group, the relative differences in ambulatory scores from the reference group were disproportionately greater over time (β = −0.003, SE = 0.001, P = 0.021). Patients with combined depressive symptoms and cognitive impairment also showed a significantly lower MBI score, (β = −10.92, SE = 4.01, P = 0.007) and SF-12 MCS (β = −8.35, SE = 2.37, P = 0.0006). Mood and cognition status did not significantly predict mortality during the follow-up.Conclusion: Depression and cognitive impairment comorbidity is common in hip fracture rehabilitation patients and significantly predicts poor functional and quality of life outcomes.

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Depressive symptoms and quality of life in people with a diagnosis of schizophrenia: An exploratory study of the potential mediating role of health‐promoting lifestyles

Perspectives In Psychiatric Care ◽

10.1111/ppc.12516 ◽

2020 ◽

Vol 56 (4) ◽

pp. 939-948

Author(s):

Chia‐Chi Chang ◽

Jason W. Beckstead ◽

Su‐Chen Lo ◽

Chiu‐Yueh Yang

Keyword(s):

Quality Of Life ◽

Depressive Symptoms ◽

Exploratory Study ◽

Mediating Role ◽

Health Promoting

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Predictors of change over time in subjective daytime sleepiness among older adult recipients of long-term services and supports

International Psychogeriatrics ◽

10.1017/s1041610220000782 ◽

2020 ◽

Vol 32 (7) ◽

pp. 849-861

Author(s):

Darina V. Petrovsky ◽

Karen B. Hirschman ◽

Miranda Varrasse McPhillips ◽

Justine S. Sefcik ◽

Alexandra L. Hanlon ◽

...

Keyword(s):

Quality Of Life ◽

Social Support ◽

Older Adults ◽

Depressive Symptoms ◽

Daytime Sleepiness ◽

Daily Living ◽

Services And Supports ◽

Over Time

ABSTRACTObjectives:Daytime sleepiness is associated with multiple negative outcomes in older adults receiving long-term services and supports (LTSS) including reduced cognitive performance, need for greater assistance with activities of daily living and decreased social engagement. The purpose of this study was to identify predictors of change in subjective daytime sleepiness among older adults during their first 2 years of receiving LTSS.Design and Setting:Secondary analysis of data from a prospective longitudinal study of older adults who received LTSS in their homes, assisted living communities or nursing homes interviewed at baseline and every 3 months for 24 months.Participants:470 older adults (60 years and older) newly enrolled in LTSS (mean = 81, SD = 8.7; range 60–98; 71% women).Measurements:Subjective daytime sleepiness was assessed every 3 months through 2 years using the Epworth Sleepiness Scale. Multiple validated measures were used to capture health-related quality of life characteristics of enrollees and their environment, including symptom status (Symptom Bother Scale), cognition (Mini Mental Status Exam), physical function (Basic Activities of Daily Living), physical and mental general health, quality of life (Dementia Quality of Life, D-QoL), depressive symptoms (Geriatric Depression Scale) and social support (Medical Outcomes Survey-Social Support).Results:Longitudinal mixed effects modeling was used to examine the relationship between independent variables and continuous measure of daytime sleepiness. Increased feelings of belonging, subscale of the D-QoL (effect size = −0.006, 95% CI: −0.013 to −0.0001, p = 0.045) and higher number of depressive symptoms (effect size = −0.002, 95% CI: −0.004 to −0.001, p = 0.001) at baseline were associated with slower rates of increase in daytime sleepiness over time.Conclusions:Comprehensive baseline and longitudinal screening for changes in daytime sleepiness along with depression and perceived quality of life should be used to inform interventions aimed at reducing daytime sleepiness among older adults receiving LTSS.

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