Objectives: The Maastricht study of behaviour in dementia (abbreviated as MAASBED) focuses on the course and risk factors of behavioural and psychological symptoms of dementia (BPSD). MAASBED consists of two parts: part 1 focuses on predictors of BPSD in the patient, and part 2 examines the relationship between BPSD and caregiver characteristics. This paper presents results on the relationship between behavioural problems in patients with dementia and changes in the marital relationship
Design: MAASBED is a two-year follow-up study including 199 patients with dementia as well as 119 informal caregivers. Baseline results of 53 spouse caregivers of dementia patients are presented.
Methods: Caregiver perception of changes in the quality of their relationship was examined with a questionnaire and interviews. Behavioural disturbances in the patient were measured with the NeuroPsychiatric Inventory (NPI). Regression analysis was used to investigate the relationship between patient functioning and deterioration of the marital relationship. Qualitative methods were used to further assess the association between patient behavioural problems and relationship quality.
Results: Caregivers experienced a deterioration of their relationship, yet at the same time most felt closer to their spouse now than in the past. Regression analysis revealed that patient behavioural problems, mood/apathy symptoms in particular, were associated with deterioration in the quality of the relationship between patient and caregiver, independent of patient cognitive status or functional impairment. Qualitative data revealed that patient apathy rather than depressive mood was associated with this deterioration. Apathy diminished the amount and reciprocity of interactions between partners.
Conclusions: These results show that passive behaviour rather than excessive behaviour has most impact on the deterioration of the marital relationship. Intervention programmes should target relationship problems when problem behaviour, especially apathy, is present in patients with dementia.
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