Predictors of positive and negative appraisal among Cuban American caregivers of Alzheimer's disease patients.

OBJECTIVE: This study investigated predictors of positive (satisfaction) and negative (burden) appraisal among Cuban American (CA) caregivers of Alzheimer's disease (AD) patients. DESIGN: Cross-sectional study of AD patients and their family caregivers. SETTING: A university-affiliated outpatient memory disorders clinic. SUBJECTS: A convenience sample of 40 CA family caregivers of patients diagnosed with probable or possible AD according to NINCDS-ADRDA diagnostic criteria. MEASURES: AD patients: Mini-Mental State Examination (MMSE), Blessed Dementia Scale (BDS) and the Behavioral Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD). Caregivers: Caregiving Burden Scale (CBS), Caregiving Satisfaction Scale (CSS), Perceived Emotional Support scale (PES) and the Short Form-36 Health Survey-General Health Index (GH). RESULTS: Appraised burden was predicted by increased patient behavioral pathology, female caregiver gender and lower levels of perceived emotional support. The association between older caregiver age and increased burden approached significance. Older caregiver age and higher levels of perceived social support were shown to predict appraised satisfaction. Post-hoc analyses also indicated that length of residence in the United States, a measure of acculturation, was not associated with positive or negative appraisal. CONCLUSION: Appraised burden and satisfaction represent important outcomes of dementia care that show relations with distinct factors among CA caregivers. It is clear that further research is warranted in order to ascertain the relationship of ethnicity or culture to the process and psychological consequences of dementia caregiving. Continued investigations into predictors of caregiving satisfaction are also recommended.

Depressive symptoms in Alzheimer's disease. An examination among community-dwelling Cuban American patients.

The authors examined the prevalence and clinical correlates of mood disturbance in 96 Cuban American (CA) Alzheimer's disease (AD) patients. Depression (Cornell Scale for Depression in Dementia score > or = 7) was evident in 39.6% of the participants and showed associations with comorbid psychosis, lower education, and decreased length of residence in the United States, a measure of acculturation. Mood disturbance was not related to age, gender, marital status, cognitive dysfunction, functional impairment, history of significant alcohol use, or coexisting medical conditions. The results of this investigation suggest that signs and symptoms of depression are common neuropsychiatric disturbances in CA AD patients residing in the community.

Factors associated with depressive symptoms in non-demented community-dwelling elderly.

OBJECTIVE: We examined the risk for depressive symptoms associated with age, education, ethnicity, gender, marital status, apolipoprotein E genotype (APOE) and memory complaints among non-demented elderly (> or = 60 years). DESIGN: Cross-sectional study of geriatric patients recruited from a free memory screening offered to the community. SAMPLE: This investigation included 506 community-residing elderly subjects who were screened for cognitive impairment and classified as non-demented based on age and education-adjusted Folstein Mini-Mental State Exam (MMSAdj) scores of 24 or greater. RESULTS: The prevalence of significant depressive symptoms (Hamilton Depression Rating Scale > or = 12) was 12.1% (N = 61). Increased risk for depression was associated with female gender (OR = 2.3; 95% CI = 1.1-4.8; p < 0.05), Cuban American ethnicity (OR = 4.9; 95% CI = 2.3-10.4; p < 0.0001) and memory complaints (OR = 1.3; 95% CI = 1.2-1.4; p < 0.0001). The APOE allele frequencies in the current sample were 0.07, 0.80 and 0.13 for the epsilon 2, epsilon 3 and epsilon 4 alleles, respectively. CONCLUSIONS: The results suggest that signs and symptoms of depression are common among non-demented elderly subjects in the community. In this study, mood disturbances were associated with Cuban American ethnicity, female gender and more memory complaints. Factors that were not confirmed by this study include age, education, marital status and APOE genotype. The observed APOE, epsilon 4 allele frequency of 0.13 supports the normal cognitive classification of the sample.

South Florida Program on Aging and Health. Assessing the prevalence of Alzheimer's disease in three ethnic groups.

The South Florida Program on Aging and Health was initiated in 1992 with the aim to assess physical and mental health of the elderly in Dade County and provide a basis for public health policy. This report describes the methodology applied in the study and preliminary screening results in a probability sample of 2,400 African American, Cuban American and white non-Hispanic American elderly men and women. Of 2,013 participants screened by May 1995, 11.5% had cognitive impairment. An increase in prevalence from 4-7% to 25-36% with advancing age was found among men and women of each group, from the youngest (65-74) to the oldest (85+ years). Male and female prevalences were similar but vary by ethnic group and age.