How Does Receipt of Dementia Screening Impact Depressive Symptoms Among Patients and Their Family Members?

BACKGROUND: The impact of dementia screening on the mental health of older adults and their family members remains insufficiently understood, particularly in light of the bidirectional dynamics within the older adult-family dyad. This study aims to examine how dementia screening affects older adults and their family members over time, and whether these effects occur independently or simultaneously within the dyad. PARTICIPANTS AND SETTING: One thousand eight hundred five older adults (≥ 65 years old) and their family member dyads participated in the multi-site Caregiver Outcomes of Alzheimer's Disease Screening (COADS) trial were randomized into three study arms: screening only, screening plus referral for diagnostic assessment, and no-screening control. METHODS: Depressive symptoms measured by Patient Health Questionnaire-9 (PHQ-9) were collected in both older adults and their family members at baseline, 6 months, and 12 months post-intervention. A cross-lagged panel model was used to examine longitudinal and dyadic associations in depressive symptoms between members of the dyad. Intervention status (0 = no-screening control, 1 = combined screening group who received negative results, 2 = combined screening group who received positive results) was included as a predictor of depressive symptoms at 6 months. RESULTS: Compared with controls, dyads in the combined screening groups who received negative (β = -0.53, p = 0) and positive (β = -0.84, p = 0.058) results showed lower depressive symptoms among older adults at 6 months. Improvements in older adults' depressive symptoms subsequently influenced family members' mental health through a dyadic pathway, resulting in reduced depressive symptoms among family members at 12 months (β = 0.05, p = 0.016). CONCLUSIONS: The findings suggest that screening for dementia in older adults has a spillover effect to family members. Dementia screening may have a double benefit in families. Further clinical trials should include measures of both dyad members to understand how to best target the mental health of families more efficiently.