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Aging Clinical and Experimental Research

, Volume 17, Issue 1, pp 46–53 | Cite as

The Caregiver Burden Inventory in evaluating the burden of caregivers of elderly demented patients: results from a multicenter study

  • Martina Marvardi
  • Paola Mattioli
  • Liana Spazzafumo
  • Roberta Mastriforti
  • Patrizia Rinaldi
  • Maria Cristina Polidori
  • Antonio Cherubini
  • Roberto Quartesan
  • Luisa Bartorelli
  • Salvatore Bonaiuto
  • Domenico Cucinotta
  • Angelo Di Iorio
  • Maurizio Gallucci
  • Marcello Giordano
  • Marina Martorelli
  • Giorgio Masaraki
  • Antonio Nieddu
  • Carla Pettenati
  • Paolo Putzu
  • Vincenzo Solfrizzi
  • Aldo Edoardo Tammaro
  • Pia Francesca Tomassini
  • Carlo Vergani
  • Umberto Senin
  • Patrizia Mecocci
  • Study Group on Brain Aging of the Italian Society of Gerontology and Geriatrics
Original Articles

Abstract

Background and aims: The burden perceived by caregivers of patients with dementia is a fundamental prognostic aspect in the history of the disease. The aim of this study was to demonstrate the internal consistency of the Caregiver Burden Inventory (CBI), a scale used to quantify burdens in different aspects of a caregiver’s life, and the influence of patients’ and caregivers’ characteristics on its different dimensions. Methods: In this cross-sectional study, 419 demented patients and their caregivers were evaluated in 16 geriatric centers in Italy. Cognitive status and behavioral disturbances were assessed by the Mini Mental State Examination (MMSE) and Neuropsychiatric Inventory (NPI), respectively. Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) were also evaluated. Comorbidity was assessed by the Cumulative Illness Rating Scale (CIRS). The severity of dementia was evaluated by the Clinical Dementia Rating (CDR) score. Caregiver distress due to the behavioral problems of the patient was assessed by the Neuropsychiatric Inventory-Distress, a subscale of the NPI wich evaluates stress caused by each behavioral disturbance of the patient, and by the Brief Symptom Inventory wich evaluates anxiety and depression. Burden was evaluated by the CBI. Results: The CBI showed very high internal consistency (Cronbach’s alpha value >0.80). Factor analysis showed that the items clustered into four dimensions, and not five as originally proposed. Multiple regression analysis revealed that patients’ behavioral disturbances and disability were the major predictors of the time-dependent burden; the psychophysical burden was explained mainly by caregiver anxiety and depression. Conclusions: The CBI proved to be an effective multidimensional tool for evaluating the impact of burden on many aspects of caregivers’ lives.

Keywords

Burden caregiver dementia evaluation 

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References

  1. 1.
    Russo J, Vitaliano PP, Breuer DD, Katon W, Becker J. Psychiatric disorders in spouse caregivers of care recipients with Alzheimer’s disease and matched controls: a diathesis-stress model of psychopathology. J Abnorm Psychol 1995; 104: 197–204.PubMedCrossRefGoogle Scholar
  2. 2.
    Schulz R, O’Brien AT, Bookwala J, Fleissner K. Psychiatric and physical morbidity effects of dementia caregiving: prevalence, correlates, and causes. Gerontologist 1995; 35: 771–91.PubMedCrossRefGoogle Scholar
  3. 3.
    George LK, Gwyther LP. Caregiver well-being: a multidimensional examination of family caregivers of demented adults. Gerontologist 1986; 26: 253–9.PubMedCrossRefGoogle Scholar
  4. 4.
    Vitaliano PP, Young HM, Russo J, Romano J, Magana-Amato A. Does expressed emotion in spouses predict subsequent problems among care recipients with Alzheimer’s disease? J Gerontol 1993; 48: 202–9.CrossRefGoogle Scholar
  5. 5.
    Teri L. Behavior and caregiver burden: behavioral problems in patients with Alzheimer’s disease and its association with caregiver distress. Alzheimer Dis Assoc Disord 1997; 11: S35–8.PubMedGoogle Scholar
  6. 6.
    Bédard M, Pedlar D, Martin N, Malott O, Stones M. Burden in caregivers of cognitively impaired older adults living in the community: methodological issues and determinants. Int Psychogeriatr 2000; 12: 307–32.PubMedCrossRefGoogle Scholar
  7. 7.
    Novak M, Guest C. Application of a multidimensional caregiver burden inventory. Gerontologist 1989; 29: 798–803.PubMedCrossRefGoogle Scholar
  8. 8.
    Caserta M, Lund DA, Wright SD. Exploring the Caregiver Burden Inventory (CBI): further evidence for a multidimensional view of burden. Int J Aging Hum Dev 1996; 43: 21–34.PubMedCrossRefGoogle Scholar
  9. 9.
    Folstein MF, Folstein SE, McHugh PR. Mini Mental State: a practical method for grading the mental state of patients for the clinician. J Psychiatr Res 1975; 12: 189–98.PubMedCrossRefGoogle Scholar
  10. 10.
    Cummings JL, Mega M, Gray K, Rosenberg-Thompson S, Carusi DA, Gombein J. The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology 1994; 44: 2308–14.PubMedCrossRefGoogle Scholar
  11. 11.
    Katz S, Ford AB, Moskowitz R, Jackson BA, Jaffe MW. The index of ADL: a standardized measure of biological and psychosocial function. JAMA 1963; 185: 914–9.PubMedCrossRefGoogle Scholar
  12. 12.
    Lawton M, Brody E. Assessment of older people: self maintaining and instrumental activities of daily living. Gerontologist 1969; 9: 179–86.PubMedCrossRefGoogle Scholar
  13. 13.
    Parmalee PA, Thuras PD, Katz IR, et al. Validation of the cumulative illness rating scale in a geriatric residential population. J Am Geriatr Soc 1995; 43: 130–7.Google Scholar
  14. 14.
    Hughes CP, Berg L, Danzigher WL, Coben LA, Martin RL. A new clinical scale for the staging of dementia. Br J Psychiatry 1982; 140: 566–72.PubMedCrossRefGoogle Scholar
  15. 15.
    Derogatis LR, Melisaratos N. The Brief Symptom Inventory: an introductory report. Psychol Med 1983; 13: 595–605.PubMedCrossRefGoogle Scholar
  16. 16.
    Burns A. The burden of Alzheimer’s disease. Int J Neuropsy-chopharmacol 2000; 3: 31–8.CrossRefGoogle Scholar
  17. 17.
    Zarit SH, Whitlatch CJ. Institutional placement: phases of the transition. Gerontologist 1992; 32, 665–72.PubMedCrossRefGoogle Scholar
  18. 18.
    Baumgarten M, Battista RN, Infante-Rivard C, et al. The psychological and physical health of family member caring for an elderly person with dementia. J Clin Epidemiol 1992; 45: 61–70.PubMedCrossRefGoogle Scholar
  19. 19.
    Clyburn LD, Stones MD, Hadjistavropoulos T, Tuokko H. Predicting caregiver burden and depression in Alzheimer’s disease. J Gerontol 2000; 55: S2–13.CrossRefGoogle Scholar
  20. 20.
    Robinson J, Moen P, Dempster-McClain D. Women’s caregiving: changing profiles and pathways. J Gerontol 1995; 50: S362–73.CrossRefGoogle Scholar
  21. 21.
    Yaffe K, Fox P, Newcomer R, et al. Patient and caregiver characteristics and nursing home placement in patients with dementia. JAMA 2002; 287: 2090–7.PubMedCrossRefGoogle Scholar
  22. 22.
    Zarit SH, Reever KE, Bach-Peterson J. Relatives of the impaired elderly: correlates of feeling of burden. Gerontologist 1980; 20: 649–55.PubMedCrossRefGoogle Scholar
  23. 23.
    Green JC, Smith R, Gardiner M, Timbury GC. Measuring behavioral disturbance of elderly demented patients in the community and its effect on relatives: a factor analytic study. Age Ageing 1982; 11: 121–6.CrossRefGoogle Scholar
  24. 24.
    Kinney JM, Stephens MAP. Caregiving Hassles Scale: assessing the daily hassles of caring for a family member with dementia. Gerontologist 1989; 29: 328–32.PubMedCrossRefGoogle Scholar
  25. 25.
    Donaldson C, Tarrier N, Burns A. Determinants of carer stress in Alzheimer’s disease. Int J Geriatr Psychiatry 1998; 13: 248–56.PubMedCrossRefGoogle Scholar
  26. 26.
    Colvez A, Joel ME, Ponton-Sanchez A, Royer AC. Health status and work burden of Alzheimer patients’ informal caregivers: comparison of five different care programs in the European Union. Health Policy 2002; 60: 219–33.PubMedCrossRefGoogle Scholar
  27. 27.
    Weiler PG, Chiriboga DA, Black SA. Comparison of mental status tests: implications for Alzheimer’s patients and their caregivers. J Gerontol 1994; 49: 544–51.CrossRefGoogle Scholar
  28. 28.
    Parks SH, Pilsuk M. Caregiver burden: Gender and the psychological costs of caregiving. Am J Orthopsychiatry 1991; 61: 501–9.PubMedCrossRefGoogle Scholar
  29. 29.
    Semple SJ. Conflict in Alzheimer’s caregiving families: its dimensions and consequences. Gerontologist 1992; 32: 648–55.PubMedCrossRefGoogle Scholar
  30. 30.
    Haley WE, Brown SL, Levine EG. Family caregiver appraisals of patient behavioral disturbance in senile dementia. Clin Gerontol 1987; 6: 25–34.CrossRefGoogle Scholar
  31. 31.
    Schneider J, Murray J, Barnerjee S, Mann A. Eurocare: A cross-national study of co-resident spouse carers for people with Alzheimer’s disease: I-factors associated with carer burden. Int J Geriatr Psychiatry 1999; 14: 651–61.PubMedCrossRefGoogle Scholar
  32. 32.
    Gallant MP, Connell CM. Predictors of decreased self-care among spouse caregivers of older adults with dementing illnesses. J Aging Health 1997; 9: 373–95.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Internal Publishing Switzerland 2005

Authors and Affiliations

  • Martina Marvardi
    • 1
  • Paola Mattioli
    • 1
  • Liana Spazzafumo
    • 1
  • Roberta Mastriforti
    • 1
  • Patrizia Rinaldi
    • 1
  • Maria Cristina Polidori
    • 1
  • Antonio Cherubini
    • 1
  • Roberto Quartesan
    • 1
  • Luisa Bartorelli
    • 1
  • Salvatore Bonaiuto
    • 1
  • Domenico Cucinotta
    • 1
  • Angelo Di Iorio
    • 1
  • Maurizio Gallucci
    • 1
  • Marcello Giordano
    • 1
  • Marina Martorelli
    • 1
  • Giorgio Masaraki
    • 1
  • Antonio Nieddu
    • 1
  • Carla Pettenati
    • 1
  • Paolo Putzu
    • 1
  • Vincenzo Solfrizzi
    • 1
  • Aldo Edoardo Tammaro
    • 1
  • Pia Francesca Tomassini
    • 1
  • Carlo Vergani
    • 1
  • Umberto Senin
    • 1
  • Patrizia Mecocci
    • 1
  • Study Group on Brain Aging of the Italian Society of Gerontology and Geriatrics
  1. 1.Istituto di Gerontologia e Geriatria, Policlinico Monteluce-Padiglione EPerugiaItaly

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