The relationship of specific items on the Neuropsychiatric Inventory to caregiver burden in dementia: a systematic review.
Neuropsychiatric symptoms (NPSs) are common in dementia, and they have been identified as important care-recipient variables in terms of their impact on caregiver burden. The aim of this review was to describe how individual NPSs in dementia, assessed using the Neuropsychiatric Inventory, are associated with caregiver burden.



We performed a systematic review of English language, peer-reviewed articles retrieved from MEDLINE, PSYCINFO, and EMBASE.



A total of 13 studies met the inclusion criteria. Four studies examined the association between individual NPSs and caregiver burden using the Spearman rank correlation test, while three used Pearson's correlation test. Of the remaining studies, five used multiple regression analyses and one the chi-squared test. The majority of included studies did not differentiate between dementia subtypes in the analysis or mainly included only caregivers of people with Alzheimer's disease. The Clinical Dementia Rating score and mean Mini-Mental State Examination score indicate mild to moderate dementia. The majority of caregivers were women, most of whom were children (53.8%) or spouses (36%). The data indicated that irritability, followed by agitation, sleep disturbances, anxiety, apathy, and delusion seem to impact caregiver burden the most.



Our principal finding is that irritability, agitation, sleep disturbances, anxiety, apathy, and delusion seem to exert the most impact on caregiver burden. Heterogeneity in the measures and statistical analyses used, however, makes it difficult to make conclusive interpretations. Future research in this field would benefit from standardization of the scientific methodology in use. Copyright © 2017 John Wiley & Sons, Ltd.
Westeren Norway University of Applied Science, Førde, Norway.|Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger, Norway.|Department of Clinical Medicine, University of Bergen, Bergen, Norway.|Center of Health Research, Førde Hospital Trust, Førde, Norway.
Toril Marie
0000-0001-6654-8640
TM
Terum
Westeren Norway University of Applied Science, Førde, Norway.|Center of Health Research, Førde Hospital Trust, Førde, Norway.
John Roger
JR
Andersen
Department of Clinical Medicine, University of Bergen, Bergen, Norway.|Department of Research and Innovation, Helse Fonna, Haugesund, Norway.
Arvid
A
Rongve
Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger, Norway.|Wolfson Centre for Age-Related Diseases, King's College London, London, UK.
Dag
D
Aarsland
Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger, Norway.|Department of Nursing, Westeren Norway University of Applied Science, Stord, Norway.|Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Huddinge, Sweden.
Ellen J
EJ
Svendsboe
Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger, Norway.|Wolfson Centre for Age-Related Diseases, King's College London, London, UK.
Ingelin
I
Testad
D000223:Adaptation, Psychological; D000544:Alzheimer Disease / Q000523:psychology; D001007:Anxiety / Q000523:psychology; D001008:Anxiety Disorders; D057565:Apathy; D017028:Caregivers / Q000523:psychology*; D003702:Delusions / Q000523:psychology; D003704:Dementia / Q000523:psychology*; D006801:Humans; D007508:Irritable Mood; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D012893:Sleep Wake Disorders; D018454:Spouses / Q000523:psychology
Alzheimer's disease; Lewy body dementia; Neuropsychiatric Inventory (NPI); caregiver burden; dementia; frontotemporal dementia; neuropsychiatric symptoms