A - 62 Caregiver Relationship Type Significantly Moderates Association among NPI-Q Symptoms: a Moderated Network Analysis.

Abstract

We investigated the influence of caregiver type (CT; ex. spouse, child, etc.) on the association among neuropsychiatric symptoms using the caregiver-endorsed Neuropsychiatric Inventory Questionnaire (NPI-Q) and a sample from the National Alzheimer's Coordinating Center database. The selected sample (n = 12,337) includes those aged 50+ with complete baseline data for the NPI-Q and caregiver relationship. Included participants had ≥1 NPI-Q symptom(s) endorsed and a diagnosis of mild cognitive impairment or dementia with Alzheimer's disease as the primary or contributing cause. A Moderated Network Model approach estimated whether associations among NPI-Q items depend on CT (moderator variable). Spouse was used as the reference group for all comparisons. CT significantly moderated the NPI-Q. Interaction effects were found between 3 moderated node pairs: agitation/aggression and disinhibition (edgeweight = 0.02), hallucinations and nighttime behaviors (edgeweight = 0.01), and depression/dysphoria and appetite/eating problems (edgeweight = 0.01). The edgeweights for these node pairs were reduced in the final model due to variance being accounted for by the addition of CT. The association between agitation/aggression and disinhibition was smaller for spouses than children, and larger for spouses than friends and paid caregivers. The association between hallucinations and nighttime behaviors was smaller for spouses than children, and larger for spouses than friends and paid caregivers. The association between depression/dysphoria and appetite/eating problems was smaller for spouses than siblings and friends. The pairwise dependency between neuropsychiatric symptoms differs as a function of CT. Future research is needed to identify factors that influence symptom reporting, including interpersonal dynamics, amount of time spent together, and overall burden of symptoms.