title: Neuropsychiatric symptoms and caregiver's burden in Parkinson's disease.
abstract: BACKGROUND
  In Parkinson's disease (PD), neuropsychiatric symptoms (NPS) can be particularly burdensome for caregivers. The main goal of this study was to assess the impact of NPS, assessed by means of a new specific scale, on caregiver burden.
  
  
  METHODS
  A sample of 584 pairs of PD patients and their primary caregivers was studied. Patients' NPS were measured with the Scale for Evaluation of Neuropsychiatric Disorders in PD (SEND-PD), and the Zarit Caregiver Burden Inventory was used to quantify caregiver burden. Three linear regression models were built to check factors associated with caregiver burden, one for the total sample and two for subgroups stratified by the presence of dementia.
  
  
  RESULTS
  The most frequent NPS were depression (in 66% of the sample), anxiety (65%) and mental fatigue (57%). Patients with dementia (n = 94; 16% of sample) consistently presented more NPS than patients without dementia (p < 0.001). On linear regression models, the main determinants of caregiver burden (for the total sample and the sample of patients without dementia) were SEND-PD dimensions mood/apathy and psychosis, PD-related disability and disease duration. For patients with dementia, the only significant caregiver burden determinants were SEND-PD psychosis and mood/apathy subscale scores.
  
  
  CONCLUSIONS
  NPS in PD are highly associated with and are determinants of caregiver burden, and are more prevalent and burdensome in patients with dementia. Detailed assessment and specific interventions aimed at NPS could alleviate caregiver burden.
authors.affiliation: National Center of Epidemiology and CIBERNED, Carlos III Institute of Health, Madrid, Spain. Electronic address: pmartinez@isciii.es.
authors.forename: Pablo
authors.initials: P
authors.lastname: Martinez-Martin
authors.affiliation: National Center of Epidemiology and CIBERNED, Carlos III Institute of Health, Madrid, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Rodriguez-Blazquez
authors.affiliation: National School of Public Health and REDISSEC, Carlos III Institute of Health, Madrid, Spain.
authors.forename: Maria João
authors.initials: MJ
authors.lastname: Forjaz
authors.affiliation: Research Unit, Alzheimer Center Reina Sofia Foundation, Carlos III Institute of Health, Madrid, Spain.
authors.forename: Belén
authors.initials: B
authors.lastname: Frades-Payo
authors.affiliation: Research Unit, Alzheimer Center Reina Sofia Foundation, Carlos III Institute of Health, Madrid, Spain; CIBERSAM, Carlos III Institute of Health, Madrid, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Agüera-Ortiz
authors.affiliation: Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, USA; Departments of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, USA; Philadelphia Veterans Affairs Medical Center, Philadelphia, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Weintraub
authors.affiliation: Research Unit, Alzheimer Center Reina Sofia Foundation, Carlos III Institute of Health, Madrid, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Riesco
authors.affiliation: Department of Neurology, Hospital Ruber Internacional, Madrid, Spain.
authors.forename: Monica M
authors.initials: MM
authors.lastname: Kurtis
authors.affiliation: National Parkinson Foundation Centre of Excellence, Department of Neurology, King's College Hospital, and Kings Health Partners, London, UK.
authors.forename: Kallol Ray
authors.initials: KR
authors.lastname: Chaudhuri
mesh_terms: D000328:Adult; D000339:Affect; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000453:epidemiology / Q000523:psychology; D017028:Caregivers / Q000523:psychology*; D017281:Cost of Illness; D003704:Dementia / Q000453:epidemiology / Q000523:psychology*; D003863:Depression / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D005222:Mental Fatigue / Q000453:epidemiology / Q000523:psychology; D008875:Middle Aged; D010300:Parkinson Disease / Q000503:physiopathology / Q000523:psychology*; D010555:Personality Inventory; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000453:epidemiology / Q000523:psychology; D011788:Quality of Life / Q000523:psychology*; D012720:Severity of Illness Index
keywords: Caregiver burden; Neuropsychiatric symptoms; Parkinson's disease