High Caregiver Burden in Young Onset Dementia: What Factors Need Attention?

Article type: Research Article

Authors: Lim, Linda^{a; 1} | Zhang, Angeline^{a; 1} | Lim, Levinia^a | Choong, Tanya-Marie^a | Silva, Eveline^a | Ng, Adeline^a | Kandiah, Nagaendran^{a; b; *}

Affiliations: [a] Department of Neurology, National Neuroscience Institute, Singapore | [b] Duke-NUS, Graduate Medical School, Singapore

Correspondence: [*] Correspondence to: A/Prof Nagaendran Kandiah, Senior Consultant Neurologist, Department of Neurology, National Neuroscience Institute, 11 Jalan Tan Tock Seng, 308433, Singapore. Tel.: +65 6357 7171; Fax: +65 6357 7137; E-mail: nagaendran.kandiah@singhealth.com.sg.

Note: [1] These authors contributed equally to this work.

Abstract: Background:There is an increase in prevalence of young onset dementia (YOD). The specific problems among YOD patients and levels of caregiver burden (CB) in this group warrants further evaluation. Objective:To evaluate and compare level of CB in YOD and late onset dementia (LOD). Also, we sought to understand the specific factors, such as neuropsychiatric symptoms, that may affect the levels of caregiver burden in the YOD group. Methods:Patient-caregiver dyads with YOD and LOD were recruited from a tertiary neurology center. Levels of CB between YOD and LOD were compared among 183 patient-caregiver dyads. CB was quantified using the Zarit Burden Inventory (ZBI). Neuropsychological evaluations as well as the Neuropsychiatric Inventory were performed. Factors that influenced level of CB in YOD group was investigated with regression analyses. Results:There were 57 YOD and 126 LOD dyads. Caregivers of YOD subjects reported significantly higher levels of burden compared to caregivers of LOD subjects (ZBI: 17.3 versus 13.94; p = 0.015). 52.6% of YOD caregivers reported a high caregiver burden. When compared to caregivers of LOD, the odds of a caregiver of YOD reporting high caregiver burden was 2.34 (95% CI: 1.22–4.49: p = 0.010). YOD dyads with a high caregiver burden had significantly higher neuropsychiatric inventory scores. Risk factors for high caregiver burden in YOD included family history of dementia and behavioral symptoms including disinhibited behavior, delusions, and apathy. Conclusion:Targeted support for caregivers of patients with YOD is needed to address the higher CB in this group.

Keywords: Caregiver burden, neuropsychiatric symptoms, young onset dementia

DOI: 10.3233/JAD-170409

Journal: Journal of Alzheimer's Disease, vol. 61, no. 2, pp. 537-543, 2018