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Biomedical subjects

S H Zarit

Publications and source records attributed to S H Zarit.

At least 19 recordsLinked to original sources
PubMed1998

Stress reduction for family caregivers: effects of adult day care use.

OBJECTIVES: This study reports the findings of an evaluation of the psychological benefits of use of adult day care by family caregivers assisting a relative with dementia. METHODS: The study used a quasi-experimental design in which caregivers in the treatment group used substantial amounts of services, whereas caregivers in a control group did not use day care at any point during the evaluation and only small amounts of other respite services. The evaluation was guided by the stress process model of caregiving which distinguishes between appraisals of primary stressors and well-being. RESULTS: Results after 3 months of day care use showed that the treatment group had significantly lower scores than the control group on two of the three measures of primary appraisals (overload and strain) and two of the three measures of well-being (depression and anger). Findings at one year showed that the treatment group had significantly lower scores on overload and depression than the control group. DISCUSSION: These results demonstrate that use of adult day care by caregivers of dementia patients results in lower levels of caregiving-related stress and better psychological well-being when compared to that of controls.

Aged↗
PubMed1997

Early cognitive markers of the incidence of dementia and mortality: a longitudinal population-based study of the oldest old.

This study examines whether cognitive markers at prior examinations are indicative of subsequent dementia and mortality. The sample was composed of subjects aged 84-90 at baseline who were reexamined three times over a 6-year period on a comprehensive biobehavioral battery. Dementia was evaluated at each examination using DSM-III-R criteria. Results indicated that incident cases of dementia had lower cognitive scores both 2 and 4 years prior to diagnosis, compared to non-demented survivors. Evidence for terminal decline was also found, as people who subsequently died also had lower cognitive performance at prior examinations, compared to non-demented survivors. The findings suggest that mild cognitive dysfunction is an important clinical finding among the oldest old and may herald either the onset of dementia or mortality.

Aged↗
PubMed1997

Self-reports on memory functioning in a longitudinal study of the oldest old: relation to current, prospective, and retrospective performance.

Self-evaluation of memory performance, one aspect of metamemory, may be an important indicator of concurrent, retrospective, or future decline in memory functioning. The relationships among self-evaluations, cognition, and outcome were investigated in the OCTO study, a longitudinal, population-based panel of the oldest old. Using concurrent data, results indicated that overall cognitive ability, depression, gender, and education were associated with self-reports of memory for the entire sample. The relation of perception of decline to actual decline was also examined. Self-reported decline over a 2-year period was associated with actual decline in performance on three tests of memory. Finally, self-reported memory function was investigated as an indicator of future cognitive decline and diagnosis of dementia. These self-evaluations predicted decline on specific tests of memory over 2 years and subsequent diagnosis of dementia after 2 and 4 years. The amount of variance accounted for by self-evaluations, however, was relatively small, suggesting that complaints reflect different processes, only one of which is the pathological decline involved in dementia.

Aged↗
PubMed1997

Predicting change in activities of daily living: a longitudinal study of the oldest old in Sweden.

We examined predictors of stability and decline in activities of daily living (ADLs) and mobility in a population-based sample of the oldest old. Respondents were people aged 84 to 90 living in South Central Sweden. Predictors were drawn from three domains: sociodemographic variables, vitality, and physical and psychological health. Using a logistic regression model, we sought to identify variables that were associated with changes in functioning. Over the 2-year interval, we found significant main effects for stability in ADL functioning for three variables: residential status (e.g., living in the community), subjective health, and mastery (n = 142). For mobility, we identified three variables associated with stability: lung function, subjective health, and mastery (n = 137). Over the 4-year period we found that residential status was significantly associated with stability in ADL performance (n = 89), while age, marital status, grip strength, and mastery were significant predictors for stability in mobility (n = 90). The findings can direct researchers toward interventions within particular residential environments that maintain a sense of mastery and an individual's aggressive attitude toward challenging situations.

Activities of Daily Living↗
PubMed1996

A measurement model of cortisol reactivity of healthy older adults.

Research on the physiological adaptation process has found that stress is associated with the rate of cortisol secretion, the main hormone that reflects stress. However, considerable variation among subjects has been reported. Using a sample of older adults (N=46), we tested the hypothesis that cortisol reactivity is composed of (1) a situation-related component representing hypothalamic influence on cortisol secretion observed on three different occasions, and (2) a stable component representing a general trait responsible for cortisol responses observed from occasion to occasion. LISREL VIII was used to test this hypothesis. Results indicated that a homogeneous reliability model was not supported by the data. A congeneric measurement model represented a better fit to the data. Results suggest that subjects have consistent patterns of response during separate experimental occasions. However, results do not suggest a consistent pattern of response over time. The main implication of these results is that salivary cortisol measures are sensitive to experimental stress situations. As such, this noninvasive method may be useful in examining adaptive responses to stress.

Adaptation, Psychological↗
PubMed1996

Preparation for caregiving: a study of multigeneration families.

The impact of providing care to the frail elderly on individual caregivers and their families has been discussed at length, but few researchers have investigated the events and circumstances preceding the onset of caregiving. In addition, although there is evidence that several family members are usually involved in planning and decision making about caregiving, the majority of studies in this area include only one generation. Based on a larger theoretical framework of preparation for caregiving [1, 2], the extent to which family members anticipate and plan for future caregiving is investigated. In addition, the extent to which they are satisfied with these preparations is studied. Interviews were conducted with mothers, daughters, and granddaughters in thirty-three multigeneration families. While substantial numbers of both mothers and daughters anticipated the need for care for the oldest generation, few made concrete plans about how to organize future care provision. Planners were more satisfied with the amount of discussion and planning in their family than non-planners. Implications for future research and practice applications are discussed.

Activities of Daily Living↗
PubMed1995

Dimensions of social support and social conflict as predictors of caregiver depression.

The goal of this research was to examine the relationship of family social support and social conflict to stressors and depression. Fifty-seven caregiving women were interviewed regarding caregiving stressors, social support, and social conflict. Three dimensions of social support and social conflict were assessed: instrumental, informational, and affective. The findings supported the importance of distinguishing between social support and social conflict, and among the three dimensions of support and conflict. Respondents reported higher levels of support than of conflict, but consistent with earlier research, social support was not related as strongly to outcomes as social conflict was. Although instrumental support was related significantly to depression, informational and emotional support was not. Social conflict, however, was significantly related to depression. Both emotional conflict and informational conflict were significant predictors of depression. Implications for future research and interventions are discussed.

Activities of Daily Living↗
PubMed1995

Ecological measures of cognitive functioning: a validation study.

Observed cognitive decline in the elderly has been widely reported in the literature. The relation of experimental cognitive ability measures to real-world cognitive competence has been questioned. This research examines the validity of English-language versions of two measures of everyday competency: the Memory in Reality test involving object placement recall and the Coin Test, a money-sorting task. The measures were developed as part of a Swedish epidemiologic study. Validity was evaluated by comparison of these tasks with standard cognitive tests and with a measure of metamemory. It was expected that the ecological measures would have a stronger association with metamemory than the standard tests. Subjects were 93 community-dwelling women, aged 75 and older. The ecological tasks correlated positively with the standard tests, but there were inconsistent relations of both standard and ecological measures with metamemory. The results partly support use of these measures for evaluating everyday functioning.

Activities of Daily Living↗
PubMed1995

Variability in daily events and mood of family caregivers to cognitively impaired elders.

This study explores the relationship of daily mood and daily events in a caregiving context. Family caregivers to demented elders (N = 43) kept fourteen-day diaries of: 1) caregiving activities, 2) disruptive patient behaviors, and 3) daily mood. Independent raters and cluster analysis support the hypothesis of three mood patterns. Differences among the three clusters in the relationship of mood and daily caregiving events were explored. The findings indicate that some caregivers are highly distressed by caregiving demands, some report moderate levels of distress, and others show no relationship between mood and daily events. The varied patterns support an individual differences approach to understanding caregiving and in the design of interventions.

Adaptation, Psychological↗
PubMed1993

Group homes for people with dementia: a Swedish example.

We describe the development and evaluation of group homes for dementia patients in Sweden. Group homes have been established on a social model of care to provide a better quality of life than in institutional settings, while making a small savings on cost. An enriched program of activities uses familiar, everyday household tasks, with staff trained to model appropriate behaviors. An evaluation of four homes indicated that residents could be well accommodated in the setting, even as their disabilities increased. Although there were some initial problems, staff satisfaction was high and turnover low.

Aged↗
PubMed1992

Changes in cognitive functioning of the oldest old.

Cognitive changes during a 2-year interval in a representative sample of the oldest old were investigated. Respondents were 324 people aged 84 to 90 at baseline who were selected from census records in the Jönköping region of Sweden. Following a 2-year interval, it was possible to reinterview 213 people, or 94% of individuals, still alive. Performance on a battery of five cognitive tests showed a small decline in mean scores, and a 10% increase in the number of people meeting criteria for significant cognitive impairment. Respondents with better functioning at baseline tended to have stable performance over this period.

Aged↗
PubMed1992

Institutional placement: phases of the transition.

The consequences of institutionalization were examined for a sample of caregivers of dementia patients. Consistent with the stress process model, institutionalization was hypothesized to have a large impact on the primary effects of caregiving and lesser influence on secondary effects and well-being. Following placement, relatives experienced relief from primary effects of caregiving (e.g., feelings of overload and tension) and improved well-being, whereas other indicators of stress remained unchanged.

Caregivers↗
PubMed1991

Dementia and cognitive impairment in the oldest old: a comparison of two rating methods.

Rates of cognitive impairment in a representative population of the oldest old (aged 84 to 90) were examined using two indicators: The Global Deterioration Scale (GDS), and a Cognitive Rating (CR) derived from performance on five neuropsychological tests. Prevalence was estimated at 25.3%, using the GDS, and 30% with the CR. The overall degree of congruence between the measures was high, with most disagreements involving mildly impaired cases. The results indicate a high degree of convergence of clinical and neuropsychological indicators. The findings also confirm high rates of impairment among the oldest old.

Aged↗
PubMed1991

Efficacy of interventions with caregivers: a reanalysis.

This paper presents a reanalysis of data from a previously reported study with family caregivers of dementia patients using the method of prediction analysis. Compared with subjects on a waiting list or enrolled in support groups, caregivers in individual and family counseling were more likely to have successful outcomes on all dependent measures (Brief Symptom Inventory, personal strain, and role strain).

Aged↗
PubMed1991

Informal support from black churches and the well-being of elderly blacks.

This paper explores the type of support black churches and families provide, and how that support relates to the well-being of elderly blacks. Findings indicate that the family network is perceived as more supportive than the church network, but that church support contributes to feelings of well-being. Perceptions of support from the churches and not the spiritual aspects of religion or involvement in organized religious activities were associated with well-being.

Black or African American↗
PubMed1991

Caregiver activity on respite and nonrespite days: a comparison of two service approaches.

Use of time was examined among female caregivers of dementia patients who used home care (n = 20) and day care (n = 20) respite services. Assessment of caregiver activity during respite and nonrespite days revealed significant program differences in the amount of caregiving time and overall differences in the amount of noncaregiving time. Use of respite time was also examined. Significant predictors of willingness to continue care were identified. Ratings of program satisfaction were very high.

Adult↗
PubMed1991

Current research issues in caregiving to the elderly.

Caregivers for dependent elders have been the subject of numerous studies in recent years. This first wave of research demonstrates that caregiving is demanding and may be expensive to the caregiver socially, psychologically, physically, and financially. This article reviews the caregiving literature and focuses on current limitations and future directions for study in two areas: sampling and research design. Specifically suggested are ways to refine sampling procedures and to more carefully define what a caregiver is. In the design of caregiving studies, both group and individual differences offer insight into the impact of caregiving. In addition, dyadic measurement of the caregiver, the elder, and the family are suggested. Finally, in examining a progressive phenomenon such as Alzheimer's disease or memory loss, longitudinal designs are necessary and timely.

Aged↗