title: Predicting caregiver burden from daily functional abilities of patients with mild dementia.
abstract: OBJECTIVE
  To assess the relationship between performance- and informant-based measures of activities of daily living (ADLs) in patients with early dementia and burden or psychological distress experienced by the patients' caregivers.
  
  
  METHODS
  Descriptive study.
  
  
  METHODS
  Ambulatory center.
  
  
  METHODS
  Thirty-four patient-caregiver dyads in which the patient had mild dementia (Mini-Mental State Examination score >17).
  
  
  METHODS
  A performance-based ADL measure (the Direct Assessment of Functional Status (DAFS)) was administered to patients with mild dementia. Caregivers completed an informant-based measure of patient functional status (instrumental activities of daily living). Caregivers also completed the Caregiver Burden Inventory (CBI) and the Brief Symptom Inventory (BSI).
  
  
  RESULTS
  Significant correlations were found between the informant-based ADL measure and caregiver burden (CBI) and psychological distress (BSI) (correlation coefficient (r)=-0.34 to -0.71, all P<.05). Alternatively, fewer and weaker relationships were observed between the DAFS (performance-based) ADL measure and caregiver burden or distress ratings (r=-0.32 to -0.43, all P<.05). Of the seven tasks assessed using the DAFS, impairments in orientation, communication, financial, and transportation skills in patients were associated with greater time and developmental burden and greater hostility in caregivers. Impairment in financial skills in patients was the strongest predictor of time-dependence burden and hostility in caregivers, whereas impairment in patient transportation skills was the best predictor of developmental burden.
  
  
  CONCLUSIONS
  The ADL abilities of cognitively impaired patients can predict caregiver burden and psychological distress, with informant-based measures having the greatest association with patient impairment.
authors.affiliation: Department of Psychology, California State University, Northridge, Northridge, California 91330, USA. jill.razani@csun.edu
authors.forename: Jill
authors.initials: J
authors.lastname: Razani
authors.forename: Bernadette
authors.initials: B
authors.lastname: Kakos
authors.forename: Carla
authors.initials: C
authors.lastname: Orieta-Barbalace
authors.forename: Jennifer T
authors.initials: JT
authors.lastname: Wong
authors.forename: Rachel
authors.initials: R
authors.lastname: Casas
authors.forename: Po
authors.initials: P
authors.lastname: Lu
authors.forename: Cathy
authors.initials: C
authors.lastname: Alessi
authors.forename: Karen
authors.initials: K
authors.lastname: Josephson
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000368:Aged; D017028:Caregivers / Q000523:psychology*; D003704:Dementia / Q000523:psychology*; D005260:Female; D015577:Geriatric Assessment; D006791:Hostility; D006801:Humans; D008297:Male; D008875:Middle Aged; D011369:Professional-Patient Relations; D011379:Prognosis; D011569:Psychiatric Status Rating Scales; D013315:Stress, Psychological / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology