Bottom Line: An observational study of 663 caregivers and the patients with dementia they care for suggests caregiver depression is associated with increased emergency department visits for their patients. A total of 84 caregivers had depression at the study start and it was associated with an increase in rates of emergency department use by patients after accounting for a number of other potential mitigating factors including patient age and the severity of dementia. There were 196 patients with dementia who had at least one emergency department visit in the first six months of the study. Caregiver depression was associated with an additional 0.7 emergency department visits per person-year for patients compared to caregivers without depression (1.5 vs. 0.8 visits) on an absolute scale. Limitations of the study to consider include selection bias because those caregivers with higher depression may have declined to participate. Other factors may also influence the results, including socioeconomic status. Still, the results reveal an important potential caregiver vulnerability that if overlooked in clinical encounters could neglect an important component of care and limit the ability to maximize patient outcomes.
Authors: Elan L. Guterman, M.D., of the University of California, San Francisco, and coauthors
(doi:10.1001/jamaneurol.2019.1820)
Editor's Note: The article includes conflict of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
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JAMA Neurology