Objective: Alzheimer’s Disease is a progressive and degenerative brain disorder, characterized by cognitive deterioration and behavioral and psychiatric symptoms (BPS). As the disease progresses, the patient becomes dependent to a caregiver. Cognitive symptoms in general but especially the BPS create a great burden on caregivers. The aim of this study was to evaluate the relationship between the BPS of Alzheimer’s disease and caregiver burden, depression and anxiety levels.
Design: Twenty patients of the Dementia Outpatient Unit at the Department of Psychiatry of Uludag University and their 20 caregivers were included in the study.
Materials and Methods: The patient group consisted of 20 patients (female=12, male=8) with a mean age of 78,30±7,45 years. Mean age of females and males were 79,7±7,5 years and 76,3±7,4 years respectively. The caregiver group consisted of 20 caregivers (female=14, male=6) with a mean age of 54,3±12,6. Mean age of female and male caregivers were 53,5±11,5 and 56,2±16,1 respectively. The caregiver group was categorized into 3 subgroups according to their relationship to the patient: Children (n=9, 45%), spouses (n=6, 30%) and daughter-in-laws (n=5, 25%). Sociodemographic characteristics of the patients and their caregivers were questioned. The Global Deterioration Scale (GDS), Standardized Mini-Mental State Examination (S-MMSE) were administered to the patients. Behavioral Pathology in Alzheimer’s Disease Frequency Weighted Scale (BEHAVE-AD-FW), Zarit’s Burden Interview (BI), Hamilton Depression Rating Scale (HAM-D), Montgomery and Asberg Depression Rating Scale (MADRS) and Hamilton Anxiety Assessment Scale (HAM-A) were performed to their caregivers.
Results: Caregiver burden was found to be correlated with both total and daily caregiving duration. Caregivers who were in the same sex with patient, those who were their daughter-in-law and unassisted caregivers were found to have significantly higher burden scores. Behavior pathology categories such as hallucinations, activity disturbances, aggressiveness, and anxieties/phobias were found to be correlated with caregiver burden. Symptoms in these categories such as visual hallucination, wandering, purposeless activity, inappropriate activity, verbal outburst, and fear of being left alone were also found to increase care giver burden. Furthermore, depression and anxiety scale scores were found to be significantly higher in female caregivers compared to male counterparts, and negatively correlated with caregiver’s education level. Although no correlation was observed between behavioral and psychological symptoms of the patients and anxiety and depression scores of caregivers, caregiver burden scale scores were correlated with anxiety and depression scores.
Conclusion: Certain categories of BPS and caregiver characteristics were found to be correlated with caregiver burden. It can be suggested that these findings could be taken into account during the development of treatment strategies and determining caregiver population under burden risk.
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