title: Predictors of high level of burden and distress in caregivers of demented patients: results of an Italian multicenter study.
abstract: BACKGROUND
  Considerable suffering is experienced by carers of patients with dementia. Most existing studies do not consider the coexistence of subjective and objective aspects that cause, interacting to each other, this suffering.
  
  
  OBJECTIVE
  In this study we: (1) define the high-risk group of caregivers on the bases of the scores obtained on the four scales evaluating burden, distress, depression and anxiety (BDDA) taken into account simultaneously and (2) evaluate risk factors related to the high level of BDDA.
  
  
  METHODS
  419 elderly outpatients with dementia and their caregivers were enrolled. Patients were evaluated for their cognitive, neuropsychological and functional impairment and for comorbidity. Caregivers were evaluated with four scales for the assessment of burden, distress related to neuropsychological disturbances, depression and anxiety. Cluster analysis was used to identify the group with the High level of BDDA (HBDDA).
  
  
  RESULTS
  By multiple logistic analysis, disability, specific behavioural disturbances of the patients as well as caregiver's age, type of relationship and living in the south of Italy were observed to be a major risk factor for HBDDA.
  
  
  CONCLUSIONS
  The targeted use of scales specifically assessing BDDA of the caregiver and the identification of particular patient and caregiver characteristics are able to allow a precise and early definition of caregivers at high risk of burden and distress. This might be helpful in planning the correct social/clinical/rehabilitative approach.
authors.affiliation: Department of Gerontology and Geriatrics, University of Perugia, Perugia, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Rinaldi
authors.forename: L
authors.initials: L
authors.lastname: Spazzafumo
authors.forename: R
authors.initials: R
authors.lastname: Mastriforti
authors.forename: P
authors.initials: P
authors.lastname: Mattioli
authors.forename: M
authors.initials: M
authors.lastname: Marvardi
authors.forename: M C
authors.initials: MC
authors.lastname: Polidori
authors.forename: A
authors.initials: A
authors.lastname: Cherubini
authors.forename: G
authors.initials: G
authors.lastname: Abate
authors.forename: L
authors.initials: L
authors.lastname: Bartorelli
authors.forename: S
authors.initials: S
authors.lastname: Bonaiuto
authors.forename: A
authors.initials: A
authors.lastname: Capurso
authors.forename: D
authors.initials: D
authors.lastname: Cucinotta
authors.forename: M
authors.initials: M
authors.lastname: Gallucci
authors.forename: M
authors.initials: M
authors.lastname: Giordano
authors.forename: M
authors.initials: M
authors.lastname: Martorelli
authors.forename: G
authors.initials: G
authors.lastname: Masaraki
authors.forename: A
authors.initials: A
authors.lastname: Nieddu
authors.forename: C
authors.initials: C
authors.lastname: Pettenati
authors.forename: P
authors.initials: P
authors.lastname: Putzu
authors.forename: V A
authors.initials: VA
authors.lastname: Tammaro
authors.forename: P F
authors.initials: PF
authors.lastname: Tomassini
authors.forename: C
authors.initials: C
authors.lastname: Vergani
authors.forename: U
authors.initials: U
authors.lastname: Senin
authors.forename: P
authors.initials: P
authors.lastname: Mecocci
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000523:psychology; D017028:Caregivers / Q000523:psychology*; D016000:Cluster Analysis; D005260:Female; D006801:Humans; D007558:Italy; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D013315:Stress, Psychological