Abstract
Neuropsychiatric symptoms (NPS) of dementia constitute one of the most related factors to caregiver burden and patients' early institutionalization. Few studies in Brazil have examined which symptoms are associated with higher levels of caregiver distress.OBJECTIVETo evaluate the caregiver distress related to individual NPS in familial caregivers of patients with dementia. We also examined which caregiver and patient factors predict caregiver distress associated with NPS.METHODSOne hundred and fifty-nine familial caregiver and dementia outpatient dyads were included. The majority of the patients had a diagnosis of Alzheimer's disease (66.7%). Caregivers were assessed with a sociodemographic questionnaire, Beck Anxiety and Depression Inventories, and the Neuropsychiatric Inventory – Distress Scale. Patients were submitted to the Mini-Mental State Examination, Functional Activities Questionnaire, and the Neuropsychiatric Inventory. Spearman's rank correlation was used to assess the relationships between the continuous variables. Multiple linear regression analyses with backward stepping were performed to assess the ability of caregiver and patient characteristics to predict levels of caregiver distress associated with NPS.RESULTSApathy (M=1.9; SD=1.8), agitation (M=1.3; SD=1.8), and aberrant motor behavior (AMB) (M=1.2; SD=1.7) were the most distressful NPS. The frequency/severity of NPS was the strongest factor associated with caregiver distress (rho=0.72; p<0.05).CONCLUSIONThe early recognition and management of apathy, agitation and AMB in dementia patients by family members and health professionals may lead to better care and quality of life for both patients and caregivers.
Highlights
Neuropsychiatric symptoms (NPS) of dementia constitute one of the most related factors to caregiver burnout and early institutionalization of patients.[1,2] Different subtypes of NPS impose varied patterns of distress experienced by the caregiver
A strong correlation was found between Neuropsychiatric Inventory (NPI) and Neuropsychiatric Inventory - Distress Scale (NPI-D) total scores (Spearman rho=0.72; p
This study showed that apathy, agitation, and Aberrant Motor Behavior (AMB) are the most distressful NPS according to familial caregivers of patients with dementia
Summary
Neuropsychiatric symptoms (NPS) of dementia constitute one of the most related factors to caregiver burnout and early institutionalization of patients.[1,2] Different subtypes of NPS impose varied patterns of distress experienced by the caregiver. Aberrant Motor Behavior (AMB) and sleep disturbances are highly distressing because they impose higher physical demands. Delusions of theft and identification are psychologically stressful for the caregiver because of the patient’s inability to recognize them. The burden associated with NPS is influenced by the stage of the dementia. Depressive and anxious symptoms are commonly observed during the early stages of Alzheimer’s disease (AD), whereas psychotic symptoms and AMB occur in the moderate stages of the dementia.[3]
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