Behavioral Change in Persons With Dementia: Relationships With Mental and Physical Health of Caregivers

Abstract

The purpose of this study was to examine the effects that changes in behavioral and psychological symptoms of dementia of persons with Alzheimer's disease have on their caregivers' mental health and physical health. The research design was a prospective, longitudinal follow-up study conducted in a major medical center and in participants' homes. Longitudinal analysis linking change in behavior to caregiver outcomes was based on 64 cases. Care recipients were assessed at the time of diagnosis with the Mini-Mental State Examination (MMSE). To provide information on the care recipient's behaviors, caregivers participated in an interview with the Modified Neuropsychiatric Inventory at diagnosis and at follow-up. Caregivers also completed a battery of established instruments to measure stress appraisal, mental health, and perceptions of their physical health at follow-up. Results showed that increases in problem behaviors among persons living with dementia, along with residence status, were significant predictors of caregivers' mental health and also their physical health. However, these relationships were mediated through stress appraisal. Variables such as MMSE score of the person with dementia, number of years caregiving, relationship status, and education level were not significant predictors of caregivers' health when behavior change was in the model.

The Differential Impact of Unique Behavioral and Psychological Symptoms for the Dementia Caregiver: How and Why Do Patients' Individual Symptom Clusters Impact Caregiver Depressive Symptoms?

“…(37;38) In our examination of mediators of the patient depression-caregiver depression relationship both impact on patient’s functioning and burden to caregiver were important. While caregiver burden has been previously shown to mediate the relationship between patient objective behavior and caregiver outcomes,(15;17;39) the role of impact on patient functioning in the causal pathway has not been previously explored. Our findings suggest that caregivers recognize the difficulty that patient depressive symptoms may cause for patients and that this mechanism may independently result in caregiver depression.…”

“…Using this model, studies report that the association between objective stressors such as BPSD and mental and physical health outcomes of caregivers are mediated by subjective stress appraisal. (15–17) Suffering may be another pathway by which BPSD results depression in caregivers(18) suggesting that perception of the patient’s quality of life and their ability to function daily may affect the caregiver by evoking empathy for the patient.…”

Health self-perception by dementia family caregivers: sociodemographic and clinical factors

“…The literature on this theme indicated the strong association of neuropsychiatric disorders with caregivers' health perception and stress 27 . A possible explanation for our results may be the lower prevalence of care recipients' behavioral neuropsychiatric symptoms.…”

Influence of personality on caregiver's burden, depression and distress related to the BPSD

“…These BPSD occur in a dynamic process involving the patient, the family caregiver and their environment. They are known to be more stressful to caregivers than cognitive or functional decline, because are felt as the most difficult to manage (Donaldson et al, 1998;Hooker et al, 2002;Vugt et al, 2003;Matsumoto et al, 2007) and have a negative impact on the relationships between the caregiver, patient and family (Lyons et al, 2002). It has been reported that caregivers differ in their emotional responses to BPSD even when facing similar problems and the caregiver's perception of patient's problems is more important than problem behaviour 'per se' (Zarit, 1996;Vugt et al, 2005), furthermore, caregivers can interpret poorly and react inadequately to BPSD (Paton et al, 2004).…”