title: Examining carer stress in dementia: the role of subtype diagnosis and neuropsychiatric symptoms.
abstract: BACKGROUND
  Caring for people with dementia incurs significant stress for carers. Stress has been related to the duration of caring role, the number of weekly hours provided and severity of cognitive impairment. What remains less clear is the impact of neuropsychiatric symptoms and subtype of dementia on carer stress and this study aimed to examine these.
  
  
  METHODS
  Dementia carers were recruited for people with a range of dementia subtypes. Carers were interviewed using the Neuropsychiatric Inventory with the Carer Distress Scale. Cognitive fluctuations were assessed using the Dementia Cognitive Fluctuations Scale. All patients were also examined with The Cambridge Assessment for mental disorders in the elderly.
  
  
  RESULTS
  Dementia diagnostic subtype, the presence of cognitive fluctuations and some neuropsychiatric symptoms (psychosis and mood disturbance) did predict carer stress (all at p < 0.01) but age, gender and severity of cognitive impairment did not (all p > 0.33). Carers of people with dementia with Lewy bodies (DLB) and Parkinson's disease dementia (PDD) experienced more stress than those caring for patients with Alzheimer's disease and vascular dementia. Carer stress was associated with higher levels of psychosis, mood disturbances, daytime sleep and cognitive fluctuations in the person with dementia.
  
  
  CONCLUSIONS
  This study identified the significant impact on carers of providing care for people with DLB and PDD dementia subtypes and also highlighted the significant impact of providing care for patients with high levels of psychosis, mood disturbances and cognitive fluctuations.
authors.affiliation: Institute for Ageing and Health, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK. D.R.Lee@newcastle.ac.uk
authors.forename: David R
authors.initials: DR
authors.lastname: Lee
authors.forename: Ian
authors.initials: I
authors.lastname: McKeith
authors.forename: Urs
authors.initials: U
authors.lastname: Mosimann
authors.forename: Arunima
authors.initials: A
authors.lastname: Ghosh-Nodyal
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Thomas
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D017028:Caregivers / Q000523:psychology*; D003704:Dementia / Q000451:nursing* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D012307:Risk Factors; D012737:Sex Factors; D013315:Stress, Psychological / Q000209:etiology*; D006113:United Kingdom