Bidirectional relationship between caregiver burden and neuropsychiatric symptoms in patients with Alzheimer's disease: A narrative review

Işık, Ahmet Turan; Soysal, Pınar; Solmi, Marco; Veronese, Nicola

doi:10.1002/gps.4965

Cited by 113 publications

(104 citation statements)

References 95 publications

(221 reference statements)

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“…Compromised emotional well-being in caregivers (eg, mental disorders) may adversely impact care recipients. There is evidence, for example, that care recipients have poorer general health, mental health, and quality of life and exacerbated disability symptomatology when caregivers experience mental health problems [ 20 , 21 ]. The caregiver burden has also been associated with poorer caregiving quality, including the use of coercive or harmful management techniques, which may damage the relational bond between a caregiver and the care recipient [ 22 - 24 ].…”

Section: Introductionmentioning

confidence: 99%

Efficacy of a Smartphone App Intervention for Reducing Caregiver Stress: Randomized Controlled Trial

et al. 2020

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Background Caregivers play a pivotal role in maintaining an economically viable health care system, yet they are characterized by low levels of psychological well-being and consistently report unmet needs for psychological support. Mobile app–based (mobile health [mHealth]) interventions present a novel approach to both reducing stress and improving well-being. Objective This study aims to evaluate the effectiveness of a self-guided mobile app–based psychological intervention for people providing care to family or friends with a physical or mental disability. Methods In a randomized, single-blind, controlled trial, 183 caregivers recruited through the web were randomly allocated to either an intervention (n=73) or active control (n=110) condition. The intervention app contained treatment modules combining daily self-monitoring with third-wave (mindfulness-based) cognitive-behavioral therapies, whereas the active control app contained only self-monitoring features. Both programs were completed over a 5-week period. It was hypothesized that intervention app exposure would be associated with decreases in depression, anxiety, and stress, and increases in well-being, self-esteem, optimism, primary and secondary control, and social support. Outcomes were assessed at baseline, postintervention, and 3-4 months postintervention. App quality was also assessed. Results In total, 25% (18/73) of the intervention participants were lost to follow-up at 3 months, and 30.9% (34/110) of the participants from the wait-list control group dropped out before the postintervention survey. The intervention group experienced reductions in stress (b=−2.07; P=.04) and depressive symptoms (b=−1.36; P=.05) from baseline to postintervention. These changes were further enhanced from postintervention to follow-up, with the intervention group continuing to report lower levels of depression (b=−1.82; P=.03) and higher levels of emotional well-being (b=6.13; P<.001), optimism (b=0.78; P=.007), self-esteem (b=−0.84; P=.005), support from family (b=2.15; P=.001), support from significant others (b=2.66; P<.001), and subjective well-being (b=4.82; P<.001). On average, participants completed 2.5 (SD 1.05) out of 5 treatment modules. The overall quality of the app was also rated highly, with a mean score of 3.94 out of a maximum score of 5 (SD 0.58). Conclusions This study demonstrates that mHealth psychological interventions are an effective treatment option for caregivers experiencing high levels of stress. Recommendations for improving mHealth interventions for caregivers include offering flexibility and customization in the treatment design. Trial Registration Australian New Zealand Clinical Trial Registry ACTRN12616000996460; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=371170

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Section: Introductionmentioning

confidence: 99%

Efficacy of a Smartphone App Intervention for Reducing Caregiver Stress: Randomized Controlled Trial

et al. 2020

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“…This observation was supported by a 2-year longitudinal study showing that the burden of caregivers remained stable, and severe depression decreased along with the cognitive, functional, and behavioral worsening of the patients. 17 We aimed to follow for 1 year dyads of patients with AD/ family caregivers selected in clinical case series during the early-middle stages of the disease to evaluate the relationships between anxiety and depression and the burden of caregivers with cognitive, behavioral, and functional deterioration in the patients. Early literature on these topics were not focused on AD dyads, 12,14,15 were not prospective, 11,12 or were obtained by systematic reviews.…”

Section: Introductionmentioning

confidence: 99%

Anxiety and Depression Are Not Related to Increasing Levels of Burden and Stress in Caregivers of Patients With Alzheimer’s Disease

Tentorio

Dentali

Moioli

et al. 2020

Am J Alzheimers Dis Other Demen

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Sixty-nine dyads of patients with Alzheimer’s disease and primary caregivers have been followed up for 1 year to evaluate cognitive (Mini-Mental State Examination), functional (Instrumental Activities of Daily Living), and behavioral (Neuropsychiatric Inventory) decline of patient in relation to burden (Caregiver Burden Inventory), stress (Relative Stress Scale), anxiety (State-Trait Anxiety Inventory Y), and depression (Beck Depression Inventory) reported by the caregivers. After 1 year of observation, cognitive and functional scores worsened while behavioral problems remained unchanged and relatively mild in patients. After 1 year, caregivers’ scores of scales of anxiety and depression decreased significantly, while stress scores remained unchanged and burden slightly increased. In our opinion, the unexpected improvement in psychological situation of caregivers may be mainly due to educational interventions focused on knowledge of the disease with a particular attention directed toward emotional support and individual needs.

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“…The results of the present study support the use of the three subscales of the ZBI namely; embarrassment/ anger, reaction to patients' dependency, and selfcriticism as a measurement of caregiver burden. Isik and colleagues [47], pointed out the fact that caregivers of persons with dementia are experienced more burden and anxiety as compared to caregivers of older adults because they have to cope with both agerelated conditions and dementia related factors, which could worsen the relationship between caregivers and patients [47]. Also, Chiao and colleagues [48] in their provide a positive thinking training intervention among caregivers of persons with dementia to help decrease their burden, which eventually will impact their care recipients challenging behavior.…”

Section: Discussionmentioning

confidence: 99%

Factor Structure and Psychometric Properties of Cognitive-Behavioral Scales in Caregivers of Persons with Dementia

Bekhet¹,

Garnier‐Villarreal²

2018

Int J Psychol Psychoanal

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Background/Purpose: Caregiving can be costly to dementia caregivers' well-being. Assessing the factor structure and psychometric properties of Cognitive-Behavioral Scales in dementia caregivers is an essential step in addressing the gap in the current state of research. Specifically, it is essential to determine first whether the factorial structure of the three measures used in this study namely, the Positive Thinking Skills Scale, the Revised Memory and Behavior Problems Checklist, and the Zarit Burden Interview are good representation of the data by studying the good model fit. Next, evaluating the reliability of each factor of the three measures used are essential to learn about the precision of the factors. Lastly, it is vital to study the factor correlation and its relevance to the theory used to determine the validity of the factors. Methods: A descriptive, correlational, cross-sectional design in a convenience sample of 100 caregivers. Results: Results indicated that the factorial structure of the three scales is a good representation of the data; an acceptable reliability of each factor of the three measures; and the factors correlated as expected and showed their relevance to the underlying theory. Conclusions: Future studies might consider studying the mediating/moderating effects of positive thinking on carerecipients challenging behavior problems. The findings can be used as a guide to provide a positive thinking training intervention among caregivers.

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Bidirectional relationship between caregiver burden and neuropsychiatric symptoms in patients with Alzheimer's disease: A narrative review

Cited by 113 publications

References 95 publications

Efficacy of a Smartphone App Intervention for Reducing Caregiver Stress: Randomized Controlled Trial

Efficacy of a Smartphone App Intervention for Reducing Caregiver Stress: Randomized Controlled Trial

Anxiety and Depression Are Not Related to Increasing Levels of Burden and Stress in Caregivers of Patients With Alzheimer’s Disease

Factor Structure and Psychometric Properties of Cognitive-Behavioral Scales in Caregivers of Persons with Dementia

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