title: Caregiver burden: a clinical review.
abstract: OBJECTIVE
  Caregiver burden may result from providing care for patients with chronic illness. It can occur in any of the 43.5 million individuals providing support to midlife and older adults. Caregiver burden is frequently overlooked by clinicians.
  
  
  OBJECTIVE
  To outline the epidemiology of caregiver burden; to provide strategies to diagnose, assess, and intervene for caregiver burden in clinical practice; and to evaluate evidence on interventions intended to avert or mitigate caregiver burden and related caregiver distress.
  
  
  METHODS
  Cohort studies examining the relation between demographic and social risk factors and adverse outcomes of caregiver burden were reviewed. Review of recent meta-analyses to summarize the effectiveness of caregiver burden interventions were identified by searching Ovid MEDLINE, AgeLine, and the Cochrane Library.
  
  
  RESULTS
  Risk factors for caregiver burden include female sex, low educational attainment, residence with the care recipient, higher number of hours spent caregiving, depression, social isolation, financial stress, and lack of choice in being a caregiver. Practical assessment strategies for caregiver burden exist to evaluate caregivers, their care recipients, and the care recipient's overall caregiving needs. A variety of psychosocial and pharmacological interventions have shown mild to modest efficacy in mitigating caregiver burden and associated manifestations of caregiver distress in high-quality meta-analyses. Psychosocial interventions include support groups or psychoeducational interventions for caregivers of dementia patients (effect size, 0.09-0.23). Pharmacologic interventions include use of anticholinergics or antipsychotic medications for dementia or dementia-related behaviors in the care recipient (effect size, 0.18-0.27). Many studies showed improvements in caregiver burden-associated symptoms (eg, mood, coping, self-efficacy) even when caregiver burden itself was minimally improved.
  
  
  CONCLUSIONS
  Physicians have a responsibility to recognize caregiver burden. Caregiver assessment and intervention should be tailored to the individual circumstances and contexts in which caregiver burden occurs.
authors.affiliation: Division of Geriatrics and Palliative Medicine, Weill Cornell Medical College, Cornell University, New York, New York2CV Starr Biomedical Science Information Center, Samuel J. Wood Library, Weill Cornell Medical College, Cornell University, New York, New.
authors.forename: Ronald D
authors.initials: RD
authors.lastname: Adelman
authors.affiliation: CV Starr Biomedical Science Information Center, Samuel J. Wood Library, Weill Cornell Medical College, Cornell University, New York, New York.
authors.forename: Lyubov L
authors.initials: LL
authors.lastname: Tmanova
authors.affiliation: CV Starr Biomedical Science Information Center, Samuel J. Wood Library, Weill Cornell Medical College, Cornell University, New York, New York.
authors.forename: Diana
authors.initials: D
authors.lastname: Delgado
authors.affiliation: Division of Geriatrics and Palliative Medicine, Weill Cornell Medical College, Cornell University, New York, New York2CV Starr Biomedical Science Information Center, Samuel J. Wood Library, Weill Cornell Medical College, Cornell University, New York, New.
authors.forename: Sarah
authors.initials: S
authors.lastname: Dion
authors.affiliation: Division of Geriatrics and Palliative Medicine, Weill Cornell Medical College, Cornell University, New York, New York2CV Starr Biomedical Science Information Center, Samuel J. Wood Library, Weill Cornell Medical College, Cornell University, New York, New.
authors.forename: Mark S
authors.initials: MS
authors.lastname: Lachs
mesh_terms: D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology*; D002908:Chronic Disease / Q000451:nursing; D015331:Cohort Studies; D017281:Cost of Illness; D005260:Female; D006801:Humans; D008297:Male; D012307:Risk Factors; D012944:Social Support; D013406:Suicide, Attempted