Predicting Caregiver Burden from Daily Functional Abilities of Patients with Mild Dementia

Abstract

OBJECTIVES-To assess the relationship between performance-and informant-based measures of activities of daily living (ADLs) in patients with early dementia and burden or psychological distress experienced by the patients' caregivers. DESIGN-Descriptive study. SETTING-Ambulatory center.PARTICIPANTS-Thirty-four patient-caregiver dyads in which the patient had mild dementia (Mini-Mental State Examination score ≥ 17).MEASUREMENTS-A performance-based ADL measure (the Direct Assessment of Functional Status (DAFS)) was administered to patients with mild dementia. Caregivers completed an informant-based measure of patient functional status (instrumental activities of daily living). Caregivers also completed the Caregiver Burden Inventory (CBI) and the Brief Symptom Inventory (BSI).RESULTS-Significant correlations were found between the informant-based ADL measure and caregiver burden (CBI) and psychological distress (BSI) (correlation coefficient (r) = −0.34 to −0.71, all P < .05). Alternatively, fewer and weaker relationships were observed between the DAFS (performance-based) ADL measure and caregiver burden or distress ratings (r = −0.32 to −0.43, all P < .05). Of the seven tasks assessed using the DAFS, impairments in orientation, communication, financial, and transportation skills in patients were associated with greater time and developmental burden and greater hostility in caregivers. Impairment in financial skills in patients was the strongest Address correspondence to Jill Razani, PhD, Department of Psychology, California State University, Northridge, 18111 Nordhoff Street, Northridge, CA 91330. E-mail: jill.razani@csun.edu. Author Contributions: Jill Razani: design, acquisition of subjects, implementation of study, data analyses, and preparation of the manuscript. Bernadette Kakos: implementation, data analyses, and preparation of the manuscript. Carla Orieta-Barbalace: acquisition of subjects, implementation, data analyses, and preparation of the manuscript. Jennifer T. Wong and Rachel Casas: acquisition of subjects, implementation, and preparation of the manuscript. Po Lu and Cathy Alessi: acquisition of subjects and review and critique of drafts of the manuscript. Karen Josephson: acquisition of subjects and review and critique of drafts of the manuscript. Sponsor's Role:The role of the sponsor (NIH) was to provide funding to the first author (JR) in order to conduct the current study. The sponsor was not involved in the design or implementation of the study. A growing body of literature on the caregivers of patients with dementia indicates that these individuals experience physical, psychological or emotional, social, and financial problems. 4 A study 5 using a brief screening measure to characterize cognitive impairment in patients with Alzheimer's disease found that patients' cognitive scores played a significant role in predicting the amount of time caregivers spent caring for the patient. A number of recent studies have found that caregivers of patients with dementia frequently report physical a...

Caregiver Burden among Caregivers of Koreans with Dementia

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