Henry Brodaty1, Michael Woodward2, Karyn Boundy3, David Ames4, Robert Balshaw5. 1. Dementia Collaborative Research Centre and Centre for Healthy Brain Ageing, University of New South Wales, Sydney, New South Wales, Australia; Austin Health, Heidelberg, Victoria, Australia. Electronic address: h.brodaty@unsw.edu.au. 2. Austin Health, Heidelberg, Victoria, Australia. 3. The Queen Elizabeth Hospital, Woodville South, South Australia, Australia. 4. National Ageing Research Institute and University of Melbourne Academic Unit for Psychiatry of Old Age, St. George's Hospital, Kew, Victoria, Australia. 5. Syreon Corporation, Vancouver, British Columbia, Canada.
Abstract
OBJECTIVE: To examine prevalence and predictors of burden in caregivers of people with dementia attending memory clinics. METHODS: This Prospective cohort study conducted at nine memory clinics in Australia rated 732 outpatient attendees and their primary caregivers at baseline and at 3, 6, 12, 24, and 36 months. Ratings were based on the following: dementia diagnosis according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Mini-Mental State Exam, Alzheimer's Disease Assessment Scale-Cognitive, Functional Autonomy Measurement System, Neuropsychiatric Inventory, use of psychotropic and antidepressant medications, patient and caregiver resource use, and the Zarit Caregiver Burden Interview (ZBI). RESULTS: Half the caregivers had significantly high levels of burden, rising to 57.7% at 12 months; with moderate to severe burden rates, rising from 14.7% at baseline to 22.8% at 12 months; and mean ZBI levels rising from 22.9 at baseline to 25.5 at 6 months and 27.7 at 12 months. Caregiver predictors of 6- and 12-month burden were their neuroticism and baseline ZBI score. Patient predictors were their level of behavioral symptoms, use of antipsychotics and antidepressants, and more rapid functional decline. Other predictors (female caregiver, level of cognition and function, diagnosis of frontotemporal dementia) were not significant in regression analyses. CONCLUSION: Caregivers of people with dementia have high and persistent rates of burden. Identification of caregivers likely to have high levels of burden at 12 months may allow more accurate targeting of interventions.
OBJECTIVE: To examine prevalence and predictors of burden in caregivers of people with dementia attending memory clinics. METHODS: This Prospective cohort study conducted at nine memory clinics in Australia rated 732 outpatient attendees and their primary caregivers at baseline and at 3, 6, 12, 24, and 36 months. Ratings were based on the following: dementia diagnosis according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Mini-Mental State Exam, Alzheimer's Disease Assessment Scale-Cognitive, Functional Autonomy Measurement System, Neuropsychiatric Inventory, use of psychotropic and antidepressant medications, patient and caregiver resource use, and the Zarit Caregiver Burden Interview (ZBI). RESULTS: Half the caregivers had significantly high levels of burden, rising to 57.7% at 12 months; with moderate to severe burden rates, rising from 14.7% at baseline to 22.8% at 12 months; and mean ZBI levels rising from 22.9 at baseline to 25.5 at 6 months and 27.7 at 12 months. Caregiver predictors of 6- and 12-month burden were their neuroticism and baseline ZBI score. Patient predictors were their level of behavioral symptoms, use of antipsychotics and antidepressants, and more rapid functional decline. Other predictors (female caregiver, level of cognition and function, diagnosis of frontotemporal dementia) were not significant in regression analyses. CONCLUSION: Caregivers of people with dementia have high and persistent rates of burden. Identification of caregivers likely to have high levels of burden at 12 months may allow more accurate targeting of interventions.
Authors: Steven H Zarit; Courtney A Whetzel; Kyungmin Kim; Elia E Femia; David M Almeida; Michael J Rovine; Laura Cousino Klein Journal: Am J Geriatr Psychiatry Date: 2014-02-02 Impact factor: 4.105
Authors: Jeremy A Tanner; Betty S Black; Deirdre Johnston; Edward Hess; Jeannie-Marie Leoutsakos; Laura N Gitlin; Peter V Rabins; Constantine G Lyketsos; Quincy M Samus Journal: Am J Geriatr Psychiatry Date: 2014-08-13 Impact factor: 4.105