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Factors associated with caregiver burden: comparative study between Brazilian and Spanish caregivers of patients with Alzheimer's disease (AD)

Published online by Cambridge University Press:  28 March 2016

Maria Fernanda B. Sousa ,
Raquel L. Santos ,
Oriol Turró-Garriga ,
Rachel Dias ,
Marcia C. N. Dourado  and
Josep L. Conde-Sala
Maria Fernanda B. Sousa*
Affiliation:
Center for Alzheimer's Disease, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
Raquel L. Santos
Affiliation:
Center for Alzheimer's Disease, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
Oriol Turró-Garriga
Affiliation:
Research Unit, Santa Caterina Hospital, Institut d'Assistència Sanitària, Salt, Spain
Rachel Dias
Affiliation:
Center for Alzheimer's Disease, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
Marcia C. N. Dourado
Affiliation:
Center for Alzheimer's Disease, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
Josep L. Conde-Sala
Affiliation:
Faculty of Psychology, University of Barcelona, Barcelona, Spain
*
Correspondence should be addressed to: Maria Fernanda B. Sousa, Avenida Venceslau Brás, 71 – fundos - Botafogo, 22290-140 - Rio de Janeiro - Brazil. Phone: +55 21 988490677. Email: maria_fernandabs@yahoo.com.br.
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Abstract

Background:

Transcultural studies regarding the comparison of levels of burden in caregivers of patients with Alzheimer's disease (AD) from Europe and Latin America are rare. We designed this study to investigate the differentiating factors associated with burden in Brazilian and Spanish caregivers of patients with AD.

Methods:

This is a cross-sectional study composed by samples of outpatients with AD and their caregivers from Brazil (n = 128) and Spain (n = 146). Caregivers answered the Zarit Burden Interview (ZBI) and a Sociodemographic Questionnaire. Patients were assessed with the Mini-Mental State Examination (MMSE), Functional Activities Questionnaire (FAQ), Disability Assessment for Dementia (DAD), Neuropsychiatric Inventory (NPI), and Clinical Dementia Rating (CDR) Scale.

Results:

In the multivariate regression analysis, high burden levels were reported in Brazil, when caregivers were female (p = 0.025) and when patients did not attend Day Care Center (p = 0.025). In Spain, high burden levels were associated with living with the patient (p = 0.014), younger caregivers (p = 0.003), and participation of patients at Day Care Center (p = 0.046). Also, different neuropsychiatric symptoms explained high burden levels: in Brazil, depression (p < 0.001) and anxiety (p = 0.024) and, in Spain, apathy/indifference (p < 0.001), agitation/aggression (p = 0.019) and irritability/lability (p = 0.027).

Conclusions:

Caregivers’ gender, patients who attended Day Care Center and neuropsychiatric symptoms were differentiating factors in the burden of Brazilian and Spanish caregivers.

Keywords

Alzheimer's diseasefamily caregiversburdenneuropsychiatric symptomsDay Care Centertranscultural studies
Type
Research Article
Information
International Psychogeriatrics , Volume 28 , Issue 8 , August 2016 , pp. 1363 - 1374
Copyright
Copyright © International Psychogeriatric Association 2016 

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References

American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders – Text Revision, 4th edn (DSM-IV-TR). Washington, DC: American Psychiatric Association.Google Scholar
Bédard, M., Koivuranta, A. and Stuckey, A. (2004). Health impact on caregivers of providing informal care to a cognitively impaired older adult: rural versus urban settings. Canadian Journal of Rural Medicine, 9, 15–23.Google ScholarPubMed
Bottino, C. M. C. et al. (2002). Reabilitação cognitiva em pacientes com Doença de Alzheimer: relato de trabalho em equipe multidisciplinar. Arquivos de Neuropsiquiatria, 60, 70–79. doi:10.1590/S0004-282X2002000100013.CrossRefGoogle Scholar
Camozzato, A. L. et al. (2008). Reliability of the Brazilian Portuguese version of the neuropsychiatric inventory (NPI) for patients with Alzheimer's disease and their caregivers. International Psychogeriatrics, 20, 383–393. doi:10.1017/S1041610207006254.CrossRefGoogle ScholarPubMed
Chen, J. C., Borson, S. and Scanlan, J. M. (2000). Stage-specific prevalence of behavioral symptoms in Alzheimer's disease in a multi-ethnic community sample. American Journal of Geriatric Psychiatry, 8, 123–133.CrossRefGoogle Scholar
Conde-Sala, J. L., Garre-Olmo, J., Turró-Garriga, O., Vilalta-Franch, J. and López-Pousa, S. (2010). Differential features of burden between spouse and adult-child caregivers of patients with Alzheimer's disease: an exploratory comparative design. International Journal of Nursing Studies, 47, 1262–1273. doi:10.1016/j.ijnurstu.2010.03.001.CrossRefGoogle ScholarPubMed
Cummings, J. L., Mega, M., Gray, K., Rosemberg-Thompson, S., Carusi, D. A. and Gornbein, J. (1994). The neuropsychiatric inventory. Comprehensive assessment of psychopathology in dementia. Neurology, 44, 2308–2314.CrossRefGoogle ScholarPubMed
Dwyer, J. W. and Miller, M. K. (1990). Differences in characteristics of the caregiving network by area of residence: implications for primary caregiver stress and burden. Family Relations, 39, 27–37.CrossRefGoogle Scholar
Ehrlich, K., Boström, A. M., Mazaheri, M., Heikkilä, K. and Emami, A. (2015). Family caregivers’ assessments of caring for a relative with dementia: a comparison of urban and rural areas. International Journal of Older People Nursing, 10, 27–37. doi:10.1111/opn.1204.CrossRefGoogle ScholarPubMed
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatry Research, 12, 189–198. doi:1016/0022-3956(75)90026-6.CrossRefGoogle ScholarPubMed
Gélinas, I., Gauthier, L., McIntyre, M. and Gauthier, S. (1999). Development of a functional measure for persons with Alzheimer's disease: the disability assessment for dementia. American Journal of Occupational Therapy, 53, 471–481.CrossRefGoogle ScholarPubMed
Kim, S. W. et al. (2006). Correlates of caregiver burden for Korean elders according to cognitive and functional status. International Journal of Geriatric Psychiatry, 21, 853–861.CrossRefGoogle ScholarPubMed
Knight, B. G., Silverstein, M., McCallum, T. J. and Fox, L. S. (2000). A sociocultural stress and coping model for mental health outcomes among African American caregivers in Southern California. Journal of Gerontology: Psychological Sciences and the Journal of Gerontology: Social Sciences, 55, 142–150.CrossRefGoogle ScholarPubMed
Kwok, T., Young, D., Yip, A. and Ho, F. (2013). Effectiveness of day care services for dementia patients and their caregivers. Asian Journal of Gerontology and Geriatrics, 8, 9–15.Google Scholar
McCallum, T.J., Sorocco, K. H. and Fritsch, T. (2006). Mental health and diurnal salivary cortisol patterns among African American and European American female dementia family caregivers. American Journal of Geriatric Psychiatry, 14, 684–693.CrossRefGoogle ScholarPubMed
McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D. and Stadlan, E. M. (1984). Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of the Department of Health and Human Services Task Force on Alzheimer's disease. Neurology, 34, 939–944. doi:10.1212/WNL.34.7.939.CrossRefGoogle ScholarPubMed
Moraes, S. R. and Silva, L. S. (2009). An evaluation of the burden of Alzheimer patients on family caregivers. Caderno de Saude Publica, 25, 1807–1815. doi:10.1590/S0102-311X2009000800017.CrossRefGoogle ScholarPubMed
Morris, J. (1993). The CDR: current version and scoring rules. Neurology, 43, 2412–2414. doi:10.1212/WNL.43.11.2412-a.CrossRefGoogle ScholarPubMed
Nogueira, M. M. et al. (2015). Spouse-caregivers’ quality of life in Alzheimer's disease. International Psychogeriatrics, 27, 837–845. doi: 10.1017/S1041610214002646.CrossRefGoogle ScholarPubMed
Park, M., Sung, M., Kim, S. K., Kim, S. and Lee, D. Y. (2015). Multidimensional determinants of family caregiver burden in Alzheimer's disease. International Psychogeriatrics, 8, 1–10. doi: 10.1017/S1041610215000460.Google Scholar
Pfeffer, R. I., Kurosaki, T. T., Harrah, C. H., Chance, J. M. and Filos, S. (1982). Measurement of functional activities in older adults in the community. The Journals of Gerontology, 37, 323–329. doi:10.1093/geronj/37.3.323.CrossRefGoogle ScholarPubMed
Santos, R. L., Sousa, M. F. B., Ganem, A. C., Silva, T. V. and Dourado, M. C. N. (2013). Cultural aspects in dementia: differences in the awareness of Brazilian caregivers. Trends in Psychiatry and Psychotherapy, 35, 191–197. doi:10.1590/S2237-60892013000300006.CrossRefGoogle ScholarPubMed
Stella, F. et al. (2015). Caregiver report versus clinician impression: disagreements in rating neuropsychiatric symptoms in Alzheimer's disease patients. International Journal of Geriatric Psychiatry, 9, doi:10.1002/gps.4278.Google Scholar
Tatsch, M. F. et al. (2006). Neuropsychiatric symptoms in Alzheimer's disease and cognitively impaired, nondemented elderly from a community-based sample in Brazil: prevalence and relationship with dementia severity. American Journal of Geriatric Psychiatry, 14, 438–445.CrossRefGoogle ScholarPubMed
Truzzi, A., Valente, L., Ulstein, I., Engelhardt, E., Laks, J. and Engedal, K. (2012). Burnout in familial caregivers of patients with dementia. Revista Brasileira de Psiquiatria, 34, 405–412.CrossRefGoogle ScholarPubMed
Truzzi, A. et al. (2013). Patterns of neuropsychiatric sub-syndromes in Brazilian and Norwegian patients with dementia. International Psychogeriatrics, 25, 228–235. doi: 10.1017/S1041610212001640.CrossRefGoogle ScholarPubMed
Turró-Garriga, O., Soler-Cors, O., Garre-Olmo, J., López-Pousa, S., Vilalta-Franch, J. and Monserrat-Vila, S. (2008). Distribución factorial de la carga en cuidadores de pacientes con enfermedad de Alzheimer. Revista de Neurologia, 46, 582–588.CrossRefGoogle Scholar
van der Lee, J., Bakker, T. J., Duivenvoorden, H. J. and Dröes, R. M. (2014). Multivariate models of subjective caregiver burden in dementia: a systematic review. Ageing research reviews, 15, 76–93. doi: 10.1016/j.arr.2014.03.003.CrossRefGoogle ScholarPubMed
Xiao, L. D., Wang, J., He, G. P., De Bellis, A., Verbeeck, J. and Kyriazopoulos, H. (2014). Family caregiver challenges in dementia care in Australia and China: a critical perspective. BMC Geriatrics, 23, 6–13. doi:10.1186/1471-2318-14-6.CrossRefGoogle Scholar
Zarit, S. H., Reever, K. E. and Bach-Peterson, J. (1980). Relatives of the impaired elderly: correlates of feeling of burden. The Gerontologist, 20, 649–655. doi:10.1093/geront/20.6.649.CrossRefGoogle Scholar