Perceived stress and depressive symptoms not neuropsychiatric symptoms predict caregiver burden in Alzheimer’s disease: a cross-sectional study

Pinyopornpanish, Manee; Pinyopornpanish, Kanokporn; Soontornpun, Atiwat; Tanprawate, Surat; Nadsasarn, Angkana; Wongpakaran, Nahathai

doi:10.1186/s12877-021-02136-7

Cited by 26 publications

(28 citation statements)

References 48 publications

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“…So, female caregivers face the risk to perceive an especially higher burden. Contrary to our results, the Pinyopornpanish et al (39) study showed that no sociodemographic variables were significantly related to CB and NPI.…”

Section: Discussioncontrasting

confidence: 99%

“…Also, in the study by Chen et al, the results showed that NPI score was independently associated with mean NPI-burden score (38). Pinyopornpanish et al (39) study in 2021 also showed that the higher the NPS score, the higher the care pressure. In addition, among neuropsychiatric symptoms, hallucination (P = 0.010), AMD (P = 0.011), delusion (P = 0.003), depression (P = 0.001), and changes in appetite/eating (P = 0.013) had significant association with CB.…”

Section: Discussionmentioning

confidence: 92%

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Neuropsychiatric Symptoms of Alzheimer's Disease and Caregiver Burden

Iravani

Abdollahi

Eslamdoust-Siahestalkhi

et al. 2022

Front. Neurol.

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Introduction/ObjectivesIn addition to cognitive decline, one of the most important problems for caregivers of patients with Alzheimer's is neuropsychiatric symptoms (NPS). This study aimed to evaluate the NPS in patients with Alzheimer's disease (AD) and investigate its relationship with caregiver burden (CB).MethodsIn a cross-sectional study of 85 patients with AD referred to Shafa Hospital in Rasht and their caregivers in 2020, information was collected using a demographic questionnaire, Neuropsychiatric Inventory Questionnaire (NPI-Q), and the Caregiver Burden Inventory (CBI). Data were analyzed by Spearman correlation, t-test, and linear regression, with SPSS version 22.ResultsThe mean age of the patients and their caregivers were 74.95 ± 8.87 years and 43.98 ± 11.38 years, respectively. The mean total score of NPS in patients with AD was 44.25 (0–144) and the mean CB score was 36.27 (0–96), which was a moderate level. According to the results, 91% of patients had apathy, while happiness/euphoria was reported as the most uncommon symptom. In addition, there was a significant relationship between the score of NPS and CB (r = 0.542, P < 0.0001), as well as all its sub-components, time-dependence burden with more correlation (r = 0.509, P < 0.0001), and social burden with less correlation (r = 0.352, P < 0.001). NPS, hallucination, aberrant motor behavior (AMB), delusion, and depression were most correlated with CB. Also, the mean score of CB was significantly higher in women than in men (P = 0.045). Living in a rural area had a significant relationship with NPS score (P = 0.026). Also, linear regression showed that with increasing 1 year of patients' age, the mean score of patient's NPS decreased by 0.374 (P = 0.048).ConclusionNeuropsychiatric symptoms, especially hallucination, aberrant motor behavior (AMB), delusion, and depression were associated with caregiver burden. Apathy was the most common symptom in patients with AD.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 92%

Neuropsychiatric Symptoms of Alzheimer's Disease and Caregiver Burden

Iravani

Abdollahi

Eslamdoust-Siahestalkhi

et al. 2022

Front. Neurol.

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“…A prior study demonstrated that the overall Neuropsychiatric Inventory Questionnaires (NPI-Q) score, an instrument used for assessing BPSD, is associated with caregiver burden through caregiver stress and depression 18 . However, inconsistent results about the association between specific symptoms of BPSD and psychosocial outcomes in caregivers have been found among studies 19 , 20 .…”

Section: Introductionmentioning

confidence: 99%

Impact of behavioral and psychological symptoms of Alzheimer’s disease on caregiver outcomes

Pinyopornpanish

Soontornpun

Wongpakaran

et al. 2022

Sci Rep

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This study was to determine the prevalence of behavioral and psychological symptoms of dementia (BPSD) and its association with dementia severity and to explore the association between specific BPSD and caregiver stress, burden, and depression. A cross-sectional study involving the interviewing of the primary caregivers of patients with Alzheimer’s disease (AD) was conducted. Multivariable analysis was used to analyze the associations between specific symptoms of BPSD and caregiver outcomes. A total of 102 AD patients (age 79.4 ± 7.9 years, 70.6% female) and their caregivers were included. Nearly 46% had moderate-to-severe AD. Nearly all patients (99.0%) had at least one BPSD. Apathy was among the most common symptoms (74.5%), and hallucination was the only symptom associated with severity of AD (p = 0.017). After adjustment, agitation was associated with Patient Health Questionnaire-9 (PHQ-9) and Zarit Burden Interview (ZBI-22) (p = 0.021 and 0.007, respectively); sleep disorders were associated with only PHQ-9 (p = 0.049). In conclusion, the BPSD, especially agitation and sleep disorders, can give rise to difficulties for both patients and their caregivers. The prevalence of BPSD is high (99.0%), and the symptoms can start early. Routine screening of BPSD in all AD patients is advocated.

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“…Furthermore, some behavioral symptoms may impact caregiver wellbeing more so than others and thus effects their reporting of frequency and severity. There is some evidence to suggest that the number of behaviors being managed versus behavior-type and perceived stress are associated with caregiver burden and depression [ 41 – 43 ]. The evidence is inconclusive and associational, lacking hypothesis-driven analyses or testing of causal mechanisms.…”

Section: Discussionmentioning

confidence: 99%

Effects of the tailored activity program (TAP) on dementia-related symptoms, health events and caregiver wellbeing: a randomized controlled trial

et al. 2021

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Background People living with dementia (PLWD) and caregivers are adversely impacted by lack of meaningful activity leading to worse symptoms and impaired quality-of-life. There is a critical need to develop effective and well-tolerated treatments that mitigate clinical symptoms, engage PLWD and support caregiver wellbeing. We tested whether, compared to attention control, the Tailored Activity Program (TAP) reduced clinical symptoms and health-related events, and improved caregiver wellbeing, and if TAP activities were well-tolerated. Methods We conducted a single-blind randomized controlled trial among 250 dyads recruited from Baltimore-Washington DC (2012–2016) with a dementia diagnosis and clinically significant agitation/aggression. Dyads were randomized to TAP (n = 124) or attention control (n = 126), and interviewed at baseline, 3 (endpoint) and 6-months (follow-up) by interviewers masked to group allocation. TAP assessed PLWD abilities/interests, instructed caregivers in using prescribed activities, and provided dementia education and stress reduction techniques. Attention controls received disease education and home safety tips. Both groups had up to 8 home visits over 3-months. The primary outcome was frequency by severity scores for agitation/aggression subscales of Neuropsychiatric Inventory-Clinician using caregiver ratings. Secondary outcomes included number of instrumental (IADL) and activities of daily living (ADL) needing assistance, caregiver wellbeing, and confidence using activities. Health-related events (PLWD death, hospitalizations, caregiver hospitalization, depression) and perceived study benefits were captured over 6 months. PLWD tolerability of prescribed activities was examined. Results Of 250 dyads, most caregivers were female (81.2 %, n = 203), non-spouses (54.4 %, n = 136), white (59.2 %, n = 145) or African American (36.7 %, n = 90) with mean age = 65.4 (SD = 12.6). PLWD were mostly female (63.2 %, n = 158) with mean age = 81.4 (SD = 7.9), and mean MMSE = 14.3 (SD = 7.8). At 3-months, compared to controls, TAP conferred no benefit to agitation/aggression (p = 0.43, d = 0.11), but resulted in less IADL (p = 0.02, d=-0.33), and ADL (p = 0.04, d=-0.30) assistance, improved caregiver wellbeing (p = 0.01, d = 0.39), and confidence using activities (p = 0.02, d = 0.32). By 6-months, 15 PLWD in TAP had ≥ 1 health-related event versus 28 PLWD in control, demonstrating 48.8 % improvement in TAP (p = 0.03). TAP caregivers were more likely to perceive study benefits. Prescribed activities were well-tolerated. Conclusions Although TAP did not benefit agitation/aggression, it impacted important outcomes that matter to families warranting its use in dementia care. Clinical trial registration Clinicaltrials.gov # NCT01892579 at https://clinicaltrials.gov/; Date of clinical trial registration: 04/07/2013; Date first dyad enrolled: 15/11/2013.

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Perceived stress and depressive symptoms not neuropsychiatric symptoms predict caregiver burden in Alzheimer’s disease: a cross-sectional study

Cited by 26 publications

References 48 publications

Neuropsychiatric Symptoms of Alzheimer's Disease and Caregiver Burden

Neuropsychiatric Symptoms of Alzheimer's Disease and Caregiver Burden

Impact of behavioral and psychological symptoms of Alzheimer’s disease on caregiver outcomes

Effects of the tailored activity program (TAP) on dementia-related symptoms, health events and caregiver wellbeing: a randomized controlled trial

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