Zarit Burden Interview Score Research Articles

Persisting Burden Predicts Depressive Symptoms in Dementia Caregivers

Dementia caregivers often report feeling burdened by caretaking responsibilities. Caregiver burden is correlated with caregiver depression, but the interrelationship between burden and depression requires further investigation. This study hypothesized that persisting elevated burden results in subsequent depressive symptoms. Participants were 33 dementia caregivers divided into two groups based on their Zarit Burden Interview score. The outcome variable was the total score on the Geriatric Depression Scale after 12 months. Caregivers who had persisting high burden showed significantly worse depression scores after 12 months compared to those caregivers without persisting high burden. Regression analysis controlling for baseline depression also demonstrated burden as a significant predictor of subsequent depression. These data suggest that longitudinal burden may be predictive of higher depressive symptoms; therefore, reducing burden could decrease depressive symptoms in dementia caregivers.

Emotional burden and psychological morbidity in caregivers of patients with obsessive-compulsive disorder

Introduction:The objective of this study was to evaluate the emotional burden, psychological morbidity and level of family accommodation in caregivers of obsessive-compulsive disorder (OCD) patients, according to sociodemographic and clinical factors.Method:Fifty Brazilian DSM-IV OCD patients and their caregivers were evaluated using the Family Accommodation Scale, the Zarit Burden Interview (ZBI), the Self Report Questionnaire (caregivers), the Yale-Brown Obsessive-Compulsive Scale and the Beck Depression Inventory (patients).Results:Most caregivers (80%) were aged between 30 and 59 years-old and lived with the patient (88%). Forty-two percent presented a common mental disorder and their mean ZBI score was 28.9. Family accommodation was moderate in 26% and severe or very severe in 24%. Caregivers' levels of psychological morbidity, accommodation and emotional burden were associated with each other and with the severity of patient obsessive-compulsive and depressive symptoms.Conclusion:The results suggest that caregivers of OCD patients have important levels of burden and psychological morbidity and should receive orientation and support to minimize this emotional impact.

Trazodone for Alzheimer's disease: A naturalistic follow-up study

This study intended to provide a patient profile for trazodone (a triazolopyridine-derivative of phenylpiperazine) prescription in everyday clinical practice in patients with Alzheimer's disease (AD), and to describe clinical evaluation and the impact on caregiver burden at a 6-month follow-up. A naturalistic, prospective and observational study was performed, with a 6-month follow-up in 396 patients with probable AD, according to the NINCDS-ARDRA criteria. At the baseline and at the 6-month visit, patients were administered the Neuropsychiatric Inventory (NPI) to determine their Behavioral and Psychological Symptoms of Dementia (BPSD), and the Zarit Burden Interview (ZBI) to assess the impact on caregiver burden. Trazodone was prescribed for 6.1% of patients. With respect to the baseline visit, the untreated group showed an increased global NPI score (3.1 points; 95% CI = 1.9–4.2; p = 0.001) and ZBI score (2.2 points; 95% CI = 0.9–3.4; p = 0.001). At 6 months, the global NPI and ZBI scores remained unchanged for the treated group. The treated group showed a significant reduction in the NPI irritability subscale score (2.1 points; 95% CI = 0.4–3.7; p = 0.015). In the clinical practice, trazodone treatment was prescribed for patients with irritability, agitation and disinhibition. After 6 months, patients treated with trazodone exhibited no increase in BPSD frequency or severity, nor was an increase noted in the caregiver burden.

Validation of the Zarit Burden Interview for Chinese Canadian Caregivers

The factor structure of a Chinese version of the Zarit Burden Interview was assessed with a random sample of Chinese caregivers in Canada. The results indicated that the latent constructs identified in earlier studies on caregivers did not fit well when tested with Chinese caregivers. Exploratory factor analysis reported a five-factor solution, which accounted for 32.45% of the variance in eigenvalues. Maximum-likelihood confirmatory factor analysis was conducted to assess the generalizability of this five-factor model and a better fit to the observed data was reported. The findings showed that Chinese caregivers had different experiences in providing care. The concept of burden was more than practical challenges and strain; it also included negative feelings such as embarrassment, anger, and uncertainty due to the loss of control over the future of the caring process. KEY WORDS: caregiving burden; family caregivers; Zarit Burden Interview ********** The need for caregiving of elderly family members increases as the aging population continues to grow. An informal caring system is sustained by family caregivers who provide basic care in health, social, emotional, and financial domains, particularly for those who are frail or suffer from chronic illnesses. However, informal caring can also be burdensome. Family caregivers spend less time with their family and friends because of caregiving responsibilities (Neal, Chapman, & Ingersoll-Dayton, 1988) and have increased rates of depression (Baumgarten et al., 1994; Canadian Study of Health and Aging Working Group, 1994; Chappell & Penning, 1996; Livingston, Manela, & Katona, 1996). The time required for caring for a frail older family member often amounts to a full-time job (Schulz et al., 2003), and employed family caregivers take more time off than their noncaregiving coworkers, are more often interrupted because of family matters, and work fewer hours than desired (Birenbaum & Clarke-Steffen, 1992; Covinsky et al., 1994; Schulz et al.; Stommel, Given, & Given, 1993). Caregiving employees have also reported adverse health effects, such as difficulty sleeping, frequent headaches, and weight gain or loss (Wagner, 1987). Clearly, social workers working with the elderly population must also provide support to family caregivers. Measuring the needs and the burden of family caregivers requires a valid assessment tool. The Zarit Burden Interview (ZBI) is a widely used 22-item assessment tool for measuring caregiver's perceived burden of providing family care (Zarit, Orr, & Zarit, 1985). It asks family caregivers about areas that may cause stress and strain such as physical, psychological, economic, and relational problems. Items are answered on a five-point scale ranging from 0 = never to 4 = always. Scores are added to give total score ranges from zero to 88, with higher scores implying greater perceived caregiver burden (Rankin, Haut, Keefover, & Franzen, 1994). Zarit and Zarit (1987) originally proposed severe burden at scores in the 61 to 88 range, moderate to severe burden at 41 to 60, mild to moderate burden at 21 to 40, and little or no burden at less than 21. The psychometric properties of the ZBI include an acceptable inter-item reliability and convergent validity, indicated by a Cronbach's alpha of .79 and a correlation coefficient of .71, between caregiver's global evaluation and ZBI scores (Scott, Roberto, Hutton, & Slack, 1985). A test-retest reliability of .71 and internal consistency (Cronbach's alpha = .91) also have been reported (Gallagher et al., 1985). Spearman's rho correlations include .32 with activities of daily riving (Poulshock & Deimling, 1984), .32 with social life restrictions (Thompson, Futterman, Gallagher-Thompson, Rose, & Lovett, 1993), .41 with the Brief Symptoms Inventory (Derogatis, Lipman, Covi, Richels, & Uhlenhutg, 1970), .71 with the global index of burden, and -. …

Falls of the elderly are associated with burden of caregivers in the community

Little attention has been paid to the impact on caregivers who provide care to a family member who has falls. The purpose of the current study was to determine whether falls of care recipients are associated with caregivers' burden. A cross-sectional study of 1874 community-dwelling care recipients and 1478 caregivers was conducted. We examined the characteristics of care recipients and caregivers, including demographic characteristics, depressive mood as assessed by the Geriatric Depression Scale (GDS-15), the basic activities of daily living (bADL), fall history in the past 6 months, and physician-diagnosed chronic diseases to determine whether there was an association with caregivers' burden as assessed by the Zarit Burden Interview (ZBI). A total of 567 care recipients (30.3%) had a history of falls in the past 6 months. The mean ZBI score of caregivers with falls was significantly higher than that of caregivers without falls. There were negative correlations between the ZBI score and recipient bADL score and positive correlations between the ZBI score and GDS-15 scores of the recipient and caregiver, the level of severity of dementia, and the Charlson comorbidity index. Male recipient, fall history, behavioral disturbance, and dementia had significantly higher ZBI scores than those of controls. The stepwise multiple regression analyses found that the GDS-15 score of caregivers and recipients, level of severity of dementia, bADL score, and fall history were independently associated with the ZBI score. Among the community-dwelling frail elderly, falls are associated with caregiver burden even when controlling for various possible confounding factors.

The PINK1 phenotype can be indistinguishable from idiopathic Parkinson disease

Mutations in the PINK1 gene cause autosomal recessive parkinsonism characterized by early onset and a variable phenotypic presentation. A patient homozygous for the Ala168Pro mutation has been fully characterized clinically. Apart from onset at age 39 years and the excellent and sustained response to levodopa, all clinical and laboratory features, including SPECT and assessment of autonomic function, were indistinguishable from typical idiopathic Parkinson disease.

10th Annual Convention

We examined the effects of aromatherapy on agitation in patients with dementia and evaluated related caregiver burden. Patients and their caregivers from two hospitals in Turkey were selected and divided into an intervention group (n = 14) and a control group (n = 14). Patients were stratified according to their dementia phase and intake of antipsychotic medication. The intervention group received aromatherapy via massage and inhalation at home for 4 weeks. The control group received no intervention. Data were collected using the Neuropsychiatric Inventory (NPI), the Cohen-Mansfield Agitation Inventory (CMAI) and the Zarit Burden Interview (ZBI). At 2 and 4 weeks, the NPI scores were significantly lower in the intervention group (p < 0.05). At 4 weeks, the CMAI and ZBI scores were significantly lower in the intervention group (p < 0.05). In conclusion, after aromatherapy, agitation, neuropsychiatric symptoms, and caregiver distress significantly reduced, and aromatherapy prevented caregiver burden increase.