Caregiver distress associated with behavioral and psychological symptoms in mild Alzheimer's disease

Abstract

The aim of this study was to analyze the relationship between Caregiver Distress and Behavioral and Psychological Symptoms in Dementias (BPSD) in mild Alzheimer’s disease.MethodsFifty patients and caregivers were interviewed using the Neuropsychiatric Inventory (NPI).Results96.0% of the patients had at least one BPSD. The mean NPI total score was 19.6 (SD=18.05; range=0-78) whereas the mean Caregiver Distress Index (CDI) total score was 11.5 (SD=10.41; range=0-40). For the individual symptoms, the weighted mean CDI was 2.8 (SD=1.58). All symptom CDI means were higher than 2.0 except for euphoria/elation (m=1.8; SD=1.49). There were correlations between CDI and derived measures (Frequency, Severity, FxS, and Amplitude) for all symptoms, except Disinhibition and Night-time behavior. Correlations ranged between 0.443 and 0.894, with significance at p<0.05.ConclusionsAll the derived measures, including amplitude, were useful in at least some cases. The data suggests that CDI cannot be inferred from symptom presence or profile. Symptoms should be systematically investigated.

A systematic review of the relationship between behavioral and psychological symptoms (BPSD) and caregiver well-being

“…Two studies consistently had the highest mean distress rating across each of the behavior domains: Balieiro et al (2010) and Tan et al (2005). Both of these studies were clinic-based, higher distress ratings would be expected as those experiencing more BPSD might be more likely to attend a clinic, as, indeed, were the majority of studies included in the meta-analysis.…”

The relationship of specific items on the Neuropsychiatric Inventory to caregiver burden in dementia: a systematic review

“…Coefficients were only provided for the individual NPSs that were retained in the models. Four of the studies examined the association between individual NPSs and caregiver burden using the Spearman rank correlation test (Allegri et al, 2006;Godinho et al, 2008;Balieiro et al, 2010;Lou et al, 2015), while three used Pearson's correlation test (Huang et al, 2012;Wang et al, 2015;Oh et al, 2015). The majority of these included a sample size of 100 dyads or less, limiting the ability to detect smaller effect sizes (Godinho et al, 2008;Balieiro et al, 2010;Huang et al, 2012;Hall et al, 2014;Oh et al, 2015).…”

“…The majority of caregivers were women (70.4%), most of whom were adult children (53.8%) or spouses (36%). In five studies, the patients were diagnosed with AD (Allegri et al, 2006;Godinho et al, 2008;Balieiro et al, 2010;Lou et al, 2015;Sousa et al, 2016), and in one Parkinson's disease dementia (Oh et al, 2015). siblings, child in-laws) or not specified.…”

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

“…Recent studies demonstrated that depressive behaviors were the “most important symptoms” relative to caregiver burden followed by agitation, aggression, sleep disturbances, apathy, and repetitive behavior while euphoria was the least distressing . However, in general, while it is clear that NPs are associated with negative caregiver outcomes, it is difficult to say that only one of these NP clusters is responsible for distress of the caregiver, but the frequency and severity of the NPs is an important predictive factor . On the other hand, different symptoms' clusters may have different effects on caregivers.…”