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EXPLANATION BOX

OBJECTIVE : to identify target groups for prevention of depression among caregivers of persons with dementia METHODS Design : cohort followed over 18 months. Participants : 725 caregivers of dementia patients who at baseline had not met the criteria for depression (CES-D<16)

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EXPLANATION BOX

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  1. OBJECTIVE : to identify target groups for prevention of depression among caregivers of persons with dementia METHODS Design: cohort followed over 18 months. Participants: 725 caregivers of dementia patients who at baseline had not met the criteria for depression (CES-D<16) Outcome measure: Incident depression defined as: 1) presence of depression at follow-up (CES-D score ≥16), and 2) significant increase in depression severity between two follow-up measurements (change score on the CES-D ≥ 5). Selecting high risk groups Strongest risk indicators of incident depression were selected (significant OR) and used to select the best target groups for preventive interventions. This was based on 4 indices: OR and AF (largest potential health benefit), ER and NNT (smallest effort and costs) Identifying target groups for the prevention of depression among family caregivers of dementia patients KJ Joling1 F Smit1,2 HWJ van Marwijk1 HE van der Horst1 P Scheltens3 R Schulz4 HPJ van Hout1 1 EMGO Institute for Health and Health Care Research, VU University Medical Centre, Amsterdam, The Netherlands 2 Trimbos Institute (Netherlands Institute for Mental Health and Addiction), Utrecht, The Netherlands. 3 Department of Neurology, Alzheimer Centre, VU University Medical Centre, Amsterdam, The Netherlands. 4 Department of Psychiatry, University of Pittsburgh and Center for Social and Urban Research, Pittsburgh, PA, USA. RESULTS 180 (24.8%) caregivers developed depression. Table 1. Significant risk indicators from the multivariate model # p<0.05, *p<0.001 Figure 1. Selecting high-risk groups for depression prevention EXPLANATION BOX Attributive Fraction (AF): % by which the IR of depression in the population can be reduced when the risk factor is completely eliminated. Number Needed to be Treated (NNT): number of people in the population that must receive the intervention in order to avoid one new case of depression. Exposure Rate (ER): % of the population exposed to a risk indicator, or to a combination of risk indicators. CONCLUSION: Detection of only a few characteristics makes it possible to identify high-risk groups in an efficient way and might contribute to a cost-effective prevention of depression in caregivers. Contact: k.joling@vumc.nl

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