Caregiver Burden Associated with Behavioral and Psychological Symptoms of Dementia in Elderly People in the Local Community

Abstract

Background: Despite many studies about the association between caregiver burden and behavioral and psychological symptoms of dementia (BPSD), there have been no population-based studies to evaluate caregiver burden associated with each BPSD. Objective: To evaluate caregiver burden associated with the individual BPSD in elderly people living in the community. Methods: The subjects were 67 participants with dementia living with their caregivers (diagnosed in the third Nakayama study): 51 Alzheimer’s disease, 5 vascular dementia and 11 other. The Neuropsychiatric Inventory (NPI) and NPI Caregiver Distress Scale (NPI-D) were used to assess subjects’ BPSD and related caregiver distress, respectively. Results: In the subjects exhibiting BPSD, aberrant motor behavior had the highest mean NPI score, and depression/dysphoria had the lowest. Agitation/aggression had the highest mean NPI-D score, and euphoria/elation had the lowest. Delusion, agitation/aggression, apathy/indifference, irritability/lability and aberrant motor behavior showed a correlation between the NPI and NPI-D scores. Conclusion: The burden associated with BPSD is different for each symptom and does not always depend on frequency and severity of BPSD. These findings suggest that some symptoms, such as agitation/aggression and irritability/lability, may affect the caregivers significantly, although their frequency and severity are low.

Self-Efficacy Partially Mediates between Social Support and Health-Related Quality of Life in Family Caregivers for Dementia Patients in Shanghai

“…Dementia-related impairments [8,9,10] of care recipients (CR) including cognitive and physical impairments as well as behavioral and psychological symptoms of dementia (BPSD) [12,13] and the social support for caregivers [14] are two external factors that have been reported to be strong predictors of HRQoL. The impairments of CR, particularly BPSD that can increase caregiver burden [6,9,10,15,16,17], were found to be detrimental to caregivers' HRQoL [9,18]. Social support has been regarded as an influential buffer in dealing with the stressful task of caring for a family member with dementia [19].…”

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).…”

Non-pharmacological Management of Behavioral Symptoms in Frontotemporal and Other Dementias

“…Regardless of etiology, behavioral symptoms are challenging for family caregivers and result in considerable consequences including caregiver burden and stress [13,14] increased risk for placement [15][16][17] and significant cost to the health care system [18,19]. Some data report that caregivers of people with FTD and dementia with Lewy bodies (DLB) are particularly burdened by behavioral symptoms [20,21].…”