Mediating role of care partner burden among dementia care partners during post-hospital transition
Open accessAbstract
OBJECTIVES: This study examined the mediating role of care partner burden on the relationship between patient clinical factors (i.e. cognition, physical function, and behavioral and psychological symptoms of dementia [BPSD]) and care partner mental health (i.e. anxiety and depression) among dementia care partners at hospital discharge. METHOD: The sample consisted of 431 patient and care partner dyads enrolled in the Family centered Function-focused Care (Fam-FFC) study; ClinicalTrials.gov identifier NCT03046121. Mediation analyses were conducted to test the role of care partner burden on the associations between patient clinical factors, and care partner anxiety and depression. RESULTS: Mediation models demonstrated that care partner burden partially mediated the relationship between patient physical function and care partner anxiety and depression, as well as patient BPSD and care partner anxiety and depression. CONCLUSION: Findings highlight the need for clinicians and service providers to implement comprehensive strategies that address both patient clinical factors (i.e. physical function and BPSD) and care partner burden, to optimize care partner mental health outcomes during post-hospital transition.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Substantial cognitive decline and behavioural and psychological symptoms of dementia increased reliance on carers to manage care needs.
“Substantial cognitive decline, behavioural and psychological symptoms of dementia (BPSD) increased reliance on carers to manage care needs [28, 46, 69].”
From Do hospital-to-home transitions work for older adults with multiple long-term conditions including dementia? A realist review (2025) · cites this paper as [69]
The Results (page unavailable) associate poorer patient cognition and greater BPSD with greater care partner burden. The Introduction (page unavailable) also describes increased care dependency after hospitalization. The paper does not establish that cognitive decline and BPSD caused increased reliance on carers to manage care needs; its limitations explicitly say the cross-sectional analysis cannot establish causation. (LLM, conf=0.82)
Experimental — accuracy not yet measuredIncreasing care needs due to other conditions was linked to exacerbation of dementia symptoms, increasing reliance on others, and subsequently placing more responsibility on carers (CMOC1).
“Increasing care needs due to other conditions was linked to exacerbation of dementia symptoms, increasing reliance on others, and subsequently placing more responsibility on carers (CMOC1) [28, 44, 46–48, 54, 59, 69–74].”
From Do hospital-to-home transitions work for older adults with multiple long-term conditions including dementia? A realist review (2025) · cites this paper as [69]
The Introduction (page not provided) describes increased care dependency and medically complex needs after hospitalization, with greater stress and burden for care partners. The Discussion (page not provided) links poorer physical function and greater dementia symptoms to care partner burden. Neither section establishes that other conditions exacerbate dementia symptoms and thereby cause the proposed sequence of increasing reliance and carer responsibility. (LLM, conf=0.84)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment
Nasreddine, Z. S., Phillips, N. A., Bédirian, V., Charbonneau, S., Whitehead, V., Collin, I., Cummings, J. L., & Chertkow, H. (2005) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2005.53221.x · Cited by 25,553 · see citing works
Hirono, N., Mori, E., Ikejiri, Y., Imamura, T., Shimomura, T., Hashimoto, M., Yamashita, H., & Ikeda, M. (1997) · PubMed · Cited by 21,010 · see citing works
Kok, J. S., Berg, I. J., & Scherder, E. J. A. (2013) · Dementia and Geriatric Cognitive Disorders Extra · doi:10.1159/000353441 · Cited by 20,589 · see citing works
Functional evaluation : Barthel index
Mahonery, F. I. (1965) · Medical Entomology and Zoology · Cited by 12,762 · see citing works
The Neuropsychiatric Inventory: Comprehensive assessment of psychopathology in dementia
Cummings, J. L., Mega, M., Gray, K., Rosenberg-Thompson, S., Carusi, D. A., & Gornbein, J. (1994) · Neurology · doi:10.1212/wnl.44.12.2308 · Cited by 7,568 · cited 2× · see citing works
“To assess BPSD, we used the Brief Neuropsychiatric Inventory (NPI-Q), which consists of 12 items evaluating neuro-psychiatric symptoms (Cummings et al., 1994).”
Caregiving and the stress process: an overview of concepts and their measures
Pearlin, L. I., Mullan, J. T., Semple, S. J., & Skaff, M. M. (1990) · The Gerontologist · doi:10.1093/geront/30.5.583 · Cited by 4,810 · see citing works
2023 Alzheimer's disease facts and figures
(2023) · Alzheimer's & Dementia · doi:10.1002/alz.13016 · Cited by 3,212 · see citing works
Measurement of Functional Activities in Older Adults in the Community
PFEFFER, R. I., Kurosaki, T., Harrah, C. H., Chance, J. M., & Filos, S. (1982) · Journal of Gerontology · doi:10.1093/geronj/37.3.323 · Cited by 2,978 · see citing works
Herrmann, C. (1997) · Journal of Psychosomatic Research · doi:10.1016/s0022-3999(96)00216-4 · Cited by 2,885 · see citing works
Morris, J. C. (1997) · International Psychogeriatrics · doi:10.1017/s1041610297004870 · Cited by 1,641 · see citing works
Association of Incident Dementia With Hospitalizations
Phelan, E. A., Borson, S., Grothaus, L., Balch, S., & Larson, E. B. (2012) · JAMA · doi:10.1001/jama.2011.1964 · Cited by 547 · see citing works
Validity and reliability of the AD8 informant interview in dementia
Galvin, J. E., Roe, C. M., Xiong, C., & Morris, J. C. (2006) · Neurology · doi:10.1212/01.wnl.0000247042.15547.eb · Cited by 495 · see citing works
Liu, C., Badana, A. N. S., Burgdorf, J., Fabius, C. D., Roth, D. L., & Haley, W. E. (2021) · The Gerontologist · doi:10.1093/geront/gnaa028 · Cited by 136 · see citing works
Hospitalization and Cognitive Decline: Can the Nature of the Relationship Be Deciphered?
Mathews, S. B., Arnold, S. E., & Epperson, C. N. (2013) · American Journal of Geriatric Psychiatry · doi:10.1016/j.jagp.2012.08.012 · Cited by 135 · see citing works
Watson, B. N., Tatangelo, G. L., & McCabe, M. P. (2018) · The Gerontologist · doi:10.1093/geront/gny049 · Cited by 132 · see citing works
Psychometric Evaluation of the Montreal Cognitive Assessment (MoCA) in Three Diverse Samples
Bernstein, I. H., Lacritz, L. H., Barlow, C. E., Weiner, M., & DeFina, L. F. (2010) · The Clinical Neuropsychologist · doi:10.1080/13854046.2010.533196 · Cited by 117 · see citing works
García‐Alberca, J. M., Lara, J. P., & Berthier, M. L. (2011) · The International Journal of Psychiatry in Medicine · doi:10.2190/pm.41.1.f · Cited by 116 · see citing works
Gough, K., & Hudson, P. (2008) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2008.04.012 · Cited by 113 · see citing works
Gender effects on components of burden and depression among dementia caregivers
Pillemer, S., Davis, J., & Tremont, G. (2018) · Aging & Mental Health · doi:10.1080/13607863.2017.1337718 · Cited by 100 · see citing works
Risk adjustment for older hospitalized persons
van Doorn, C., Bogardus, S. T., Williams, C. S., Concato, J., Towle, V. R., & Inouye, S. K. (2001) · Journal of Clinical Epidemiology · doi:10.1016/s0895-4356(00)00367-x · Cited by 97 · see citing works
Nursing Home Admission in Elderly Subjects With Dementia: Predictive Factors and Future Challenges
Dramé, M., Lang, P. O., Jolly, D., Narbey, D., Mahmoudi, R., Lanièce, I., Somme, D., Gauvain, J., Heitz, D., Voisin, T., et al. (2011) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2011.03.002 · Cited by 73 · see citing works
Arthur, P. B., Gitlin, L. N., Kairalla, J. A., & Mann, W. C. (2018) · International Psychogeriatrics · doi:10.1017/s104161021700237x · Cited by 71 · see citing works
Ballesteros, J., Santos, B., González–Fraile, E., Muñoz-Hermoso, P., Domínguez-Panchón, A. I., & Martı́n-Carrasco, M. (2012) · Value in Health · doi:10.1016/j.jval.2012.07.005 · Cited by 69 · see citing works
Gual, N., Morandi, A., Pérez, L. M., Brítez, L., Burbano, P., Man, F., & Inzitari, M. (2018) · Dementia and Geriatric Cognitive Disorders · doi:10.1159/000485794 · Cited by 64 · see citing works
Boltz, M., Chippendale, T., Resnick, B., & Galvin, J. E. (2015) · Alzheimer Disease & Associated Disorders · doi:10.1097/wad.0000000000000072 · Cited by 61 · see citing works
Self-citationLiang, X., Guo, Q., Luo, J., Li, F., Ding, D., Zhao, Q., & Hong, Z. (2016) · BMC Neurology · doi:10.1186/s12883-016-0712-2 · Cited by 53 · see citing works
Zhang, J., Wang, J., Liu, H., & Wu, C. (2023) · BMC Geriatrics · doi:10.1186/s12877-023-03774-9 · Cited by 51 · see citing works
Lin, C., Wang, J., Pai, M., & Ku, L. E. (2016) · Archives of Gerontology and Geriatrics · doi:10.1016/j.archger.2016.08.005 · Cited by 50 · see citing works
Boltz, M. P., Kuzmik, A., Resnick, B. M., Trotta, R. L., Mogle, J. A., BeLue, R., LESLIE, D. L., & Galvin, J. E. (2018) · Trials · doi:10.1186/s13063-018-2875-1 · Cited by 47 · see citing works
Self-citationSteinsheim, G., Malmedal, W., Follestad, T., Olsen, B., & Saga, S. (2023) · BMC Geriatrics · doi:10.1186/s12877-023-04358-3 · Cited by 34 · see citing works
Reliability of nursing assistants’ observations of functioning and clinical symptoms and signs
Ranhoff, A. H. (1997) · Aging Clinical and Experimental Research · doi:10.1007/bf03339617 · Cited by 32 · see citing works
Factors Associated with Caregiver Burden in Caregivers of Older Patients with Dementia in Indonesia
Putri, Y. S. E., Putra, I. G. N. E., Falahaini, A., & Wardani, I. Y. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph191912437 · Cited by 32 · see citing works
Abbott, R. A., Rogers, M., Lourida, I., Green, C., Ball, S., Hemsley, A. G., Cheeseman, D., Clare, L., Moore, D. A., Hussey, C., et al. (2022) · Age and Ageing · doi:10.1093/ageing/afac190 · Cited by 30 · see citing works
Depression in the Family of Patients With Dementia in Korea
Jang, S., Bae, H.-C., Shin, J., Jang, S., Hong, S., Han, K., & Park, E. (2016) · American Journal of Alzheimer s Disease & Other Dementias® · doi:10.1177/1533317515628048 · Cited by 19 · see citing works
Gender Differences in Disease, Function, and Behavioral Symptoms in Residents with Dementia
Resnick, B. M., Galik, E. M., McPherson, R., Boltz, M. P., Haitsma, K. S. V., & Kolanowski, A. M. (2021) · Western Journal of Nursing Research · doi:10.1177/01939459211018822 · Cited by 18 · see citing works
Self-citationBoltz, M., Mogle, J., Kuzmik, A., BeLue, R., Leslie, D., Galvin, J. E., & Resnick, B. (2023) · Innovation in Aging · doi:10.1093/geroni/igad083 · Cited by 15 · see citing works
Self-citationThe Modified Caregiver Strain Index in Black and White Dementia Caregivers at Hospital Discharge
Kuzmik, A., Boltz, M. P., BeLue, R., Resnick, B. M., Scott, J., Mogle, J. A., LESLIE, D. L., & Galvin, J. E. (2022) · Clinical Gerontologist · doi:10.1080/07317115.2022.2106927 · Cited by 11 · see citing works
Self-citation(1965) · PubMed
Flagged first, then by citations
Cited by
Sorted by citations
Lawson, L., Cooper, M., Tolley, C., Hand, A., & Nazar, H. (2025) · BMC Geriatrics · doi:10.1186/s12877-025-06123-0 · Cited by 10 · see citing works
“Substantial cognitive decline, behavioural and psychological symptoms of dementia (BPSD) increased reliance on carers to manage care needs [28, 46, 69].”
Kuzmik, A., Rodriguez, M., Wellington, J., Yahaya, A., & Boltz, M. P. (2025) · Journal of Applied Gerontology · doi:10.1177/07334648251338875 · Cited by 2 · see citing works
Self-citationBoltz, M. P., Liu, Y., Yahaya, A., AL-Harrasi, A. M., Wellington, J., & Kuzmik, A. (2026) · International Psychogeriatrics · doi:10.1016/j.inpsyc.2026.100295
Self-citation
- Authors
- Kuzmik, A., Best, I., Al Harrasi, A. M., & Boltz, M.
- Affiliations
- Pennsylvania State University (US)
- Ross and Carol Nese College of Nursing, The Pennsylvania State University, University Park
- Corresponding author
- Kuzmik, Ashley
- Venue
- Aging & Mental Health
- Publisher
- Informa UK Limited
- Published
- 2024-06-25
- Volume
- 28
- Issue
- 12
- Pages
- 1753-1759
- ISSN
- 1360-7863 (ISSN-L)
- 1364-6915
- PMC
- PMC11560607
- OpenAlex
- W4400011403
- Cited by
- 3
- References
- 38
- Citations by year
- 2026: 1 · 2025: 2
- FWCI
- 0.88
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Aging & Mental Health (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Aging (R01AG054425)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Health Professions › Pharmacy › Nursing care and research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Keywords
- dementia care partners, caregiver burden, mediation, hospital discharge, caregiver anxiety, caregiver depression, behavioral and psychological symptoms of dementia, physical function, cognitive function, family-centered care, caregiver mental health
- MeSH terms
- Caregiver Burden, Aged, Aged, 80 and over, Anxiety, Dementia, Depression, Female, Humans, Male, Middle Aged, Patient Discharge, Caregivers
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
