title: Care participation and burden among informal caregivers of older adults with care needs and associations with dementia.
abstract: BACKGROUND
  Few studies have estimated care burden in large, representative, multi-ethnic Asian population-based informal caregivers of older adults with care needs. This study describes informal caregivers' care participation for a population-based sample of older adults with care needs in Singapore, investigates differences by dementia status, and examines correlates of caregivers' burden.
  
  
  METHODS
  Data collected from 693 pairs of older adults, aged 60 to 100 years, having any care needs, and their informal caregivers, who were aged 21 to 88 years, closely involved in their care and "knew the older resident best," and were interviewed during a cross-sectional national survey, were used. Clinical characteristics of older adults, including behavioral and psychological symptoms of dementia (BPSD) and dementia diagnosis, care needs, and socio-demographic characteristics of participants were obtained. Care burden was assessed with the Zarit Burden Interview.
  
  
  RESULTS
  Informal caregivers' participation was highest in activities related to communication (35.1%), feeding (32%), and bathing (21.1%). Among the older adults with any care need, 356 (51.4%) had dementia. Care burden was significantly associated with married caregivers (odds ratio (OR) 2.4 vs. never married), when their relative belonged to a younger cohort (OR 2.5 vs. >84 years), needed care much of the time (OR 2.5 vs. no care needed), exhibited BPSD (OR 3.5 vs. no BPSD), and had dementia (OR 2.52 vs. no dementia).
  
  
  CONCLUSIONS
  Factors related to older adults--more care needs, presence of BPSD, and dementia--were significant contributors to informal caregivers' burden, and these should be considered while planning interventions to alleviate care burden.
authors.affiliation: Research Division,Institute of Mental Health,10 Buangkok View,Singapore.
authors.forename: Janhavi Ajit
authors.initials: JA
authors.lastname: Vaingankar
authors.affiliation: Research Division,Institute of Mental Health,10 Buangkok View,Singapore.
authors.forename: Siow Ann
authors.initials: SA
authors.lastname: Chong
authors.affiliation: Research Division,Institute of Mental Health,10 Buangkok View,Singapore.
authors.forename: Edimansyah
authors.initials: E
authors.lastname: Abdin
authors.affiliation: Research Division,Institute of Mental Health,10 Buangkok View,Singapore.
authors.forename: Louisa
authors.initials: L
authors.lastname: Picco
authors.affiliation: Research Division,Institute of Mental Health,10 Buangkok View,Singapore.
authors.forename: Anitha
authors.initials: A
authors.lastname: Jeyagurunathan
authors.affiliation: Research Division,Institute of Mental Health,10 Buangkok View,Singapore.
authors.forename: YunJue
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Research Division,Institute of Mental Health,10 Buangkok View,Singapore.
authors.forename: Rajeswari
authors.initials: R
authors.lastname: Sambasivam
authors.affiliation: Research Division,Institute of Mental Health,10 Buangkok View,Singapore.
authors.forename: Boon Yiang
authors.initials: BY
authors.lastname: Chua
authors.affiliation: Changi General Hospital,2 Simei Street 3,Singapore.
authors.forename: Li Ling
authors.initials: LL
authors.lastname: Ng
authors.affiliation: King's College London,Strand,London,UK.
authors.forename: Martin
authors.initials: M
authors.lastname: Prince
authors.affiliation: Research Division,Institute of Mental Health,10 Buangkok View,Singapore.
authors.forename: Mythily
authors.initials: M
authors.lastname: Subramaniam
mesh_terms: D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology*; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D003704:Dementia / Q000451:nursing* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012720:Severity of Illness Index; D012846:Singapore; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: Zarit Burden Interview; behavioral and psychological symptoms of dementia; care need; correlates of care burden