Correlation between neuropsychiatric symptoms and caregiver burden in a population-based sample from São Paulo, Brazil: A preliminary report

Abstract

Neuropsychiatric symptoms and caregiver burden are highly prevalent in older adults with Alzheimer's disease (AD).OBJECTIVE: To evaluate the correlation between neuropsychiatric symptoms and caregiver burden in a community-based sample from São Paulo, Brazil.METHODSA total of 1,563 randomly-selected subjects were assessed by the Mini-Mental State Examination, Fuld Object Memory Evaluation, Informant Questionnaire on Cognitive Decline in the Elderly and Bayer – Activities of Daily Living Scale. Subjects considered screen-positives were submitted to a dementia workup and diagnosis was determined according to ICD-10 criteria. The neuropsychiatric Inventory was applied to caregivers to evaluate neuropsychiatric symptoms and the Zarit Burden Interview was also applied to assess caregivers' burden.RESULTSSixty-one AD patients, 25 Cognitively Impaired Non Demented (CIND) and 79 healthy elderly subjects were evaluated. Zarit mean scores for controls, CIND and AD were 2.32, 3.92 and 20.11, respectively. There was strong positive correlation between total NPI and Zarit scores.CONCLUSIONIn conclusion, neuropsychiatric symptoms showed a significant association with higher rates of caregiver stress.

Zarit Burden Interview Psychometric Indicators Applied in Older People Caregivers of Other Elderly

“…These features are different from the data generated by the large volume of studies developed with younger caregivers and caregivers of patients with Alzheimer's disease 16 . Among younger caregivers and also those who care for older adults with Alzheimer, scores in Zarit Burden Scale (ZBI) also tend to be higher than those found in this study that reached an average of 26.1 points within a possible range 0-88 points 17 . The prevalence rate of depression suggested by the GDS-15 also showed no significant differences related to the rate found in the aged population in general 18 - 19 .…”

Caregiver burden in older adults with bipolar disorder: relationship to functionality and neuropsychiatric symptoms

“…Neuropsychiatric symptoms are the main factors related to caregiver distress and institutionalization of patients with dementia . Several studies have suggested a relationship between the presence of neuropsychiatric symptoms and caregiver burden in older adults with dementia . Similarly, in our study, anxiety, depression, and apathy as measured by the NPI related to higher caregiver burden.…”

“…Assessment instruments with the capacity to measure caregiver burden with defined psychometric properties and practical utility have been used to develop clinically effective and viable interventions . The Zarit Caregiver Burden Interview (ZBI) has been used to measure caregiver burden in caregivers of adults with BD, chronic illness, mild cognitive impairment, frontotemporal dementia, and in many studies of Alzheimer disease …”

Sintomas Neuropsiquiátricos De Idosos Com Demência: Repercussões Para O Cuidador Familiar

“…43 Therefore, appropriately treating and managing neuropsychiatric symptoms in patients with dementia may positively influence the patients' quality of life and that of caregivers. 40 In regard to this study's limitations, the results portray the reality of a local context, so caution should be taken when making generalizations. Additionally, the cross-sectional design employed in this study does not allow causal relationships to be established.…”

“…One study assessing correlation between neuropsychiatric symptoms and caregiver burden in a community sample in São Paulo reports that symptoms such as delusions, hallucinations, disinhibition and aberrant motor behavior, were those that correlated with the highest scores in the Zarit Inventory. 40 The constant work of caregivers providing care to elderly individuals with dementia who present characteristic neuropsychiatric symptoms may impose higher levels of stress on caregivers, especially symptoms such as aggressiveness and delusions. 23 Note that there was a correlation between the NPI-D total score (caregiver distress) and the frequency and severity of neuropsychiatric symptoms, number of symptoms, number of days dedicated to care delivery, and the caregivers' health.…”