Assessment, Measures and Approaches to Easing Caregiver Burden in Alzheimer??s Disease

Abstract

The reduction of caregiver burden for those caring for patients with Alzheimer's disease (AD) is especially important given the prevalence of AD as populations age. This paper reviews the complex nature of caregiver burden, how it is measured, and possible interventions that may affect caregiver burden. Caregiver characteristics as well as symptoms exhibited by patients contribute to burden. A number of specific quantitative measures which have been developed to better evaluate caregiver burden are discussed. Such measures are also useful in measuring the impact of interventions on caregiver burden. Pharmacological treatment of patients with AD through the use of acetylcholinesterase inhibitors has positively affected cognition, activities of daily living, and behavioural problems. These benefits significantly reduce caregiver burden. The same is true for psychosocial interventions for the caregiver. It has been suggested that combining both approaches should be utilised for optimal management. Our knowledge of caregiver burden has greatly increased over the past two decades with clear benefits for both patients and caregivers. However, many aspects still clearly require further research. Given the significance of caregiver burden, various aspects have been extensively studied including contributing and protective factors, quantitative assessment, and pharmacological and psychosocial intervention. It is important for clinicians to be aware of this knowledge so that they can effectively incorporate it into their treatment plans for those affected by AD.

Predictors of high level of burden and distress in caregivers of demented patients: results of an Italian multicenter study

“…Many studies (Burns and Rabins, 2000;Farcnik and Persyko, 2002) have been focused on identifying factors that can predict caregiver distress (the stress to cope with the caregiver role), caregiver burden (the strain or load on people caring), and caregiver anxiety and depression. Some authors point out that patient characteristics, such as decline or loss of functional activities or severity of clinical symptoms, are the factors mainly involved in caregiver distress.…”

Counsellors contact dementia caregivers - predictors of utilisation in a longitudinal study

“…Moreover, the extent of emotional stress for the caregiving family member must be taken into consideration especially in the care of patients with dementia, since there is evidence of an elevated risk that the family member will become ill (e.g. depression) and that the risk of inappropriate care behaviour increases with increasing subjective stress [25,26]. …”

Stroke, dementia, and drug delivery

“…Whilst clinical drug trial patients may not be representative of the normal population of patients with dementia in the community, economic evaluations of anticholinesterase therapy have suggested savings in terms of healthcare costs and caregiver time [41]. There is also evidence that anticholinesterase therapy can reduce caregiver burden [42].…”