Caregiver self‐efficacy and associated factors among caregivers of patients with dementia with Lewy bodies and caregivers of patients with Alzheimer's disease

Abstract

Background: Dementia with Lewy bodies (DLB) is characterized by neuropsychiatric symptoms, which can be distressing to caregivers. However, little is known about their subjective distress in terms of caregiver self-efficacy. Thus, we examined the differences in caregiver self-efficacy and their associated factors between DLB and Alzheimer's disease (AD) caregivers. Methods: We conducted a comprehensive questionnaire for DLB and AD caregivers. Caregiver self-efficacy was evaluated using three domains (Self-Efficacy for Obtaining Respite: SE-OR, Self-Efficacy for Responding to Disruptive Patient Behaviours: SE-RDPB, Self-Efficacy for Controlling Upsetting Thoughts about Caregiving: SE-CUT) of the Revised Scale for Caregiving Self-Efficacy (RSCSE). In addition, data on the following features of caregivers were assessed: depression, sleep disturbance, caregiver burden, executive function, loneliness, social support, and distress associated with neuropsychiatric symptoms. The patients were assessed for general cognitive tasks, executive function, and neuropsychiatric symptoms. Results: Compared with AD caregivers, DLB caregivers experienced a significantly higher burden in terms of not only various clinical factors, but also all three domains of caregiver self-efficacy. Among the caregiverassociated factors, different domains were predictors of self-efficacy in DLB and AD caregivers (distress due to sleep disturbances in DLB patients; distress due to delusions in AD patients). Among the patient-associated factors, different domains were also predictors of self-efficacy in DLB and AD caregivers (sleep disturbances in DLB patients; delusions in AD patients). Among both the caregivers and the patients, executive function was a significant predictor of one RSCSE domain (SE-CUT). Conclusions: A reduction in caregiver self-efficacy may contribute to a severe subjective burden among DLB caregivers. Furthermore, two neuropsychiatric symptoms (delusions and sleep disturbances) affected caregiver self-efficacy differently depending on whether care was being provided to a DLB or AD patient. Understanding the association between specific neuropsychiatric symptoms and caregiver self-efficacy may be useful for conducting interventions for DLB patients.

Treatment needs of dementia with Lewy bodies according to patients, caregivers, and physicians: a cross-sectional, observational, questionnaire-based study in Japan

“…Previous studies have mainly focused on caregiver burden/stress among those caring for DLB and AD patients [ 14 – 18 ]; the caregiver burden/stress among those caring for patients with DLB was found to be higher than that of those caring for AD patients, and this burden/stress was found to be associated with BPSD, cognitive fluctuations, and the decline of activities of daily living (ADL) [ 14 – 16 ]. Based on these previous studies, BPSD and ADL impairments, which are associated with high caregiver burden, may be considered as caregivers’ treatment needs, but the treatment needs of the patients themselves cannot be known from these studies.…”

The relationship between burden and caregiver’s sleep disturbances in dementia: a systematic review

“…This golden self-rated questionnaire analyzes seven dimensions of sleep quality: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction. Three studies used the Insomnia Severity Index (ISI) 17 , 22 , 30 , leading to a need for more specific information about this disturbance.…”

“…In the analysis of caregiver burden and stress, the studies used the Zarit Burden Interview Short Version (ZBI) 11 , 15 , 25 , 29 , 30 , 34 , the Stress Process Model of Caregiving (SPM) 8 , the Caregiver Burden Inventory (CBI) 33 , the Perceived Stress Scale (PSS) 16 , 28 , and the Relative Stress Scale (RSS) 5 .…”

“…Among the studies analyzed, four were descriptive longitudinal 4,12,25,27 , twenty were descriptive cross-sectional 2,[4][5][6][7]9,11,13,[16][17][18][19]21,26,[29][30][31][32][33][34] , one was a randomized clinical trial 15 , one was a multi-centric cross-sectional prospective 28 , and one was a retrospective cross-sectional analysis 14 .…”

Structural Cerebral Network Differences in Prodromal Alzheimer’s Disease and Prodromal Dementia with Lewy Bodies

“…A recent review proposed the research criteria for the diagnosis of MCI with Lewy bodies (MCI-LB) [4]. Since the clinical course, care, and treatment of DLB are different from those of AD [5,6], it is necessary to discriminate MCI-LB from MCI-AD. The authors of the abovementioned review commented that each of the following was a useful biomarker of MCI-LB: reduced dopamine transporter uptake in basal ganglia demonstrated by single-photon emission computed tomography (SPECT) or positron emission tomography (PET); reduced meta-iodobenzylguanidine (MIBG) uptake on myocardial scintigraphy; and low occipital uptake on perfusion/metabolism scan [4].…”