Relationship between cognitive functioning and caregiver burden in dementia

Abstract

Byline: Manoj. Bajaj, Uday. Sinha Aim: The present study examined the relationship among cognitive deficits of the dementia patients and the perceived burden by the caregivers. Materials and Methods: Purposive sampling method was employed in this study. The sample composed of total 40 participants among whom were dementia patients (n = 20) and their primary caregivers (n = 20). In addition to a socio-demographic and clinical data sheet (SCDS), the tools used were Hindi mental status examination (HMSE), triads test (to measure divided attention), logical memory (passage recall), Rey's complex figure test (RCFT), and Zarit burden interview (ZBI). Results and Conclusion: The results showed that persons with dementia who were having impairment in dividing attention, impairment in encoding and retrieval of information, and poor cognitive functions were significantly related with caregiver's burden. Visual memory and visual construction ability was not found significantly related to burden, although a relationship exist. Introduction Dementia is a common disorder in the later stage of life that is assuming increasing prominence with the demography shift toward an ever-increasing aging population. Throughout history, the disorder that we now think of as dementia was viewed as an inevitable consequences of aging.[sup] [1] The distinction between the aging process and dementia is a recent conceptual development. The cognitive methodology that[sup] [2] used to make their seminal observation represents the foundation of a rich collaboration between cognitive neuroscientists and clinicians. The fundamental principles established by these pioneers are that components of cognitive function important to dementia can be identified and that these components can be quantified. Dementia, in contrast to disorders defined by deficits in one cognitive or behavioral domain, is diagnosed when deficits are seen in multiple domains. Beside memory dysfunction, the other cognitive and behavioral manifestations of the dementia syndrome include abnormalities in speech and language, visuospatial function, abstract reasoning and executive function, and mood and personality. Dementia is a generic term for a syndrome that has a variety of etiologies. The most common etiology is Alzheimer disease (AD), which accounts for approximately 60%-70% cases of late onset dementia. Dementia associated with cerebrovascular disease i.e. vascular dementia, dementia associated with Parkinson's disease (PD), and Lewy body dementia etc. are the most common causes of dementia in elderly. Cognitive impairment in dementia Cognition in a broad sense means information processing. It denotes a relatively high level of processing of specific information including thinking, memory, perception, motivation skilled movements, and cognition. Among the specific functions that may be assessed in determining the intactness of adequacy of cognition are orientation, the ability to learn necessary skills, solve problems, think abstractly reason and make judgments, the ability to retain and recall events, mathematical ability and other form of symbol manipulation, control over primitive actions and behaviors, language use and comprehension, attention, perception, and praxis.[sup] [3] Cognitive deficits may results in to pay attention, processing information quickly, remember and recall information, respond to information quickly, think critically, plan and solve problems, and initiate speech. The most extensive literature available regarding the neuropsychological assessment of individuals with AD is for those who have mild-to-moderate cognitive impairment. Cognitive deficits associated with AD and other cortical disorders include intellectual impairment, encoding and/or storage-based memory deficits, aphasia, agnosia, apraxia, and visuo spatial, and constructional deficits. However, two areas of cognitive functioning, language and memory show distinct patterns of deficits and thus may have potential use in differential diagnosis. …