International Psychogeriatrics

Research Article

Specific effects of caring for a spouse with dementia: differences in depressive symptoms between caregiver and non-caregiver spouses

Kathryn Betts Adamsa1 c1

a1 The Mandel School of Applied Social Sciences and University Memory and Aging Center, Case Western Reserve University, Cleveland, Ohio, U.S.A.


Background: Caring for spouses with dementia is a risk factor for increased levels of depression. Less is known about specific symptom differences between groups of caregivers and non-caregivers. This study characterizes differences on the CES-D depression screening scale between caregiving and non-caregiving spouses.

Methods: Data were obtained from 391 spouse caregivers of persons with dementia and 226 control subjects. Significant between-group differences on demographic variables determined covariates used in two multivariate ANCOVA analyses, on the set of four CES-D subscales and on the set of the 20 CES-D individual items. Significant multivariate analyses were followed by univariate tests between the two groups.

Results: Dementia caregiving spouses had significantly more depressive symptoms than non-caregiving married adults, after controlling for group differences. Proportion of variance in the set of CES-D subscales explained by caregiver group status was 13.4%. The greatest between-groups difference in univariate analysis was found in the Positive Affect subscale, and significant differences were found in 11 of the 20 CES-D items. Caregiver spouses experienced less hope for the future and less happiness and enjoyment in life than the non-caregiving spouses. They also reported greater degrees of sadness, being bothered, and loneliness than the non-caregivers.

Conclusions: The differences, particularly caregivers' lack of positive affect, suggest the need for appropriate intervention approaches to assist spouse caregivers.

(Received May 28 2007)

(Online publication June 25 2007)

(Revised July 30 2007)

(Accepted July 31 2007)

(Online publication October 15 2007)


c1 Correspondence should be addressed to: Dr. Kathryn Betts Adams, Assistant Professor of Social Work, The Mandel School of Applied Social Sciences, Case Western Reserve University, 10600 Euclid Avenue, Cleveland, OH 44106, U.S.A. Phone: +1 216 368 6155. Email: