The experience of caregiving: the influence of coping strategies on behavioral and psychological symptoms in patients with Alzheimer's disease

Abstract

Objectives: To determine whether caregiver coping strategies are independently associated with behavioral and psychological symptoms (BPS) in Alzheimer's disease (AD) after accounting for patient characteristics.

Methods: Cross-sectional data analysis of 80 patients with AD and their primary caregivers. The presence of BPS was recorded using the Neuropsychiatric Inventory (NPI). The relationship between caregiver characteristics and BPS was assessed through one-way analysis of variance, two-tailed student t-tests or correlation coefficients. Multivariate linear regression was used to determine the combined effect of all caregiver factors that were significant on bivariate analysis regarding coping and BPS controlling for patient characteristics.

Results: Caregivers were on average 62 years old, 77% female, and most were the children or the spouse of the patient. Over 50% had significant depression or anxiety. Patients were on average 77 years old and 62% were female, and most had moderate to severe dementia. After adjusting for patient characteristics, patients cared for by more depressed, more burdened, or those using more disengagement coping strategies showed higher NPI mean composite scores.

Conclusion: Coping strategies are associated with BPS regardeless of patient characteristics. Interventions to reduce BPS should focus on which psychological coping strategies caregivers use. Understanding how coping strategies influence BPS may help tailor specific interventions for caregivers.

Keywords:

• Alzheimer’s disease
• caregiver
• coping
• behavioral and psychological symptoms
• burden

Notes

Notes: MMSE = mini mental state examination; B-ADL = Bayer activities daily.

Living; NPI = neuropsychiatric inventory: GDS = global deterioration scale.

Notes: SD = standard deviation; CBI = caregiver burden interview; BDI = Beck depression; NPI = neuropsychiatric inventory; STAI-S = State-Trait Anxiety Inventory-State.

*Pearson's correlation coefficient. t-Student or F-ANOVA.

Notes: β = standardized regression coefficient.; R ² = determination coefficient.