OBJECTIVES: The primary objective of this study was to determine whether caregiving burden mediated the relationship between specific behavior disturbances and time to nursing home admission (NHA) for persons with dementia (i.e., Alzheimer disease or a related disorder). DESIGN: The study used secondary longitudinal data from the Medicare Alzheimer's Disease Demonstration, a Medicare-covered home care benefit and case management program for family caregivers of persons with dementia. Primary caregivers of persons with dementia were assessed via in-person and telephone interviews every 6 months over a 3-year period. SETTING: Dementia caregivers were recruited from eight catchment areas throughout the United States. PARTICIPANTS: The baseline sample included 5,831 dementia caregivers. Just more than 40% (43.9%; N = 2,556) of persons with dementia permanently entered a nursing home during the 3-year study period. MEASUREMENTS: Individual behavior problems were measured with the Memory and Behavior Problem Checklist. Caregiving burden was assessed with a short version of the Zarit Burden Inventory. Key covariates, including sociodemographic background, functional status, and service utilization, were also considered. RESULTS: Event history analyses revealed that time-varying measures of caregiver burden fully mediated the relationship between four behavioral disturbances (episodes of combativeness, property destruction, repetitive questions, and reliving the past) and NHA. CONCLUSIONS: The findings highlight the multifaceted, complex pathway to NHA for persons with dementia and their family caregivers. The results emphasize the need for comprehensive treatment approaches that incorporate the burden of caregivers and the behavioral/psychiatric symptoms of persons with dementia simultaneously.
OBJECTIVES: The primary objective of this study was to determine whether caregiving burden mediated the relationship between specific behavior disturbances and time to nursing home admission (NHA) for persons with dementia (i.e., Alzheimer disease or a related disorder). DESIGN: The study used secondary longitudinal data from the Medicare Alzheimer's Disease Demonstration, a Medicare-covered home care benefit and case management program for family caregivers of persons with dementia. Primary caregivers of persons with dementia were assessed via in-person and telephone interviews every 6 months over a 3-year period. SETTING:Dementia caregivers were recruited from eight catchment areas throughout the United States. PARTICIPANTS: The baseline sample included 5,831 dementia caregivers. Just more than 40% (43.9%; N = 2,556) of persons with dementia permanently entered a nursing home during the 3-year study period. MEASUREMENTS: Individual behavior problems were measured with the Memory and Behavior Problem Checklist. Caregiving burden was assessed with a short version of the Zarit Burden Inventory. Key covariates, including sociodemographic background, functional status, and service utilization, were also considered. RESULTS: Event history analyses revealed that time-varying measures of caregiver burden fully mediated the relationship between four behavioral disturbances (episodes of combativeness, property destruction, repetitive questions, and reliving the past) and NHA. CONCLUSIONS: The findings highlight the multifaceted, complex pathway to NHA for persons with dementia and their family caregivers. The results emphasize the need for comprehensive treatment approaches that incorporate the burden of caregivers and the behavioral/psychiatric symptoms of persons with dementia simultaneously.
Authors: Maria Carmela Tartaglia; Bei Hu; Kala Mehta; John Neuhaus; Kristine Yaffe; Bruce L Miller; Adam Boxer Journal: Alzheimer Dis Assoc Disord Date: 2014 Apr-Jun Impact factor: 2.703
Authors: Katherine Ornstein; Joseph E Gaugler; D P Devanand; Nikos Scarmeas; Carolyn Zhu; Yaakov Stern Journal: Am J Geriatr Psychiatry Date: 2013-02-06 Impact factor: 4.105
Authors: Mary Guerriero Austrom; Yvonne Yueh-Feng Lu; Anthony J Perkins; Malaz Boustani; Christopher M Callahan; Hugh C Hendrie Journal: Am J Alzheimers Dis Other Demen Date: 2014-01-09 Impact factor: 2.035
Authors: Paula T Trzepacz; Andrew Saykin; Peng Yu; Phani Bhamditipati; Jia Sun; Ellen B Dennehy; Brian Willis; Jeffrey L Cummings Journal: Am J Geriatr Psychiatry Date: 2013-04-18 Impact factor: 4.105
Authors: Travonia B Hughes; Betty S Black; Marilyn Albert; Laura N Gitlin; Deirdre M Johnson; Constantine G Lyketsos; Quincy M Samus Journal: Int Psychogeriatr Date: 2014-08-08 Impact factor: 3.878