Cognitive, Functional and Behavioral factors associated with the Burden of caring for Geriatric Patients with Cognitive Impairment or Depression: evidence from a South American sample.

GERARDO MACHNICKI, RICARDO F. ALLEGRI, CAROL DILLON, CECILIA M. SERRANO AND FERNANDO E TARAGANO.

INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY.

Wiley Publishers

Lugar: New York; Año: 2009 vol. 24 p. 382 - 389

0885-6230

Caregiving of elderly adults is valuable and needed, however it can negatively impact the physical and psychological health of caregivers. This analysis was undertaken examine behavioral, cognitive and functional factors associated with psychosocial burden in caregivers of geriatric patients. Methods: Primary caregivers assessed were included if the geriatric patient cared for had a cognitive impairment or dementia (degenerative, vascular or mixed) (group 1) or depression and cerebrovascular disease (CVD) (group 2). Caregivers completed the Zarit questionnaire, the Neuropsychiatric Inventory (NPI) and Instrumental Activities of Daily Living (IADL). Patients were evaluated for dementia severity using the Clinical Dementia Rating (CDR), Mini Mental State Examination (MMSE) and Beck Depression Inventory (BDI).  Structural equation modelling was used to assess measurement models and the factors associated with burden. Results: 258 caregiver-patient pairs were included.  The best model fit was obtained with a model with two constructs: function-cognition (CDR, MMSE, and IADL) and behaviour (psychotic, frontal and depressive symptoms from the NPI). In cognitive impairment and dementia, both function (B= 0.32. T=2.79) and behaviour (B=0.72, T=7.84) were significantly correlated with caregiver burden, although the strength of association was more than two times higher for behaviour. In contrast in CVD/depression, behaviour was related to caregiver burden (B=0.68, T=6) but not function-cognition (B=0.16, T=1.36).Conclusion: These findings suggest that behavioral symptoms are an important factor associated with caregiver burden in patients with cognitive impairment, dementia, or depression, while functional and cognitive factors seem to also have an influence in patients with cognitive impairment.