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      O lugar do cuidador familiar de idosos com doença de Alzheimer: uma revisão de literatura no Brasil e Estados Unidos Translated title: The place of family caregivers for older adults with Alzheimer’s disease: a literature review in Brazil and the United States

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          Abstract

          Resumo Apresenta-se uma revisão de literatura sobre cuidadores familiares de pacientes com a doença de Alzheimer, no período de 2013 a 2017, disponíveis nas bases de dados BVS, Scopus e PubMed. Descritores utilizados: doença de Alzheimer (DA), cuidadores, saúde do idoso, por combinação. Dos 163 artigos analisados, após aplicação do teste de relevancia, foram selecionados 26, apresentados a partir de cinco unidades temáticas: 1- Revisões de literatura; 2- Perfis de prevalencia dos cuidadores de DA; 3- Pesquisas qualitativas que analisam os sentimentos e os sofrimentos dos cuidadores; 4- Estudos comparativos e testes objetivos; 5- Pesquisas de avaliação de programas de intervenção. A análise compreensiva e comparativa das investigações demarcou diferenças e semelhanças, vantages e desvantagens das amostras e metodologias adotadas no Brasil e nos Estados Unidos. Os artigos analisaram fatores que influenciam o impacto sobre cuidadores familiares com doença de Alzheimer, situando os laços afetivos envolvidos, a reciprocidade esperada, os custos físicos, emocionais e sociais associados a uma doença crônica prolongada e de exigência de cuidados cada vez mais complexos. Verificou-se que o cuidador familiar tanto quanto as pessoas idosas com DA demandam uma ampla rede de suporte, acessível ou articulada, dentro e fora da família.

          Translated abstract

          Abstract This is a review of the literature on family caregivers of patients with Alzheimer’s disease from 2013 to 2017 available in the BVS, Scopus, and PubMed databases. The descriptors used (translated from Portuguese) were Alzheimer’s disease, caregivers, elderly health, by combination. Of the 163 papers analyzed, after applying the relevance test, we selected 26 papers presented from five thematic units: 1- Literature reviews; 2- Prevalence profiles of AD caregivers; 3- Qualitative research that analyzes the feelings and sufferings of caregivers; 4- Comparative studies and objective tests; 5- Evaluation studies of intervention programs. The comprehensive and comparative analysis of the investigations highlighted differences and similarities, advantages, and disadvantages of the samples and methodologies adopted in Brazil and the US. The articles analyzed factors that influence family caregivers’ impact with Alzheimer’s disease, identifying the affective bonds involved, the expected reciprocity, the physical, emotional, and social costs associated with a prolonged chronic illness and requiring increasingly complex care. Family caregivers and older adults with AD require a broad, accessible, or articulated support network inside and outside the family.

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          Most cited references 40

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          Exploring the effectiveness of an internet-based program for reducing caregiver distress using the iCare Stress Management e-Training Program.

          Determine if the online iCare Stress Management e-Training Program reduces stress, bother, depression, and poor life quality for dementia family caregivers (CGs).
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            A randomized clinical trial of Behavioral Activation (BA) therapy for improving psychological and physical health in dementia caregivers: results of the Pleasant Events Program (PEP).

            Dementia caregiving is associated with elevations in depressive symptoms and increased risk for cardiovascular diseases (CVD). This study evaluated the efficacy of the Pleasant Events Program (PEP), a 6-week Behavioral Activation intervention designed to reduce CVD risk and depressive symptoms in caregivers. One hundred dementia family caregivers were randomized to either the 6-week PEP intervention (N = 49) or a time-equivalent Information-Support (IS) control condition (N = 51). Assessments were completed pre- and post-intervention and at 1-year follow-up. Biological assessments included CVD risk markers Interleukin-6 (IL-6) and D-dimer. Psychosocial outcomes included depressive symptoms, positive affect, and negative affect. Participants receiving the PEP intervention had significantly greater reductions in IL-6 (p = .040), depressive symptoms (p = .039), and negative affect (p = .021) from pre- to post-treatment. For IL-6, clinically significant improvement was observed in 20.0% of PEP participants and 6.5% of IS participants. For depressive symptoms, clinically significant improvement was found for 32.7% of PEP vs 11.8% of IS participants. Group differences in change from baseline to 1-year follow-up were non-significant for all outcomes. The PEP program decreased depression and improved a measure of physiological health in older dementia caregivers. Future research should examine the efficacy of PEP for improving other CVD biomarkers and seek to sustain the intervention's effects.
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              Prevalence of chronic illnesses and characteristics of chronically ill informal caregivers of persons with dementia.

              to examine the prevalence of and the link of chronic illnesses (CIs) to informal caregivers of persons with dementia (PWDs), as well as to identify characteristics of caregivers with CIs.
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                Author and article information

                Journal
                csc
                Ciência & Saúde Coletiva
                Ciênc. saúde coletiva
                ABRASCO - Associação Brasileira de Saúde Coletiva (Rio de Janeiro, RJ, Brazil )
                1413-8123
                1678-4561
                2021
                : 26
                : 1
                : 147-157
                Affiliations
                Rio de Janeiro Rio de Janeiro orgnameUniversidade Veiga de Almeida Brazil
                Vitória Espírito Santo orgnameUniversidade Federal do Espírito Santo orgdiv1Centro de Ciências da Saúde Brazil elianedadalto@ 123456yahoo.com.br
                Article
                S1413-81232021000100147 S1413-8123(21)02600100147
                10.1590/1413-81232020261.38482020

                This work is licensed under a Creative Commons Attribution 4.0 International License.

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                Figures: 0, Tables: 0, Equations: 0, References: 40, Pages: 11
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