The Relationship Between Dementia Patients Psychiatric Symptoms and Caregiver Burden

1
The Relationship Between Dementia Patients
Psychiatric Symptoms and Caregiver Burden
ABSTRACT
METHODOLOGY
RESULTS
TABLE 1. Correlation Table.

• There is a significant relationship between
  dementia patients who exhibit psychiatric
  symptoms and the stress severity and burden
  experienced by their caregivers. Unfortunately,
  the literature fails to examine the relationship
  between specific psychiatric symptoms and the
  multiple domains of caregiver burden. The purpose
  of this study was to assess the relationship
  between scores on the Neuropsychiatric Inventory
  Questionnaire (NPI-Q) and the formal measurement
  of caregiver burden, Caregiver Burden Inventory
  (CBI). This study specifically looked at the
  relationship between 15 psychiatric symptoms of
  dementia patients, the distress those symptoms
  impose on the caregiver, and five domains of
  caregiver burden. The participants were fifteen
  next-of-kin caregivers of patients with
  Alzheimers disease and vascular dementia. The
  caregivers completed both the NPI-Q and the CBI
  on the patients and themselves. The NPI-Q is a
  twelve item questionnaire that requires the
  caregivers to rate the severity of the
  psychiatric symptoms experienced by the patients.
  It also requires them to rate the level of
  distress experience by caregiver. The CBI is a
  24-item questionnaire that taps into 5 different
  domains of functioning (such as social, physical,
  and emotional burden). Bivariate correlations
  suggest that the CBI Time Dependent burden (which
  measures the amount of time required in caring
  for the patient) was significantly correlated to
  dementia patients NPI-Q anxiety scores, (r
  .576, plt.05), caregiver NPI-Q stress severity of
  depression and dysphoria (r.663, plt.01), and
  caregiver NPI-Q stress severity score were
  related to anxiety (r .669, plt.01).
  Developmental burden (which measures the degree
  to which caregivers feel in sync with their
  non-caregiver peers), Physical burden and Social
  burden were all significantly correlated to NPI-Q
  patient anxiety levels (r.609, r.584 and
  r.592, respectively, plt.01). The results of the
  current study suggest that the psychiatric
  symptom, anxiety, is positively correlated with,
  developmental, time dependent and physical
  burden, but not emotional burden. However,
  caregivers who scored high on the stress severity
  scores of depression, dysphoria and anxiety were
  positively correlated with only time dependent
  burden. The current findings have implications
  for treatment planning and quality of life issues
  for caregivers who are tending to dementia
  patients with psychiatric symptoms.

• PARTICIPANTS
• 22 next-of-kin caregivers who were caring for
  patients in the mild to moderate stages of
  Alzheimers disease or Vascular dementia
  participated in this study.
• Participants were an average age of 73 with an
  average of 14 years of education.
• MATERIALS
• As part of a larger test battery, all caregivers
  were administered the following instruments
• Caregiver Burden Inventory (CBI)
• 24 item measure that the caregiver completes
  about themselves. Each item is rated on a 5 point
  scale, with higher numbers representing greater
  burden.
• This measures factors into 5 different domains
  of burden 1)Time-Dependence Burden,
  2)developmental burden, 3)physical burden,
  4)social burden, and 5)emotional burden.
• The Neuropsychiatric Inventory Questionnaire
  (NPI-Q)
• 12 item questionnaire that requires the caregiver
  to rate the presence of 12 psychiatric symptoms
• The severity level of those symptoms is rated on
  a 3 point scale, and the degree of stress caused
  for the caregiver is rated on a 6 point scale.
• A combination of high scores on both scales
  indicate greater severity of symptoms and
  distress for caregivers.
• PROCEDURE
• Caregivers completed both measures. They
  completed the NPI-Q about the patient and the CBI
  about their own experiences.

DISCUSSION

• Current results find that anxiety in patients was
  related to nearly all aspects of caregiver burden
  including time dependence, developmental,
  physical and social burden.
• Patients who exhibit agitation symptoms only
  correlated with developmental burden, however
  developmental burden was most correlated with
  stress severity scores of such as agitation,
  depression, anxiety, elation, and irritability.
• Emotional burden was only correlated with stress
  severity scores of hallucinations, irritability
  and appetite
• Stress severity of psychiatric symptoms were only
  predictors of caregiver physical burden.
  Specifically, stress severity of delusion,
  depression, apathy, dishinhibion, irrability,
  abrevent motor behavior, appetite, aggression and
  anxiety were accurate predictors.
• Whereas psychiatric symptoms were only directly
  predictive of caregiver time dependence burden,
  specifically, anxiety and elation.
• It is important to point out that caregivers of
  patients who exhibit anxiety symptoms exhibited
  time-dependence burden and were more likely to
  have higher stress severity.
• These findings suggest that patients psychiatric
  symptoms directly affect caregivers level of
  burden. Accordingly, these findings are the first
  step in learning ways to assist with treatment
  planning for patients and caregivers (i.e.,
  support groups, respite care).

INTRODUCTION

• The health of caregivers who assist dementia
  patients is affected by the care giving process.
  Due to caregiver stress, both dementia patients
  and caregivers may be negatively affected by some
  aspects of care-giving.
• The purpose of this study was to assess the
  relationship between scores of patients on the
  Neuropsychiatric Inventory Questionnaire (NPI-Q),
  as rated by their caregivers, and ratings of
  caregivers about their experienced level of
  burden on the Caregiver Burden Inventory (CBI).
• This study specifically examined the relationship
  and predictability of 15 psychiatric symptoms of
  dementia patients and the distress those symptoms
  impose on five domains of caregiver burden.

P lt .05, p lt .01
ACKNOWLEDGMENTS This project was in part
supported by the Career Opportunities in Research
program of the NIH and by supported by NIMH COR
Grant T34 MH20023, NIGMS grant GM048680, and the
California Endowment. I sincerely appreciate the
guidance of Drs. Carrie Saetermoe and Jill Razani.