Introduction and background: Care for family members suffering from neurological disorders is often demanding and increases with disease progression. Numerous patient- and caregiver-related factors underlying caregiver burden have been identified. Some potential factors need to be clarified. Little is known about the effects of comorbidities and dementia complications on the burden of care for persons living with dementia.
Objectives: We hypothesized that burdens of care for family members living with dementia increase with the number and severity of comorbidities and dementia complications.
Methods: Multi-center prospective registry study (PRODEM) on caregiver burden in family caregivers (median age 61, 66% female) of 556 persons living with mild to moderate dementia, mainly Alzheimer’s disease (median age 77, 58% female).
Results: Caregiver burden (Zarit Burden Interview) did not correlate with arterial hypertension, diabetes, hypercholesterolemia, cardioembolic/thromboembolic diagnoses, heart failure, severe arrhythmia or heart valve disease, but was worse in care recipients with symptoms of anxiety, psychotic episodes, depression and emotional, psychotic, behavioral and somatic symptom clusters (Neuropsychiatric Inventory, Geriatric Depression Scale-15 items). Moreover, caregiver burden correlated with the number of drugs taken daily. MRI evidence of cerebrovascular pathology (total volume of white matter hyperintensities on axial T2w-FLAIR sequences related to intracranial volume, measured in 301 patients) did not correlate with caregiver burden.
Discussion and conclusions: Neuropsychiatric complications and the number of drugs taken daily, but not internal medicine diseases and cerebral white matter hyperintensities increased the burden of care for caregivers of family members suffering from dementia, which is in partial agreement with the literature. However, severe internal medicine comorbidities were rare in the study. Standardized and harmonized longitudinal assessment of the scope of care and caregiver burden is required including algorhythms for age- and life situation-adjusted assessment of caregiver burden. Further studies on caregiver burden and stronger male involvement in family care are needed.
Caregiver burden, Dementia, Comorbidities, Neuropsychiatric symptoms, Medication