Quality of life of family carers of people living with dementia: review of systematic reviews of observational and intervention studies.

INTRODUCTION: Family members are the primary source of support for the growing number of people living with dementia (PLWD) worldwide. However, caring for a person living with dementia can have detrimental impacts on the carer quality of life (QoL). This review of systematic reviews explored the factors associated with the QoL of family carers of PLWD and interventions aimed at improving their QoL. SOURCES OF DATA: Several health-related databases (PUBMED, Psychinfo, Google Scholar and COCHRANE) were consulted in November 2022. Nineteen systematic reviews were included, and their methodological quality was assessed via AMSTAR-2. AREAS OF AGREEMENT: Better carer physical and mental health, provision of formal support, relationship quality between carers and PLWD, as well as positive psychological traits were associated with better carer QoL. There is no one-size-fits-all intervention that can improve the QoL of all carers, but promising results were found in most of the interventions. AREAS OF CONTROVERSY: There is inconsistency in evidence on the association between the carer age and QoL. The use of a wide range of QoL measures, particularly generic QoL scales, has contributed to inconsistencies when comparing the efficacy of interventions. GROWING POINTS: Evidence suggests the need for a person-centred approach to improving carer QoL, considering individual and contextual needs as well as the continuum and progressive nature of dementia care. TIMELY AREAS FOR DEVELOPING RESEARCH: Future research should be focused on understanding how to best implement and measure person-centred care approaches to carer QoL, including cost-effectiveness. More qualitative studies are necessary to explore carer negative and positive experiences of QoL.

Depression and frailty in older adults: A population-based cohort study.

BACKGROUND: Studies have shown an association between depression and frailty, even though the literature has not reached a consensus regarding how these syndromes interact. Although prospective cohort studies on this topic are still scarce, they could contribute to understanding this relationship. We aimed to observe whether depressive symptoms are risk factors for the onset of frailty among older adults living in São Paulo, Brazil. METHODS: Prospective cohort study using the "Health, Well-being and Aging" (SABE) Study databases of 2006 and 2010. The sample was representative of the community-dwelling older adults living in São Paulo, and it is composed of non-frail men and women aged 60 years and older without cognitive decline. We calculated the frailty incidence rate between older adults with and without depressive symptoms and calculated the incidence rate ratio. Multiple analysis was carried out through Poisson regression with robust variance estimation. RESULTS: The initial sample (n = 1,109) presented a mean age of 72 years (from 60 to 96) and 61.1% were women. The final sample was composed of 830 individuals, and the mean follow-up time in the study was 3.8 years. After adjusting the model, depressive symptoms did not predict the onset of frailty at follow-up. CONCLUSION: Depressive symptoms were not shown to be a risk factor for frailty among older adults living in São Paulo in this study.

Prevalence of Frailty in Latin America and the Caribbean: A Systematic Review and Meta-Analysis.

BACKGROUND: Countries in Latin America and the Caribbean (LAC) have experienced a rapid increase in their proportion of older people. This region is marked by a high prevalence of chronic diseases and disabilities among aging adults. Frailty appears in the context of LAC negatively affecting quality of life among many older people. AIM: To investigate the prevalence of frailty among community-dwelling older people in LAC through a systematic review and meta-analysis. METHODS: A literature search was performed in indexed databases and in the grey literature. Studies investigating the prevalence of frailty with representative samples of community-dwelling older people in Latin America and the Caribbean were retrieved. Independent investigators carried out the study selection process and the data extraction. A meta-analysis and meta-regression were performed using STATA 11 software. The systematic review was registered at the International Prospective Register of Systematic Reviews under the number CRD42014015203. RESULTS: A total of 29 studies and 43,083 individuals were included in the systematic review. The prevalence of frailty was 19.6% (95% CI: 15.4-24.3%) in the investigated region, with a range of 7.7% to 42.6% in the studies reviewed. The year of data collection influenced the heterogeneity between the studies. CONCLUSION: Frailty is very common among older people in LAC. As a result, countries in the region need to adapt their health and social care systems to demands of an older population.