title: The burden of caring for patients with dementia and its predictors.
abstract: Dementia not only affects patients but also care providers. The assessment of Caregivers' Burden (CB) has grown exponentially in the dementia field, as studies have shown that it is higher in dementia than in other diseases. Dementia care in Greece is different compared to other developed countries, as most of the patients receive care at home from family members. The aim of the present study was to examine the level of burden in Greek caregivers who live in Athens, and its association with patient and caregiver factors. This was a cross-sectional study of 161 primary caregivers of dementia patients living in the community and attending a secondary clinic. CB was assessed with the Zarit Burden Interview (ZBI) and caregivers' depression with the Center for Epidemiological Studies Depression Scale (CES-D). Clinical characteristics of the patients were also assessed using validated scales (cognitive status, functional ability, neuropsychiatric symptoms). In order to find predictors of caregiver Burden, we conducted a 3-step hierarchical regression analysis. Most patients were suffering from Alzheimer's Dementia (n=101; 62.73%) and had moderate and severe dementia according to the MMSE score (mean MMSE=11.50), with patients being unable to perform 2 basic activities of daily living on average. 45 patients (27.95%) had depression according to the CSDD; only 5 patients didn't have any behavioral problem in the NPI, while patients had more than 5 behavioral problems on average. Caregivers were involved in their role for 3.6 years on average and the mean weekly caregiving time was more than 70 hours. Nearly half (n=80; 49.06%) of the 161 caregivers demonstrated high CB (ZBI>40) and nearly one fourth had depression according to the CES-D scale. All blocks of variables entered into the regression model independently predicted caregiver burden's variance (demographics, clinical factors and caregiving characteristics). Lower caregiver's age, high behavioral symptoms of dementia patients and caregivers' depression were found to be independently associated with CB. The final regression model explained 47.2% of the variance in CB. Dementia causes a great burden in caregivers. CB is a complex issue that is associated with several patients and caregivers' factors. The level of CB should be assessed in everyday dementia clinical practice.
authors.affiliation: Alzheimer Center of the Greek Psychogeriatric Association "Nestor", Athens.
authors.forename: A A
authors.initials: AA
authors.lastname: Mougias
authors.affiliation: Department of Psychiatry, Eginition Hospital, School of Medicine, University of Athens, Athens.
authors.forename: A
authors.initials: A
authors.lastname: Politis
authors.affiliation: Alzheimer Center of the Greek Psychogeriatric Association "Nestor", Athens.
authors.forename: M A
authors.initials: MA
authors.lastname: Mougias
authors.affiliation: Alzheimer Center of the Greek Psychogeriatric Association "Nestor", Athens.
authors.forename: I
authors.initials: I
authors.lastname: Kotrotsou
authors.affiliation: Department of Psychiatry, School of Medicine, University of Ioannina, Ioannina, Greece.
authors.forename: P
authors.initials: P
authors.lastname: Skapinakis
authors.affiliation: Department of Psychiatry, School of Medicine, University of Ioannina, Ioannina, Greece.
authors.forename: D
authors.initials: D
authors.lastname: Damigos
authors.affiliation: Department of Psychiatry, School of Medicine, University of Ioannina, Ioannina, Greece.
authors.forename: V G
authors.initials: VG
authors.lastname: Mavreas
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D017028:Caregivers / Q000523:psychology / Q000706:statistics & numerical data; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D003704:Dementia / Q000175:diagnosis / Q000523:psychology; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D005260:Female; D006115:Greece / Q000453:epidemiology; D006801:Humans; D057187:Independent Living / Q000523:psychology; D007361:Intelligence Tests; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011580:Psychological Techniques; D012917:Social Adjustment; D013223:Statistics as Topic