Psychiatric Complications of Dementia: Impact on Caregivers

Victoroff, Jeff; Mack, Wendy J.; Nielson, Kristy A.

doi:10.1159/000017022

Cited by 56 publications

(61 citation statements)

References 34 publications

(44 reference statements)

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“…Aberrant motor behaviour, which affected 81% of the FTD patients, was most often rated as not or slightly distressing. These fi ndings support previous fi ndings that some problem behaviours have a greater impact on caregivers than others [27][28][29] , which underscores the importance of focusing on specifi c behavioural changes when studying and trying to ameliorate caregiver distress.…”

Section: Discussionsupporting

confidence: 87%

“…Moreover, children may still be at home which implies that the caregivers of patients with early-onset dementia have additional caretaking responsibilities and worries. Behavioural changes are a more salient characteristic of FTD than of AD [12] and are a well-known risk factor for caregiver stress [28][29][30] . Problems related to disinhibition are probably socially embarrassing to caregivers and hamper pleasant social interactions, causing the caregiver greater distress [14,31] .…”

Section: Discussionmentioning

confidence: 99%

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Impact of Behavioural Problems on Spousal Caregivers: A Comparison between Alzheimer’s Disease and Frontotemporal Dementia

Vugt

Riedijk²,

Aalten

et al. 2006

Dement Geriatr Cogn Disord

207

226

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Background: Behavioural changes are a key factor in distinguishing frontotemporal dementia (FTD) from Alzheimer’s disease (AD), however, little is known about the impact of these changes on caregivers. The aim of this study was to compare caregivers’ distress related to behavioural symptoms of AD and FTD. Methods: 47 spouse caregivers of consecutively referred patients with AD and 27 spouse caregivers of patients with FTD participated in this study. Behavioural disturbances in the patient and caregivers’ emotional reactions were measured with the Neuropsychiatric Inventory. Results: Patients with FTD had significantly higher levels of agitation, apathy, disinhibition and aberrant motor behaviour than did patients with AD. High distress scores were found for disinhibition, depression and apathy in caregivers of FTD patients whereas caregivers of AD patients reported patient apathy, depression and anxiety as being severely distressing. Higher mean distress scores were found for disinhibition in the FTD group. Furthermore, caregivers of FTD patients reported higher levels of general burden, and felt less competent than AD caregivers. Conclusions: Caregivers of FTD patients were overall more distressed by the behaviour of their partners than were the caregivers of AD patients.Findings from this study underscore the importance of differentiating between diagnostic groups and specific behavioural domains when focusing on caregiver reactions to problem behaviour.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Impact of Behavioural Problems on Spousal Caregivers: A Comparison between Alzheimer’s Disease and Frontotemporal Dementia

Vugt

Riedijk²,

Aalten

et al. 2006

Dement Geriatr Cogn Disord

207

226

View full text Add to dashboard Cite

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“…2 These symptoms include mood disturbances, psychoses, compulsions, anxiety, and agitation, symptoms that constitute a major source of morbidity and caregiver burden. 3,4 Neuropsychiatric symptoms are more prevalent in certain types of dementia. Frontotemporal dementia (FTD) is an umbrella term for a group of dementia syndromes that present clinically without amnesia, especially in the early stages.…”

Section: Introductionmentioning

confidence: 99%

Neuropsychiatric Symptoms in Behavioral Variant Frontotemporal Dementia and Primary Progressive Aphasia

Banks

Weıntraub

2008

J Geriatr Psychiatry Neurol

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Neuropsychiatric symptoms are well defined in behavioral variant frontotemporal dementia but are not as well studied in primary progressive aphasia. This study compared caregiver reported neuropsychiatric symptoms in these 2 forms of dementia at short and long disease duration. Patients with behavioral variant frontotemporal dementia had more symptoms than patients with primary progressive aphasia. However, when divided by duration of disease, patients with primary progressive aphasia with long duration had a similar number of symptoms to patients with behavioral variant frontotemporal dementia at either duration. Furthermore, this group of patients with primary progressive aphasia had more symptoms typical of behavioral variant frontotemporal dementia and less mood-related symptoms which were more common in patients with primary progressive aphasia with shorter duration. This study illustrates the emergence of neuropsychiatric symptoms as primary progressive aphasia progresses and highlights the increasing overlap with behavioral variant frontotemporal dementia because the disease affects areas outside of the language network. Keywords dementia; neuropsychiatric symptoms; primary progressive aphasia; frontotemporal dementia Neuropsychiatric symptoms are common in the neurodegenerative dementias 1 and are related to specific biochemical and anatomical changes that occur with these diseases. 2 These symptoms include mood disturbances, psychoses, compulsions, anxiety, and agitation, symptoms that constitute a major source of morbidity and caregiver burden. 3,4 Neuropsychiatric symptoms are more prevalent in certain types of dementia. Frontotemporal dementia (FTD) is an umbrella term for a group of dementia syndromes that present clinically without amnesia, especially in the early stages. FTD affects between 4% and 20% of patients presenting to dementia clinics 5 and is found to be most prevalent in individuals below 60 years of age. 6-8 FTD can be broadly divided into 2 clinical categories 9 : a behavioral variant frontotemporal dementia (bvFTD) and an aphasic variant known as primary progressive aphasia (PPA). Neuropsychiatric symptoms are the earliest manifestation in bvFTD and may occur in isolation or in addition to executive dysfunction. Different symptoms of aphasia occur early in PPA 10-13 and remain most prominent over the course of illness. Although the postmortem neuropathological findings are varied in both PPA and bvFTD, they typically affect the prefrontal and anterolateral temporal areas of the brain and are therefore subsumed under the rubric of frontotemporal lobar degeneration (FTLD). PPA refers to the class of clinical dementia syndromes in which aphasia is the earliest and most salient symptom, especially within the first 2 years of symptoms onset. Any type of aphasia can be manifested. 12 PPA has recently been classified into subtypes based on distinctive clinical and neuroimaging features: labelled agrammatic or nonfluent, semantic dementia (SD), and logopenic. [14][15][16][17] Prior t...

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“…A média de idade dos pacientes acima dos 70 anos basicamente exclui demências de aparecimento precoce (antes dos 65 anos). Vale lembrar que a demência pré-senil tende a evoluir mais rapidamente e está, com frequência, associada à presença de delírios persecutórios, alucinações e agitação grave 18 . Apesar disso, pouco se sabe sobre distúrbios de comportamento e sobrecarga dos cuidadores nesses casos.…”

Section: Resultsunclassified

“…Apesar disso, há um consenso emergente de que esses sintomas têm impacto sobre a vida do cuidador. Alguns autores acreditam que os sintomas deficitários (apatia, depressão, isolamento) seriam os de maior impacto sobre a vida do cuidador 17 , enquanto outros sugerem que agitação e comportamentos agressivos são mais freqüentemente associados com o fardo do cuidar 18 . Poucos estudos questionam o conceito de 'distúrbio de comportamento' nas síndromes demenciais, embora vários autores tenham tentado defini-lo.…”

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Distúrbios de comportamento em pacientes com demência: impacto sobre a vida do cuidador

Garrido

Almeida

1999

Arq. Neuro-Psiquiatr.

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RESUMO -Diversos estudos indicam que o cuidado de pacientes com demência está associado a sobrecarga importante sobre a vida do cuidador. Há evidências crescentes de que esse desgaste está mais intimamente ligado à presença de sintomas não cognitivos (ou psiquiátricos). Este estudo tem como objetivo realizar revisão sistemática da literatura sobre esse assunto de todos os trabalhos listados no banco de dados MedLine, que incluíssem os seguintes unitermos: 'burden or impact or cost' e 'dementia or Alzheimer's disease' e 'carer or caregiver or caregiving or family'. Foram incluídos artigos impressos entre janeiro de 1990 e janeiro de 1998. Quatorze estudos preencheram os critérios de inclusão da revisão, dentre aqueles disponíveis nas bibliotecas das universidades de São Paulo. Estes revelaram que transtornos de comportamento em pacientes dementados são importantes causas de sobrecarga na vida do cuidador, porém um consenso sobre o conceito desses transtornos ainda não está totalmente estabelecido. Além disto, não está claro quais sintomas não cognitivos são os principais responsáveis por aumento do impacto. Futuras pesquisas devem abordar esses aspectos no sentido de elucidar quais os melhores métodos de intervenção para esses casos. PALAVRAS-CHAVE: demência, doença de Alzheimer, transtornos do comportamento, depressão, delírios, alucinações, psicose, burden, impacto, cuidador. Behavioural problems in patients with dementia and their burden on carersABSTRACT -Many studies have suggested that caring for patients with dementia may be associated with increased burden, particularly when subjects present with prominent behavioural problems. The present work aimed to review studies appearing on MedLine between 1990 and January 1998 that included the following keywords: 'burden or impact or cost' and 'dementia or Alzheimer's disease' and 'carer or caregiver or caregiving or family'. Only fourteen of the studies retrieved fulfilled the entry criteria for this review: crossectional or longitudinal studies looking at the association between behavioural problems in patients with dementia and burden of carers. All studies indicated that behavioural disturbances are an important cause of burden, although there was little consistency on the definition of 'behavioural disturbances'. As a consequence, it is still unclear which behavioural symptoms are more closely associated with increased burden of care. Future research in the area should aim to clarify these issues and develop management strategies to decrease burden on carers of patients with dementia.

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Psychiatric Complications of Dementia: Impact on Caregivers

Cited by 56 publications

References 34 publications

Impact of Behavioural Problems on Spousal Caregivers: A Comparison between Alzheimer’s Disease and Frontotemporal Dementia

Impact of Behavioural Problems on Spousal Caregivers: A Comparison between Alzheimer’s Disease and Frontotemporal Dementia

Neuropsychiatric Symptoms in Behavioral Variant Frontotemporal Dementia and Primary Progressive Aphasia

Distúrbios de comportamento em pacientes com demência: impacto sobre a vida do cuidador

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