The Relationships between Caregiver Burden, Physical Frailty, Race, Behavioral and Psychological Symptoms (BPSD), and Other Associated Variables: An Exploratory Study

<i>Background and Objectives:</i> For persons with dementia, the relationships between caregiver burden, physical frailty, race, behavioral and psychological symptoms (BPSD), and other associated variables are poorly understood. Only one prior study examined the relationships among these...

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Main Authors: Carl I. Cohen, Saeed Hashem, Kay Thwe Kyaw, Sharon A. Brangman, Suzanne Fields, Bruce R. Troen, Michael Reinhardt
Format: Article
Language:English
Published: MDPI AG 2024-03-01
Series:Medicina
Subjects:
Online Access:https://www.mdpi.com/1648-9144/60/3/426
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author Carl I. Cohen
Saeed Hashem
Kay Thwe Kyaw
Sharon A. Brangman
Suzanne Fields
Bruce R. Troen
Michael Reinhardt
author_facet Carl I. Cohen
Saeed Hashem
Kay Thwe Kyaw
Sharon A. Brangman
Suzanne Fields
Bruce R. Troen
Michael Reinhardt
author_sort Carl I. Cohen
collection DOAJ
description <i>Background and Objectives:</i> For persons with dementia, the relationships between caregiver burden, physical frailty, race, behavioral and psychological symptoms (BPSD), and other associated variables are poorly understood. Only one prior study examined the relationships among these variables but did not include race, which is an important social determinant of health outcomes in the United States. To examine these interactions, we conducted a cross-sectional exploratory study based on a model by Sugimoto and colleagues. <i>Materials and Methods:</i> The sample comprised 85 patient–caregiver dyads (58% White) seen in four centers in diverse regions of New York State. All patients met DSM5 criteria for a major neurocognitive disorder, had a Clinical Dementia Rating sum score of ≥3, and Mini-Mental State Examination (MMSE) score of 10 to 26. Other measures included the SHARE-Frailty Instrument(FI), the Neuropsychiatric Inventory (NPI) to assess BPSD, Zarit’s Caregiver Burden Interview (CBI), Lawton’s Activities of Daily Living (ADL) Scale, the MMSE, the Cumulative Illness Rating Scale for Geriatrics (CIRSG), age, and gender. <i>Results:</i> In our sample, 59% met the criteria for prefrail/subsyndromal or frail/syndromal (SSF) on the SHARE-FI. SSF had significant direct effects on the NPI and significant indirect effects on the CBI mediated through the NPI; the NPI had significant direct effects on the CBI. Race (White) had significant direct effects on the CBI (higher) and SSF (lower) but did not have significant indirect effects on the CBI. MMSE, ADL, and CIRSG were not significantly associated with the NPI or the CBI. <i>Conclusions:</i> Our analysis demonstrated that frailty, race, BPSD, and caregiver burden may directly or indirectly influence one another, and therefore should be considered essential elements of dementia assessment, care, and research. These results must be viewed as provisional and should be replicated longitudinally with larger samples.
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spelling doaj.art-f17a7983289b46c0a9fbe90912aaba9c2024-03-27T13:53:36ZengMDPI AGMedicina1010-660X1648-91442024-03-0160342610.3390/medicina60030426The Relationships between Caregiver Burden, Physical Frailty, Race, Behavioral and Psychological Symptoms (BPSD), and Other Associated Variables: An Exploratory StudyCarl I. Cohen0Saeed Hashem1Kay Thwe Kyaw2Sharon A. Brangman3Suzanne Fields4Bruce R. Troen5Michael Reinhardt6Division of Geriatric Psychiatry, SUNY Downstate Health Sciences University, MSC 1203, 450 Clarkson Avenue, Brooklyn, NY 11203, USAMcLean Hospital, 115 Mill St., Belmont, MA 02478, USADivision of Geriatric Psychiatry, SUNY Downstate Health Sciences University, MSC 1203, 450 Clarkson Avenue, Brooklyn, NY 11203, USADepartment of Geriatrics, SUNY Upstate Medical University, 175 Elizabeth Blackwell Street, Syracuse, NY 13210, USADivision of General, Geriatric and Hospital Medicine, Renaissance School of Medicine, Stony Brook University, 101 Nicolls Road, Stony Brook, NY 11794, USADivision of Geriatrics and Landon Center on Aging, University of Kansas Medical Center and VA Kansas City Healthcare System, 4000 Cambridge Street, Kansas City, KS 66160, USADivision of Geriatric Psychiatry, SUNY Downstate Health Sciences University, MSC 1203, 450 Clarkson Avenue, Brooklyn, NY 11203, USA<i>Background and Objectives:</i> For persons with dementia, the relationships between caregiver burden, physical frailty, race, behavioral and psychological symptoms (BPSD), and other associated variables are poorly understood. Only one prior study examined the relationships among these variables but did not include race, which is an important social determinant of health outcomes in the United States. To examine these interactions, we conducted a cross-sectional exploratory study based on a model by Sugimoto and colleagues. <i>Materials and Methods:</i> The sample comprised 85 patient–caregiver dyads (58% White) seen in four centers in diverse regions of New York State. All patients met DSM5 criteria for a major neurocognitive disorder, had a Clinical Dementia Rating sum score of ≥3, and Mini-Mental State Examination (MMSE) score of 10 to 26. Other measures included the SHARE-Frailty Instrument(FI), the Neuropsychiatric Inventory (NPI) to assess BPSD, Zarit’s Caregiver Burden Interview (CBI), Lawton’s Activities of Daily Living (ADL) Scale, the MMSE, the Cumulative Illness Rating Scale for Geriatrics (CIRSG), age, and gender. <i>Results:</i> In our sample, 59% met the criteria for prefrail/subsyndromal or frail/syndromal (SSF) on the SHARE-FI. SSF had significant direct effects on the NPI and significant indirect effects on the CBI mediated through the NPI; the NPI had significant direct effects on the CBI. Race (White) had significant direct effects on the CBI (higher) and SSF (lower) but did not have significant indirect effects on the CBI. MMSE, ADL, and CIRSG were not significantly associated with the NPI or the CBI. <i>Conclusions:</i> Our analysis demonstrated that frailty, race, BPSD, and caregiver burden may directly or indirectly influence one another, and therefore should be considered essential elements of dementia assessment, care, and research. These results must be viewed as provisional and should be replicated longitudinally with larger samples.https://www.mdpi.com/1648-9144/60/3/426dementiafrailtycaregiver burdenbehavioral and psychological symptomsneuropsychiatric symptomsrace
spellingShingle Carl I. Cohen
Saeed Hashem
Kay Thwe Kyaw
Sharon A. Brangman
Suzanne Fields
Bruce R. Troen
Michael Reinhardt
The Relationships between Caregiver Burden, Physical Frailty, Race, Behavioral and Psychological Symptoms (BPSD), and Other Associated Variables: An Exploratory Study
Medicina
dementia
frailty
caregiver burden
behavioral and psychological symptoms
neuropsychiatric symptoms
race
title The Relationships between Caregiver Burden, Physical Frailty, Race, Behavioral and Psychological Symptoms (BPSD), and Other Associated Variables: An Exploratory Study
title_full The Relationships between Caregiver Burden, Physical Frailty, Race, Behavioral and Psychological Symptoms (BPSD), and Other Associated Variables: An Exploratory Study
title_fullStr The Relationships between Caregiver Burden, Physical Frailty, Race, Behavioral and Psychological Symptoms (BPSD), and Other Associated Variables: An Exploratory Study
title_full_unstemmed The Relationships between Caregiver Burden, Physical Frailty, Race, Behavioral and Psychological Symptoms (BPSD), and Other Associated Variables: An Exploratory Study
title_short The Relationships between Caregiver Burden, Physical Frailty, Race, Behavioral and Psychological Symptoms (BPSD), and Other Associated Variables: An Exploratory Study
title_sort relationships between caregiver burden physical frailty race behavioral and psychological symptoms bpsd and other associated variables an exploratory study
topic dementia
frailty
caregiver burden
behavioral and psychological symptoms
neuropsychiatric symptoms
race
url https://www.mdpi.com/1648-9144/60/3/426
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