Thesis (Ph.D.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / There is growing evidence of the burden of family care giving, particularly among spouses. but little attention has been paid to the gratifications experienced. A cross-sectional, non-probability, interview study conducted in Massachusetts of 50 wives ages 58 and older supports the hypothesis that caregivers who are more gratified have greater well-being and those who experience greater frustration are more distressed. The caregivers were gratified by having their husbands at home; by believing that caregiving involved reciprocity and nurturing; enjoying moments of warmth. comfort, and pleasure: having gratification from their emotional support systems; and experiencing no change in marital closeness since the illness. Caregivers at risk of mental health problems are those who are highly frustrated and not gratified by the care giving experience. The general frustrations of feeling overwhelmed, resentful, fearful and not resigned were associated with low well-being. Frustration of wives with husbands' ADL ability, with inadequate time for themselves. with constraints of caregiving, with household chore responsibility. and with changes in their emotional support systems also contributed to low well-being. Comparison of the sample with national studies all utilizing the Dupuy WellBeing Scale, shows that the majority of caregivers are in no more distress than the general adult population. Thirty-two percent, however, are in severe distress. Caregiver distress is associated primarily with anxiety, not with depression as widely believed. Distress is not associated with caregiver age or health or with patient illness characteristics, factors that should no longer be used in clinical circles to assess the status of caregivers. Maintaining continuity in preferences and patterns is important to the well-being of caregivers. The study findings can guide the mental health treatment of caregivers particularly as the data lends support to the theory that disruption in the lives of caregivers is a stressor. / 2999-01-01

No / The objective of this study was to investigate whether the presence of depressive symptoms influences the clinical expression of Alzheimer's pathology. We have analysed the relationships between the severity of Alzheimer's pathology and cognitive decline in two patient groups defined by the presence or absence of depressive symptoms. The study included 89 subjects who participated in a longitudinal research programme prior to death, underwent post-mortem examination and were found to have only Alzheimer-type pathology in their brains, ranging in severity from the entorhinal to neocortical stages. Our results indicate that depressive symptoms did not influence cognition in the early (entorhinal) stages of Alzheimer's disease (AD; where cognition was good regardless of whether or not there was evidence for depressive symptoms) or in the late (neocortical) stages (where cognition was poor regardless of whether or not there was evidence for depression). However, in the intermediate (limbic) stages, patients with depressive symptoms had significantly worse cognitive performance (mean CAMCOG of 32) than those who did not (mean CAMCOG of 73). We conclude that depressive symptoms may contribute to the cognitive decline of AD patients in that pathology, that would be otherwise silent, becomes clinically apparent. Therefore, a multiple diagnosis of early AD and depression should be more widely considered in elderly persons presenting with mild cognitive decline and depression. Treating the depressive symptoms would benefit the patient, but the cognitive improvement may not indicate that AD is absent.

Yes / Objectives: We aimed to examine change over time in self-rated quality of life (QoL) in people with mild-to-moderate dementia and identify sub-groups with distinct QoL trajectories. Method: We used data from people with mild-to-moderate dementia followed up at 12 and 24 months in the IDEAL cohort study (baseline n=1537). A latent growth model approach examined mean change over time in QoL, assessed with the QoL-AD scale, and investigated associations of baseline demographic, cognitive and psychological covariates with the intercept and slope of QoL. We employed growth mixture modelling to identify multiple growth trajectories. Results: Overall mean QoL scores were stable and no associations with change over time were observed. Four classes of QoL trajectories were identified: two with higher baseline QoL scores, labelled Stable (74.9%) and Declining (7.6%), and two with lower baseline QoL scores, labelled Stable Lower (13.7%) and Improving (3.8%). The Declining class had higher baseline levels of depression and loneliness, and lower levels of self-esteem and optimism, than the Stable class. The Stable Lower class was characterised by disadvantage related to social structure, poor physical health, functional disability, and low psychological well-being The Improving class was similar to the Stable Lower class but had lower cognitive test scores. Discussion: Understanding individual trajectories can contribute to personalised care planning. Efforts to prevent decline in perceived QoL should primarily target psychological well-being. Efforts to improve QoL for those with poorer QoL should additionally address functional impairment, isolation, and disadvantage related to social structure. / This work was supported by Economic and Social Research Council (ESRC, part of UK Research and Innovation, UKRI) and National Institute for Health Research (NIHR) grant ES/L001853/2. Alzheimer‟s Society Centre of Excellence grant 348, ASPR2-16-001

The purpose of the present study was to compare 42 community-dwelling spouse and child Alzheimer's Disease caregivers with 38 community-dwelling potential caregivers on salience of illness symptoms, and accuracy of judging symptoms of illnesses.

Thesis (Ph. D.)--University of California, San Diego and San Diego State University, 2002. / Includes bibliographical references (leaves 167-185).

Background: Alzheimer’s disease, one type of dementia, is predicted to have great impact on society and economy. This effect increases rapidly especially in developing countries. The number of people with Alzheimer’s disease is huge due to the large population in China where the effects of this disease are amplified by the one-child policy. Objective: To review the risk factors of Alzheimer’s disease in different countries and offer some suggestions that how to prevent Alzheimer’s Disease in China that has very limited research on Alzheimer’s disease. To make recommendations for potential strategies to be implemented by policy-makers, government or other stakeholders. Method and results: Relevant studies which identified the risk factors for Alzheimer’s disease and evaluated the interventions and treatments for reducing the risk of getting Alzheimer’s disease, that were published between 1990 and 2012 were searched in PubMed and Google Academic using specific keywords. A total of 1071 studies were found and 62 used. Based on this systematic review, the risk factors of Alzheimer’s disease are age, lifestyle, family history and genetics, vascular, mild cognitive impairment, head injury as well as early-life negative events. There appear to be several important contributions to Alzheimer’s disease prevention including diet, cognitive activity, physical activity, social engagement, smoking cessation, and alcohol ingestion or simply being optimistic. Conclusion: This review has included the potential risk factors of Alzheimer's disease and the ways of preventing Alzheimer's disease, as well as to produce some possible strategies of preventing Alzheimer's disease based on the situation in China for the Chinese government and policy makers such as to use media as an important channel to draw people's attention about Alzheimer's disease and to educate about preventive factors. There should be government-funded education and health services in the rural areas and plans to build more leisure and sports centers in China. The government should also subsidize hospitals and medical centers to provide affordable or even free health examinations for people and build a central database for the purpose of recording, analysis and research into Alzheimer's disease for better understanding of the disease. Medical professionals and volunteers can help to enhance this database by the implementation of data collection to look for symptoms of Alzheimer’s disease. If the patients appear to have such symptoms, further data collection should be taking place, such as family history of Alzheimer’s disease, health status, head injuries, family status, characteristics and behavior, income levels, residential areas and other background information of the patients as part of their work whenever and wherever they go, especially in rural areas. / published_or_final_version / Public Health / Master / Master of Public Health

Thesis (Ph. D.)--Michigan State University. Dept. of Psychology, 2006. / Title from PDF t.p. (viewed on Nov. 16, 2008) Includes bibliographical references (p. 71-78). Also issued in print.

Thesis (Ed.D.)--Teachers College, Columbia University, 1995. / Includes tables. Typescript; issued also on microfilm. Sponsor: Barbara Wallace. Dissertation Committee: Marie O'Toole. Includes bibliographical references (leaves 95-103).

Thesis (M.E.)--University of Canterbury, 2009. / Typescript (photocopy). Includes bibliographical references (leaves 139-142). Also available via the World Wide Web.

Caregivers for individuals diagnosed with Alzheimer's disease (AD) shoulder a remarkably complex burden as compared to other caregivers of elderly individuals. For long distance caregivers, geographical separation further compounds the problems experienced by AD caregivers, as they are isolated from family members and support networks. Both on-site and long-distance AD caregivers experience uncertainty; the findings from this study illustrate how AD caregivers manage the uncertainty of the disease and primary care, as well as how uncertainty differs between on-site and long-distance caregivers. AD caregiver (N = 13) interviews were transcribed and qualitatively analyzed using uncertainty management theory as a thematic lens. The analysis revealed that AD caregivers experience overwhelming feelings of burden, guilt, and doubt; however, these feelings manifest differently depending on caregiver type. The findings of this study demonstrate that sources for obtaining information regarding AD and caregiving were useful for on-site caregivers; however, the sources did not account for the needs of long-distance caregivers or the psychosocial needs of on-site caregivers. Furthermore, AD caregivers did not seek support or information about AD and caregiving from health care professionals. Implications for future research regarding long-distance and on-site AD caregiving are discussed.