Background:
Caring for a family member with dementia can cause stress; possible causes are the patient's lack of insight, poor functional ability or poor health. This study examined the association between level of insight in the patient and perceived burden in the carer.
Methods:
Twenty-four patients with mild Alzheimer's disease and their carers were recruited from Perth Metropolitan Memory clinics and community advertising. Patients were administered a neuropsychological battery and completed the Geriatric Depression Scale (GDS), Dysexecutive (DEX) questionnaire and SF-36 health survey. Carers were interviewed separately on the DEX, Neuropsychiatric Inventory (NPI), SF-36 and Zarit Burden Scale. Patient insight was measured using the discrepancy between carer and patient total scores on the DEX questionnaire.
Results:
The DEX discrepancy score correlated significantly with total burden score (r = .52, P = 0.009). Burden was not correlated with patient cognition, age, neuropsychiatric symptoms and patient or carer SF-36 scores. A stepwise multiple regression with total burden as the outcome variable was statistically significant (R 2 = .65, F = 8.72, P < 0.001), significant predictors of outcome were DEX discrepancy, patient GDS, CDR sum of boxes and NPI score. Carer relationship and living status did not affect perceived burden.
Conclusions:
Reduced insight in patients with dementia may result in increased isolation and frustration for their carer (compared with carers of patients who have good insight). Therefore, measuring insight in patients with dementia may be useful in identifying carers at risk for high burden levels.
