Comprehensive analysis of patient and caregiver predictors for caregiver burden, anxiety and depression in A lzheimer's disease
Abstract
AIMS AND OBJECTIVES: The primary aim of this study was to examine the correlations between patient and caregiver characteristics with caregiver burden, anxiety and depression in Alzheimer's Disease. Secondary aim was to determine which behavioural and psychological symptoms had the greatest impact on caregiver burden, anxiety and depression in Alzheimer's Disease. BACKGROUND: Caregivers of individuals with Alzheimer's Disease experience high levels of burden, both psychologically and physically. Previous studies have examined caregiver burden, anxiety and depression separately. However, no paper has examined these three psychological conditions simultaneously. DESIGN: A cross-sectional design. METHODS: A total of 310 patients with probable Alzheimer's Disease and their primary caregivers were assessed. Cognitive impairment and neuropsychiatric symptoms were assessed with the Mini Mental State Examination, Montreal Cognitive Assessment, Clock Drawing Test and Neuropsychiatric Inventory, respectively. Caregiver burden, anxiety and depression were assessed with the ZBI, Generalised Anxiety Disorder Scale-7 and Patient Health Questionnaire-9, respectively. RESULTS: All 12 neuropsychiatric symptoms in the Neuropsychiatric Inventory were significantly correlated with caregiver burden, anxiety and depression, with the top three neuropsychiatric predictors being depression, apathy and anxiety. Furthermore, higher levels of caregiver anxiety were associated with a longer duration of being a caregiver. Within caregivers, higher levels of depression were independently associated with higher numbers of additional caregivers, lower educational background and being the spouse of the patient. Higher levels of burden were associated with a longer duration of being a caregiver and being the spouse of the patient. Caregiver burden, anxiety or depression were not significantly correlated with hours/day of caring for the patient. CONCLUSIONS: Caregiver burden, anxiety and depression were significantly correlated with different neuropsychiatric symptoms in the Neuropsychiatric Inventory. RELEVANCE TO CLINICAL PRACTICE: Practitioners are able to identify caregivers at risk for burden, anxiety and depression. Understanding which Neuropsychiatric Inventory symptom is more closely associated with distress in caregivers will help practitioners to be more specific and effective in detecting caregiver distress.
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The PHQ-9 has been extensively validated among family caregivers, including those supporting persons with dementia.
“The PHQ-9 has been extensively validated among family caregivers, including those supporting persons with dementia (Alfakhri et al., 2018; Lou et al., 2015; Pinyopornpanish et al., 2021).”
From Mindfulness and rumination: stress pathways for caregivers of persons living with dementia. (2026) · cites this paper as Lou et al., 2015
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- Authors
- Lou, Q., Liu, S., Huo, Y. R., Liu, M., Liu, S., & Ji, Y.
- Affiliations
- Tianjin Huanhu Hospital (CN)
- Department of Neurology Tianjin Huanhu Hospital Tianjin China
- UNSW Sydney (AU)
- Corresponding author
- Ji, Yong
- Venue
- Journal of Clinical Nursing
- Publisher
- Wiley
- Published
- 2015-06-25
- Volume
- 24
- Issue
- 17-18
- Pages
- 2668-2678
- ISSN
- 0962-1067 (ISSN-L)
- 1365-2702
- OpenAlex
- W2143602147
- Cited by
- 79
- References
- 38
- Citations by year
- 2026: 7 · 2025: 8 · 2024: 6 · 2023: 6 · 2022: 8 · 2021: 8 · 2020: 11 · 2019: 3 · 2018: 6 · 2017: 10 · 2016: 6
- FWCI
- 5.95
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Clinical Nursing (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Natural Science Foundation of China (81300947)
- Tianjin Science and Technology Support Programs (12ZCZDSY02900, 13ZCZDSY01600)
- Tianjin Natural Science Foundation (13JCYBJC21300)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Health Professions › Pharmacy › Nursing care and research
- Social Sciences › Psychology › Clinical Psychology › Family Caregiving in Mental Illness
- Keywords
- Alzheimer's disease, caregiver burden, caregiver anxiety, caregiver depression, neuropsychiatric symptoms, behavioral and psychological symptoms of dementia, spousal caregivers, caregiver distress, apathy
- MeSH terms
- Adaptation, Psychological, Adult, Aged, Aged, 80 and over, Alzheimer Disease, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Psychometrics, Surveys and Questionnaires, Caregivers, Cost of Illness, Young Adult
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