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Relationship between the number of behavioral symptoms in dementia and caregiver distress: what is the tipping point?
Journal article   Open access   Peer reviewed

Relationship between the number of behavioral symptoms in dementia and caregiver distress: what is the tipping point?

Paul B Arthur, Laura N Gitlin, John A Kairalla and William C Mann
International psychogeriatrics, v 30(8), pp 1099-1107
Aug 2018
DOI: https://doi.org/10.1017/S104161021700237X
PMID: 29143722
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://europepmc.org/articles/pmc7103581View
Accepted (AM)Open Access (License Unspecified),  Open
url
https://doi.org/10.1017/S104161021700237XView
Published, Version of Record (VoR) Open

Abstract

Adult Aged Aged, 80 and over Behavioral Symptoms - epidemiology Behavioral Symptoms - psychology Caregivers - psychology Dementia - psychology Dementia - therapy Depression - complications Depression - diagnosis Female Humans Independent Living Linear Models Male Middle Aged Psychiatric Status Rating Scales Quality of Life ROC Curve Sensitivity and Specificity United States - epidemiology
ABSTRACTBackground:Behavioral and psychological symptoms of dementia (BPSD) are a primary manifestation of brain dysfunction in dementia and a great challenge in caregiving. While BPSD are historically associated with caregiver distress, it is unclear whether there is an identifiable point where BPSD number is associated with heightened caregiver distress. The purpose of this study was to determine if such a tipping point exists to assist clinicians in identifying caregiver compromise. Analyses were performed with three datasets totaling 569 community-dwelling persons with dementia and their caregivers. Each included identical demographic, BPSD, cognitive, and caregiver well-being measures. Linear regression was performed with 16 BPSD symptoms on caregiver well-being measures and predictive values determined with receiver operating characteristic (ROC) curves and pre-defined scores for clinically significant distress. Of the 569 persons with dementia, 549 (96%) displayed at least one BPSD, mean of 5.7 (SD = 3.06) symptoms in the past month. After controlling for covariates, BPSD symptom number was significantly associated with caregiver depression and burden (p < 0.01 for both models). Findings indicate ≥ 4 BPSD has strong predictive values for depression (sensitivity 85%, specificity 44%, area under ROC curve 0.62, p < 0.01), and burden (sensitivity 84%, specificity 43%, area under ROC curve 0.67, p < 0.01). Caring for persons with four or more BPSD appears to reflect a tipping point for clinically meaningful distress. Findings have implications for clinicians working with persons with dementia and their caregivers and suggest need for continuous monitoring of BPSD and identification of at risk caregivers.

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12 Record Views
54 citations in Web of Science
52 citations in Scopus

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UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

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Collaboration types
Domestic collaboration
Web of Science research areas
Geriatrics & Gerontology
Gerontology
Psychiatry
Psychology
Psychology, Clinical
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