Impact of Neuropsychiatric Symptoms on Caregiver Burden of People With Dementia With Lewy Bodies: A Multicentre Prospective Longitudinal Study.

BACKGROUND

Various neuropsychiatric symptoms are associated with caregiver burden in patients with dementia with Lewy bodies (DLB). However, the causal relationship between individual neuropsychiatric symptoms and caregiver burden in DLB has not been investigated in Japan.

METHODS

This prospective observational study was conducted at four medical centres, including 30 patients with probable DLB aged ≥ 65 years who met the McKeith DLB diagnostic criteria. Caregiver burden and neuropsychiatric symptoms were assessed using the Japanese version of the Zarit Burden Interview (J-ZBI) and Neuropsychiatric Inventory Questionnaire, respectively. The participants were asked whether they had newly used a day service 6 months later. Data from the initial visits and the 6-month follow-ups were compared and analysed.

RESULTS

At the initial visit, the mean age of individuals with DLB was 80.8 (5.8) years; their mean Mini-Mental State Examination score was 20.6 (5.1). J-ZBI scores significantly increased for participants with persistence or incidence of anxiety and apathy, compared with those without or with disappearance of these symptoms. Day service use did not affect the caregiver burden. The multiple regression analyses showed that changes in cognitive function and instrumental activities of daily living scores were not associated with changes in caregiver burden. The persistence or incidence of anxiety (β = 0.599, p < 0.001) and apathy (β = 0.587, p < 0.001) were also independently significantly associated with increased J-ZBI scores 6 months later.

CONCLUSIONS

Persistence or incidences of anxiety and apathy may increase caregiver burden in patients with DLB. Clinicians should pay attention to these neuropsychiatric symptoms to prevent the worsening of caregiver burden.

TRIAL REGISTRATION: UMIN Clinical Trials Registry: UMIN000051472.