Factors impacting caregiver burden in Parkinson's disease: A systematic review and meta-analysis.

BACKGROUND

Informal caregivers are integral to the long-term care of people with Parkinson's disease but often face substantial caregiving burden, which negatively affects both caregivers and care recipients. Despite its significance, there is no existing systematic review or meta-analysis that examines the significance of all potential factors using an appropriate conceptual framework.

AIM: To identify and analyze factors associated with caregiver burden in Parkinson's disease informal caregivers.

DESIGN

Systematic review and meta-analysis.

METHOD: A comprehensive search of five databases was conducted from inception to February 2025. Eligible studies included those examining informal caregivers of people with Parkinson's disease, utilizing validated measures of caregiver burden, investigating at least one associated factor, and reporting associations as correlation or regression coefficients. The Stress-Appraisal Model was used to guide categorization of factors and evidence synthesis. Meta-analyses were performed using random-effects models.

RESULTS

Sixty-six studies involving 30,533 people with Parkinson's disease and 30,419 informal caregivers were included. A total of 78 care recipient-level and 28 caregiver-level factors were identified, with 41 factors included in the meta-analyses. Care recipient-level factors including advanced disease stage, greater disability, longer disease duration, and more severe motor and non-motor symptoms, and caregiver-level factors such as greater psychological distress, longer time spent caregiving per day, older age, and poorer social support, were significantly associated with greater caregiver burden. Among all these factors, Parkinson's disease neuropsychiatric symptom severity and caregivers' psychological distress demonstrated the strongest positive associations with caregiver burden. Meta-regression revealed stronger associations in studies conducted in the Southeast Asia and Western Pacific regions.

CONCLUSION

Caregiver burden in Parkinson's disease informal caregivers is shaped by both care recipient- and caregiver-level factors, reflecting its multidimensional and complex nature. A paradigm shift in caregiver research and interventions is needed to emphasize modifiable caregiver-level and protective factors, such as caregiver psychological well-being, coping strategies, and social support, to alleviate burden and improve outcomes for the Parkinson's disease care dyads.