Cognitive, functional and behavioral factors associated with the burden of caring for geriatric patients with cognitive impairment or depression: evidence from a South American sample.Int J Geriatr Psychiatry. 2009 Apr; 24(4):382-9.IJ
To examine behavioral, cognitive and functional factors associated with psychosocial burden in caregivers of geriatric patients.
Primary caregivers assessed were included if the geriatric patient cared for had a cognitive impairment or dementia (degenerative, vascular or mixed) (Group 1) or depression and cerebrovascular disease (CVD) (Group 2). Caregivers completed the Zarit questionnaire, the Neuropsychiatric Inventory (NPI) and Instrumental Activities of Daily Living (IADL). Patients were evaluated for dementia severity using the Clinical Dementia Rating (CDR), Mini Mental State Examination (MMSE) and Beck Depression Inventory (BDI). Structural equation modelling (SEM) was used to assess measurement models and the factors associated with burden.
Two hundred and fifty-eight caregiver-patient pairs were included. The best model fit was obtained with a model with two constructs: function-cognition (CDR, MMSE, and IADL) and behavior (neuropsychiatric symptoms from the NPI). In Group 1, both function (B = 0.32. T = 2.79) and behavior (B = 0.72, T = 7.84) were significantly correlated with caregiver burden, although the strength of association was more than two times higher for behavior. In Group 2, behavior was related to caregiver burden (B = 0.68, T = 6) but not function-cognition (B = 0.16, T = 1.36).
These findings suggest that behavioral symptoms are an important factor associated with caregiver burden in patients with cognitive impairment, dementia, or depression, while functional and cognitive factors seem to also have an influence in patients with cognitive impairment.