title: Caregiver burden in Alzheimer disease: cross-sectional and longitudinal patient correlates.
abstract: OBJECTIVE
  Alzheimer disease (AD) imposes a severe burden on patients and their caregivers. Although there is substantial evidence of the adverse impact of burden, considerably less is known about its specific correlates and potential causes.
  
  
  METHODS
  The authors use data from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE)-AD study to examine the relationship of burden and depression among AD caregivers to patient and caregiver sociodemographic characteristics, patients' cognitive status, psychiatric and behavioral symptoms, functional abilities, quality of life, and intensity of care provided by caregivers.
  
  
  METHODS
  CATIE-AD included outpatients in usual care settings and assessed treatment outcomes during 9 months.
  
  
  METHODS
  Data were examined from 421 ambulatory outpatients with a diagnosis of dementia of the Alzheimer type or probable AD with agitation or psychosis.
  
  
  METHODS
  The Burden Interview, the Beck Depression Inventory, and the Caregiver Distress Scale were used to evaluate caregiver burden.
  
  
  RESULTS
  More severe psychiatric and behavioral problems and decreased patient quality of life, as well as lower functional capability were significantly associated with higher levels of burden and depression among caregivers at baseline. Six-month changes showed that decreased symptoms and improved quality of life were associated with decreased burden and accounted for most of the explained variance in change in burden measures.
  
  
  CONCLUSIONS
  Severity of psychiatric symptoms, behavioral disturbances, and patients' quality of life are the main correlates of caregivers' experience burden. Psychosocial and pharmacologic interventions targeting these two aspects of the disorder are likely to not only alleviate patient suffering but also promote caregiver well-being.
authors.affiliation: New England Mental Illness, Research, Education and Clinical Center, West Haven, CT, USA. Somaia.Mohamed@yale.edu
authors.forename: Somaia
authors.initials: S
authors.lastname: Mohamed
authors.forename: Robert
authors.initials: R
authors.lastname: Rosenheck
authors.forename: Constantine G
authors.initials: CG
authors.lastname: Lyketsos
authors.forename: Lon S
authors.initials: LS
authors.lastname: Schneider
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000523:psychology*; D017028:Caregivers / Q000523:psychology*; D017281:Cost of Illness; D003863:Depression / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000523:psychology*
references.citation: Arch Gen Psychiatry. 1961 Jun;4:561-71
references.pmid: 13688369
references.citation: Arch Gen Psychiatry. 2000 Oct;57(10):968-76
references.pmid: 11015815
references.citation: Gerontologist. 1983 Dec;23(6):597-604
references.pmid: 6662373
references.citation: Neurology. 2000 Oct 10;55(7):1008-14
references.pmid: 11061260
references.citation: J Am Geriatr Soc. 1987 Jun;35(6):522-5
references.pmid: 3553288
references.citation: Am J Psychiatry. 2004 Mar;161(3):532-8
references.pmid: 14992980
references.citation: Psychosom Med. 1991 Jul-Aug;53(4):345-62
references.pmid: 1656478
references.citation: Am J Psychiatry. 2008 Jul;165(7):844-54
references.pmid: 18519523
references.citation: Gerontologist. 1995 Dec;35(6):771-91
references.pmid: 8557205
references.citation: Int J Geriatr Psychiatry. 1997 Mar;12(3):331-6
references.pmid: 9152717
references.citation: Am J Psychiatry. 1998 Nov;155(11):1512-20
references.pmid: 9812111
references.citation: J Psychiatr Res. 1975 Nov;12(3):189-98
references.pmid: 1202204
references.citation: Am J Psychiatry. 1989 May;146(5):577-87
references.pmid: 2653053
references.citation: Br J Psychiatry. 1984 Aug;145:172-7
references.pmid: 6466915
references.citation: Gerontologist. 1993 Dec;33(6):747-55
references.pmid: 8314101
references.citation: Neurology. 2000 May 23;54(10):1965-71
references.pmid: 10822438
references.citation: Psychol Aging. 1991 Dec;6(4):569-78
references.pmid: 1777145
references.citation: Gerontologist. 1986 Jun;26(3):253-9
references.pmid: 3721232
references.citation: Alzheimer Dis Assoc Disord. 1997;11 Suppl 2:S33-9
references.pmid: 9236950
references.citation: Arch Gen Psychiatry. 1997 Mar;54(3):257-63
references.pmid: 9075466
references.citation: J Clin Epidemiol. 1992 Aug;45(8):861-70
references.pmid: 1624968
references.citation: Gerontologist. 1980 Dec;20(6):649-55
references.pmid: 7203086
references.citation: Br J Psychiatry. 1997 Jan;170:62-8
references.pmid: 9068778
references.citation: J Clin Epidemiol. 1992 Jan;45(1):61-70
references.pmid: 1738013
references.citation: JAMA. 1999 Dec 15;282(23):2215-9
references.pmid: 10605972
references.citation: Dementia. 1993 Sep-Oct;4(5):287-93
references.pmid: 8261026
references.citation: JAMA. 2002 Sep 25;288(12):1475-83
references.pmid: 12243634
references.citation: Gerontologist. 1991 Apr;31(2):246-55
references.pmid: 1828449
references.citation: Neurology. 1999 Sep 22;53(5):946-55
references.pmid: 10496251
references.citation: Am J Psychiatry. 2000 May;157(5):708-14
references.pmid: 10784462
references.citation: J Am Geriatr Soc. 1988 Oct;36(10):885-9
references.pmid: 3171027
references.citation: Gerontologist. 1989 Aug;29(4):449-56
references.pmid: 2521102
references.citation: J Aging Health. 1997 Aug;9(3):373-95
references.pmid: 10182399
references.citation: Aging Ment Health. 2006 Mar;10(2):107-11
references.pmid: 16517485
references.citation: J Gerontol. 1984 Mar;39(2):194-200
references.pmid: 6699375
references.citation: J Gerontol. 1994 Sep;49(5):M216-22
references.pmid: 8056940
references.citation: Am J Psychiatry. 1984 Nov;141(11):1356-64
references.pmid: 6496779
references.citation: Gerontologist. 1999 Jun;39(3):299-309
references.pmid: 10396888
references.citation: JAMA. 1982 Jul 16;248(3):333-5
references.pmid: 7087127
references.citation: Neurology. 1994 Dec;44(12):2308-14
references.pmid: 7991117
references.citation: J Neuropsychiatry Clin Neurosci. 1997 Fall;9(4):556-61
references.pmid: 9447496
references.citation: Community Ment Health J. 1997 Aug;33(4):269-86
references.pmid: 9250425
references.citation: Psychopharmacol Bull. 1988;24(1):122-4
references.pmid: 3387516
references.citation: Neurology. 1984 Jul;34(7):939-44
references.pmid: 6610841
references.citation: J Am Geriatr Soc. 2001 Apr;49(4):450-7
references.pmid: 11347790
references.citation: Gerontologist. 1986 Jun;26(3):248-52
references.pmid: 3721231
references.citation: Alzheimer Dis Assoc Disord. 1992 Summer;6(2):77-88
references.pmid: 1389083
references.citation: Gerontologist. 1999 Apr;39(2):177-85
references.pmid: 10224714
references.citation: Am J Psychiatry. 1984 Oct;141(10):1276-8
references.pmid: 6486267
references.citation: Int J Geriatr Psychiatry. 1997 Oct;12(10):978-88
references.pmid: 9395929
references.citation: J Am Geriatr Soc. 1992 Sep;40(9):896-901
references.pmid: 1512385
references.citation: Neurology. 1997 May;48(5 Suppl 6):S25-9
references.pmid: 9153157
references.citation: Am J Psychiatry. 1990 Aug;147(8):1049-51
references.pmid: 2375439
references.citation: Int J Geriatr Psychiatry. 2004 Jan;19(1):85-92
references.pmid: 14716704
references.citation: Schizophr Bull. 2003;29(1):57-72
references.pmid: 12908661
references.citation: N Engl J Med. 2006 Oct 12;355(15):1525-38
references.pmid: 17035647
references.citation: Int J Geriatr Psychiatry. 1998 Apr;13(4):248-56
references.pmid: 9646153
references.citation: Am J Psychiatry. 2005 Nov;162(11):2022-30
references.pmid: 16263838
references.citation: J Neuropsychiatry Clin Neurosci. 2003 Summer;15(3):346-53
references.pmid: 12928511
references.citation: J Gerontol. 1983 May;38(3):344-8
references.pmid: 6841931