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July 08, 2019

Caregiver depression linked to more ER visits for patients with dementia

But going to the emergency room may lead to subsequent depression among caregivers

The combination of a caregiver with depression and a patient with dementia can lead to a cycle of adverse outcomes for both.

Caregiver depression is linked to higher rates of emergency department use among patients with dementia, according to a new study. Additionally, emergency department use was associated with subsequent depression among caregivers.

This suggests caregivers and patients with dementia "can fall into a negative cycle of health care use and depression," according to the study, published Monday in JAMA Neurology.

The study observed 663 caregiver-patient pairings over a six-month period. All of the patients had dementia. Among the caregivers, 12.7 percent had been diagnosed with depression at the beginning of the study – a rate consistent with previous research.

Caregiver depression was associated with a 73 percent increase in the rate of emergency department use among patients with dementia, researchers found. That equates to an additional 0.7 annual emergency department visits per person.

Previous research has found that anywhere from 30 percent to 80 percent of patients with dementia visit the emergency department at least once each year.

"Acute care use among patients with dementia places a large financial burden on our health care system," researchers wrote. "This care may be avoidable and effective methods for preventing ED use could significantly reduce costs for this high-risk patient population."

The researchers added that a better understanding of the driving factors of caregiver depression could help determine effective ways to reduce it.

Virtually all of the caregivers included in the study were caring for a spouse, domestic partner or first-degree relative. About 70 percent of them were women. Their average age was nearly 65.

The patients averaged 77 years old. Just over half of them were women.

The study was led by researchers from the University of California San Francisco.

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