title: Caregiver burden in older adults with bipolar disorder: relationship to functionality and neuropsychiatric symptoms.
abstract: BACKGROUND
  There are few studies addressing caregivers of bipolar disorder (BD) patients, especially patients who are older adults with an increased need for care, often given by a relative. The aim of this study was to describe which factors increase caregiver burden among caregivers of elderly BD outpatients.
  
  
  METHODS
  Patients were older than 60 years and met the Diagnostic and Statistical Manual of Mental Disorders, fifth edition, criteria for BD. They were evaluated for current mood, cognitive and other neuropsychiatric symptoms, functionality, medical comorbidities, quality of life, years since BD diagnosis, and number of psychiatric admissions. The caregiver who spent the greatest time with each patient was evaluated with the Zarit Caregiver Burden Interview. The caregivers' global health, mood symptoms, quality of life, and tasks performed for the patient were also assessed.
  
  
  RESULTS
  Thirty-six BD patients and their caregivers were assessed. The Zarit Caregiver Burden Interview was positively correlated with patients' neuropsychiatric symptoms (r = 0.508, P = 0.002) and functional impairment (r = 0.466, P = 0.004). The Zarit Caregiver Burden Interview was also correlated with caregivers' own depression (r = 0.576, P < 0.001), anxiety (r = 0.360, P = 0.031), quality of life (r = -0.406, P = 0.014), medical comorbidities (r = 0.387, P = 0.020), and number of tasks that they completed for the patient (r = 0.480, P = 0.003).
  
  
  CONCLUSIONS
  In this group of elderly BD patients, caregiver burden was more associated with symptoms frequently seen in others diseases as in dementia than with depressive, manic, or anxiety symptoms, which are often used as treatment outcomes measures goals in BD. Potential treatable and modifiable factors associated with caregiver burden could be caregivers' depression, anxiety, and medical comorbidities, as well as support for caregivers in terms of services and social relationships.
authors.affiliation: Faculty of Medicine, Department and Institute of Psychiatry, University of São Paulo, São Paulo, Brazil.
authors.forename: Glenda D
authors.initials: GD
authors.lastname: Dos Santos
authors.affiliation: Faculty of Medicine, Department and Institute of Psychiatry, University of São Paulo, São Paulo, Brazil.
authors.forename: Orestes V
authors.initials: OV
authors.lastname: Forlenza
authors.affiliation: Faculty of Medicine, Department and Institute of Psychiatry, University of São Paulo, São Paulo, Brazil.
authors.forename: Rodolfo B
authors.initials: RB
authors.lastname: Ladeira
authors.affiliation: Faculty of Medicine, Department and Institute of Psychiatry, University of São Paulo, São Paulo, Brazil.
authors.forename: Ivan
authors.initials: I
authors.lastname: Aprahamian
authors.affiliation: Faculty of Medicine, Department and Institute of Psychiatry, University of São Paulo, São Paulo, Brazil.
authors.forename: Jouce G
authors.initials: JG
authors.lastname: Almeida
authors.affiliation: Faculty of Medicine, Department and Institute of Psychiatry, University of São Paulo, São Paulo, Brazil.
authors.forename: Beny
authors.initials: B
authors.lastname: Lafer
authors.affiliation: Faculty of Medicine, Department and Institute of Psychiatry, University of São Paulo, São Paulo, Brazil.
authors.forename: Paula V
authors.initials: PV
authors.lastname: Nunes
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000523:psychology*; D001714:Bipolar Disorder / Q000503:physiopathology / Q000523:psychology*; D017028:Caregivers / Q000523:psychology*; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life
keywords: bipolar disorder; caregiver burden; caregivers; functionality; neuropsychiatric symptoms; older adults