Predictors of behavioral and psychological symptoms and caregiver burden in spousal caregivers of people with dementia: A longitudinal study

Abstract

AbstractBackgroundAs the number of people with dementia and the demands on family caregivers continues to increase, it is important to understand the factors associated with increased burden in order to identify effective interventions that reduce burden and improve the quality of life for both the caregiver and the care‐recipient (C‐R).MethodWe examined the predictors of behavioral and psychological symptoms of dementia (BPSD) and caregiver burden in 253 spousal caregivers of people with dementia (mean age 69.64 +7.84; 64.8% female; mean length of caring 59.44 +39.29 months) followed up over 12 months.Result45% of spousal caregivers were experiencing moderate to severe burden levels at baseline as measured by the Zarit Burden Index. One‐year follow up data was available on 205 caregivers: 151 were still caring at home; 34 C‐Rs were in long‐term care; 20 C‐Rs were deceased. Among those who were still caring at home at follow‐up, caregiver depression, loneliness, anxiety and self‐efficacy for symptom management at baseline predicted BPSD severity at follow‐up, controlling for baseline BPSD severity, number of years providing care, the number of caregiving hours per day, and functional impairment. Baseline depression, loneliness, anxiety, self‐efficacy and BPSD severity also predicted caregiver burden at follow‐up. However, only BPSD severity predicted burden at follow‐up in a combined model, controlling for burden, number of years providing care, the number of caregiving hours per day, and functional impairment at baseline.ConclusionWhile the strongest predictor of caregiver burden is the severity of BPSD, the emotional health of caregivers may also contribute to greater BPSD severity over time. Targeting BPSD directly while at the same time addressing caregiver factors, such as depression, anxiety, loneliness and self‐efficacy for symptom management, has the potential to impact on the severity of BPSD and improve the quality of life of spousal carers of people with dementia.