Abstract
BackgroundThis study aimed to elucidate the influence of dementia etiologies on the degree of caregiver burden and determine which factors predict a high caregiving burden.MethodsThis 18-month retrospective cohort study enrolled 630 patients and their caregivers from the Dementia Center of Changhua Christian Hospital. The care team performed face-to-face interviews every 6 months, for 18 months from when a diagnosis of dementia was made. The primary outcome was the change in Zarit Burden Interview (ZBI) scores. Generalized estimating equations were used for the longitudinal data analysis.ResultsParticipants with Lewy body disease (LBD) had a significantly higher caregiving burden compared with those with Alzheimer's disease (AD) (β = 3.83 ± 1.47, Wald = 6.79, p = 0.009) after adjusting for patient and caregiver features. Caregivers of mixed-type dementia and frontotemporal dementia (FTD) experienced a greater burden than caregivers of AD, at 6- and 18-month follow-up. Patients with more severe dementia, neuropsychiatric symptoms, being cared for by more than two caregivers, or utilizing social resources were associated with higher ZBI scores; the depressive mood of caregiver also predicted higher ZBI scores.ConclusionThis longitudinal study demonstrated that caregiver burden was influenced by the underlying dementia etiology of patients. The dementia care team should provide personalized education and transfer patients and caregivers to appropriate resources, especially for high-risk populations.
Highlights
More than 40 million people around the world are living with dementia, and the prevalence is still increasing
This 18-month retrospective cohort study was conducted at the Dementia Center of Changhua Christian Hospital (CCH), a medical center in Central Taiwan
This study revealed that higher Clinical Dementia Rating Scale Sum of Box (CDR-SOB) and Neuropsychiatric Inventory (NPI) scores predicted higher caregiving burden; these findings were consistent with previous studies (Huang et al, 2012; Shim et al, 2016; Chen et al, 2017; Hashimoto et al, 2017; Torrisi et al, 2017; Branger et al, 2018; Ku et al, 2019; Connors et al, 2020; Kawano et al, 2020; Tsai et al, 2021)
Summary
More than 40 million people around the world are living with dementia, and the prevalence is still increasing. Alzheimer’s disease (AD) is the most common cause of dementia (Scheltens et al, 2016). Taking care of AD patients is difficult and is often associated with a high burden of care, especially over a prolonged period of time (van den Kieboom et al, 2020). The burden of caregiving can reduce the quality of life of caregivers and cause depressive symptoms (Liew et al, 2020). A high care burden typically reduces the work productivity of caregivers (Fujihara et al, 2019). This study aimed to elucidate the influence of dementia etiologies on the degree of caregiver burden and determine which factors predict a high caregiving burden
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