African-American and white caregivers of older adults with dementia: differences in depressive symptomatology and psychotropic drug use.
OBJECTIVES: To examine relationships between race and psychotropic drug use (antidepressant, antianxiety, sedative/hypnotic agents) in informal caregivers with symptoms of depression who provide care for elderly relatives with progressive dementia. Whether racial differences in medication use relate to racial differences on predisposing, enabling, and need factors associated with use of these agents was also examined. DESIGN: National survey. SETTING: Community-based population of informal caregivers of elderly male U.S. veterans with dementia living throughout the 48 contiguous states and Puerto Rico. PARTICIPANTS: Two thousand thirty-two African-American and white female caregivers of elderly male veterans diagnosed with probable Alzheimer's disease or vascular dementia. MEASUREMENTS: Depressive symptoms were measured using a modified version of the Center for Epidemiological Studies Depression Scale. Antidepressant, antianxiety, and sedative/hypnotic agents were indexed using the Veterans Affairs medication classification system. RESULTS: Of caregivers with depressive symptoms, 19% used antidepressants, 23% antianxiety agents, and 2% sedative/hypnotics. African-American caregivers with depressive symptoms were significantly less likely than whites with depressive symptoms to be using antidepressants and antianxiety medications. Caregivers who reported higher levels of social support and more physician visits during the previous 6 months were significantly more likely than others to be taking antidepressants. CONCLUSION: This study found that 81% of caregivers with depressive symptoms were not taking antidepressant medication and that African-American caregivers were less likely than whites to be taking antidepressants. Results suggest that routine screening for depression in dementia caregivers may identify unmet needs for antidepressant therapy. Particular care should be taken to ensure that African-American caregivers are made aware of the potential benefits of such therapy.
Sleath, B; Thorpe, J; Landerman, LR; Doyle, M; Clipp, E
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