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NEW YORK (Reuters Health) – The emotional and psychological strain of providing long-term care for a spouse with Alzheimer's disease or other cognitive impairment is not suddenly relieved upon the spouse's death, according to new study results. Symptoms of depression and decreased energy and enthusiasm seem to linger for up to 3 years, researchers report.

"One assumption has been that the psychological health of caregivers would improve once the burden of caregiving ends," study lead author Dr. Susan Robinson-Whelen of the Houston Veterans Affairs Medical Center said in a statement. "However, we found that the negative effects of long-term caregiving for a spouse with dementia may continue well beyond the caregiving years."

She stressed, "Former caregivers need more attention given to their needs."

In an investigation of the after effects of long-term caregiving, Dr. Robinson-Whelen and her colleagues conducted a 4-year study to compare the psychological well-being of 49 former caregivers with that of 42 continuing caregivers and a control group of 52 non-caregivers.

The researchers found that although the former caregivers exhibited slight decreases in levels of depression and loneliness each year, their status was more similar to current caregivers than to non-caregivers, even 3 years after their spouse's death.

For example, about one quarter of former caregivers and one third of current caregivers reported symptoms of mild depression during the last annual assessment, compared with less than 15% of non-caregivers, Dr. Robinson-Whelen's team reports in the current issue of the Journal of Abnormal Psychology.

In addition, although the former caregivers reported increases in positive affect the year after their spouse died, their status continued to be closer to continuing caregivers than to their non-caregiving peers, the report indicates.

"We didn't see the improvements you would hope and expect to see after caregiving has ended," Dr. Robinson-Whelen said.

On the other hand, former caregivers reported less stress and less negative affect, including anger, guilt and nervousness, in the year following their spouse's death, and maintained this improvement throughout subsequent assessments, the researchers report. In fact, at the last assessment, former caregivers reported levels of stress and negative affect similar to those reported by non-caregivers.

In other findings, reports of frequent intrusive thoughts about previous caregiving and continued attempts to stop thinking about it predicted the psychological health and well-being of former caregivers even 2 to 3 years after their spouses' death, according to Dr. Robinson-Whelen and her team.

The study was supported by grants from the National Institutes of Health and the Veteran's Affairs Rehabilitation Research and Development Service.