Perceived stress and depressive symptoms not neuropsychiatric symptoms predict caregiver burden in Alzheimer’s disease: a cross-sectional study

Abstract Background Caregiver burden affects the caregiver’s health and is related to the quality of care received by patients. This study aimed to determine the extent to which caregivers feel burdened when caring for patients with Alzheimer’s Disease (AD) and to investigate the predictors for caregiving burden. Methods A cross-sectional study was conducted. One hundred two caregivers of patients with AD at Maharaj Nakorn Chiang Mai Hospital, a tertiary care hospital, were recruited. Assessment tools included the perceived stress scale (stress), PHQ-9 (depressive symptoms), Zarit Burden Interview-12 (burden), Clinical Dementia Rating (disease severity), Neuropsychiatric Inventory Questionnaires (neuropsychiatric symptoms), and Barthel Activities Daily Living Index (dependency). The mediation analysis model was used to determine any associations. Results A higher level of severity of neuropsychiatric symptoms (r = 0.37, p < 0.01), higher level of perceived stress (r = 0.57, p < 0.01), and higher level of depressive symptoms (r = 0.54, p < 0.01) were related to a higher level of caregiver burden. The direct effect of neuropsychiatric symptoms on caregiver burden was fully mediated by perceived stress and depressive symptoms (r = 0.13, p = 0.177), rendering an increase of 46% of variance in caregiver burden by this parallel mediation model. The significant indirect effect of neuropsychiatric symptoms by these two mediators was (r = 0.21, p = 0.001). Conclusion Caregiver burden is associated with patients’ neuropsychiatric symptoms indirectly through the caregiver’s depressive symptoms and perception of stress. Early detection and provision of appropriate interventions and skills to manage stress and depression could be useful in reducing and preventing caregiver burden.

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A Cross-Sectional Study of Neuropsychiatric Symptoms in 435 Patients With Alzheimer's Disease

American Journal of Geriatric Psychiatry ◽

10.1097/00019442-200506000-00004 ◽

2005 ◽

Vol 13 (6) ◽

pp. 460-468 ◽

Cited By ~ 143

Author(s):

David Craig ◽

Ajay Mirakhur ◽

Dominic J. Hart ◽

Stephen P. McIlroy ◽

A. Peter Passmore

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Neuropsychiatric Symptoms ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional

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Risk Factors of Caregiver Burden Among Patients with Alzheimer's Disease or Related Disorders: A Cross-Sectional Study

Journal of Alzheimer s Disease ◽

10.3233/jad-142337 ◽

2015 ◽

Vol 44 (3) ◽

pp. 907-916 ◽

Cited By ~ 53

Author(s):

Virginie Dauphinot ◽

Floriane Delphin-Combe ◽

Christelle Mouchoux ◽

Aline Dorey ◽

Anthony Bathsavanis ◽

...

Keyword(s):

Risk Factors ◽

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Caregiver Burden ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional

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Can impairment in memory, language and executive functions predict neuropsychiatric symptoms in Alzheimer's disease (AD)? Findings from a cross-sectional study

Archives of Gerontology and Geriatrics ◽

10.1016/j.archger.2010.05.004 ◽

2011 ◽

Vol 52 (3) ◽

pp. 264-269 ◽

Cited By ~ 15

Author(s):

José María García-Alberca ◽

José Pablo Lara ◽

Marcelo Luis Berthier ◽

Belén Cruz ◽

Miguel Ángel Barbancho ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Executive Functions ◽

Neuropsychiatric Symptoms ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional

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Neuropsychiatric symptoms and severity of dementia

Dementia & Neuropsychologia ◽

10.1590/s1980-57642013dn70200006 ◽

2013 ◽

Vol 7 (2) ◽

pp. 171-175

Author(s):

Gustavo Henrique de Oliveira Caldas ◽

Sueli Luciano Pires ◽

Milton Luiz Gorzoni

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Motor Behavior ◽

Neuropsychiatric Symptoms ◽

Prevalence Ratio ◽

Cross Sectional Study ◽

Clinical Dementia Rating ◽

Cross Sectional ◽

Specific Stage ◽

Severity Of Dementia

ABSTRACT Neuropsychiatric symptoms (NPS) cause distress, disabilitiy and reduced quality of life for both the patient and their families Objective: To evaluate the prevalence of NPS as a specific stage of dementia status. Methods: A cross-sectional study in patients attending an outpatient clinic for dementia was performed. We applied the Neuropsychiatric Inventory and Clinical Dementia Rating (CDR) scale. Statistical analysis was carried out with SPSS 17 software. Results: The 124 subjects (mean age of 80.4±7.0 years), 88 women (70.9%) had average duration of dementia of 7.1±3.2 years, most common dementias of Alzheimer's disease (35.5%) and mixed (31.5%) and most prevalent NPS of apathy (75%) and irritability (66.9%). Correlation between apathy and a CDR 1 had a PR (prevalence ratio) = 0.289 and p<0.001 while between apathy and CDR 4-5 (PR=8.333, p<0.005). A similar result was found between aberrant motor behavior (AMB) and CDR 1 (PR=0.352, p<0.003) and between AMB and CDR4-5 (PR=2.929, p<0.006). Conclusion: Alzheimer's disease and mixed dementia were predominant, while apathy and AMB were detected in association with the progressive stages of dementia.

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Frequency and Severity of Adverse Drug Reactions to Medications Prescribed for Alzheimer’s Disease in a Brazilian City: Cross-Sectional Study

Frontiers in Pharmacology ◽

10.3389/fphar.2020.538095 ◽

2020 ◽

Vol 11 ◽

Author(s):

Tânia Regina Ferreira ◽

Luciane Cruz Lopes ◽

Cristiane de Càssia Bergamaschi

Keyword(s):

Public Health ◽

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Health System ◽

Psychiatric Disorders ◽

Public Health System ◽

Cross Sectional Study ◽

Sectional Study ◽

Drug Reactions ◽

Cross Sectional

Background: There is lack of national studies that assess the risks associated with the drugs provided under the Brazilian public health system for treating Alzheimer’s disease. Then, this study determined the prevalence and severity of self-reported adverse drug reactions (ADRs) prescribed to patients with Alzheimer’s disease in the Brazilian public health system.Methods: A cross-sectional study was carried out based on public data from the MEDEX system (information on dispensing data, known as exceptional dispensing medications) and interviews with patients and/or caregivers who get access to Alzheimer’s drugs at a public pharmacy in a large Brazilian city, between July and September 2017, inquiring about ADRs and serious adverse events (SAEs).Results: The subjects were asked about ADRs and SAEs related to the use of donepezil, galantamine, rivastigmine and memantine. Out of 285 patients enrolled on the database, 250 participated in the study (87.7%). Among the participants, approximately 63.0% were female, 70.3% aged ≥75 years and 70.3% had comorbidities. Overall, 209 patients (83.6%) reported at least one ADR (total 1,149 ADRs) and rivastigmine was associated with the largest number of ADRs per patient (7.9 ADRs/patient). The predominant adverse effects were psychiatric disorders with common frequency (57.1%) and mild severity (89.0%). Six patients (2.4%) had SAEs that required hospitalization. The use of antipsychotics was the variable associated with ADR (OR = 4.95; 95% CI: 1.45–16.93; p = 0.011).Conclusion: There was a large number of reported ADRs and most of them were of common frequency and mild severity, being mainly related to psychiatric disorders. Considering the fragility of these patients, it is important to improve safety-related care in the use of drugs for treating this disease.

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AFFECTIVE THEORY OF MIND IN PEOPLE WITH ALZHEIMER’S DISEASE

10.5327/1980-5764.rpda052 ◽

2021 ◽

Author(s):

Aline De Lucena ◽

Paulo Fernando Santos ◽

Marcia Cristina Dourado

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Emotional State ◽

Neuropsychiatric Symptoms ◽

Cross Sectional Study ◽

Social Situations ◽

Cross Sectional ◽

Emotional Reasoning ◽

Significant Difference ◽

Emotional Aspects

Background: In recent years, interest has been growing in cognitive and affective ToM functioning in individuals suffering from neurodegenerative disorders, such as Alzheimer’s disease (AD). However, the affective ToM has been less investigated. Objective: This study aims to compare affective ToM performance in persons with mild to moderate AD and healthy older controls (HOC), and its relationship with cognition. Methods: A cross-sectional study of 97 mild to moderate AD individuals and 40 HOC. To assess affective ToM, participants were administered a task that examines ability to comprehend the emotional situation nature along with the appropriate emotional state that one would experience in that situation. Assessments of cognition, dementia severity, functionality, awareness of disease and neuropsychiatric symptoms were completed for AD group. Results: Analyses of emotional reasoning indicated a group effect on performance. There was a significant difference between the AD and HOC groups in terms of their ability to understand situations of sadness, surprise, anger, and happiness, with the moderate AD showing the worst performance for all emotional situations. Ability to appropriately name the emotional state was significantly different for surprise, anger, and happiness, but not for sadness, with both AD groups showing lower performance for surprise and anger, and with the mild AD showing better performance for happiness. In both AD groups, ability to understand the emotional situation and to name the emotion was significantly correlated with cognitive impairment and awareness of disease. Neuropsychiatric symptoms were significantly correlated in moderate AD group. Conclusions: Impairment in understanding the emotional aspects of situations can lead moderate AD people to experience conflicts in family and social situations. Mild AD people can experience same conflicts when their preserved ability in understanding the emotional situation is underestimated.

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