Journal of Neurology

, Volume 262, Issue 6, pp 1526–1532 | Cite as

Caregiver burden in amyotrophic lateral sclerosis: a cross-sectional investigation of predictors

  • Tom Burke
  • Marwa Elamin
  • Miriam Galvin
  • Orla Hardiman
  • Niall Pender
Original Communication


The objective of the study was to investigate whether cognitive and behavioural impairment in Amyotrophic Lateral Sclerosis (ALS) contributes to caregiver burden, and whether carer burden affects patient outcome. Thirty-three dyads of incident patients with ALS and their primary caregivers (n = 33) completed a series of measures to determine cognitive and behavioural profiles, (patients) and carer burden (carers) to investigate the psychological impact of ALS, and the impact of behavioural change since the onset of ALS. Caregivers were divided into high- and low-burden groups using previously established norms. High burden in carers was associated with significantly higher apathy (p = 0.009), disinhibition (p = 0.005), and executive dysfunction (p = 0.015) in patients. Regression analyses for burden confirmed significant predictors such as change in apathy (r = 0.390, F = 5.19, p = 0.03), disinhibition (r = 0.530, F = 11.32, p = 0.002), and executive dysfunction (r = 0.372, F = 4.66, p = 0.039), with total behaviour change contributing to 31 % of caregiver burden (r = 0.563, F = 4.17, p = 0.015). Total distress as measured by the Hospital Anxiety and Depression Scale was also a significant predictor of caregiver burden, contributing to 38.5 % of variance (r = 0.621, F = 18.79, p < 0.000). Caregiver burden did not affect survival (p = 0.496). Caregiver burden in ALS is modulated by patient’s cognitive and behavioural status, but does not significantly impact patient survival.


Amyotrophic lateral sclerosis Neuropsychology and behaviour Burden and quality of life Survival and prognosis Health services research 



The research leading to these results has received funding from the European Community’s Seventh Framework Programme (FP7/2007-2013) under grant agreement no (259867); the JPND SOPHIA project; Irish Health Research Board (CSA2012/11) and the Irish Institute of Clinical Neuroscience (12549. 201616).

Conflicts of interest

Nothing to declare.

Ethical standard

This research has received ethical approval from Beaumont Hospital Medical Research Ethics review team, and written consent was obtained from all participants.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Tom Burke
    • 1
    • 2
  • Marwa Elamin
    • 2
  • Miriam Galvin
    • 2
    • 3
  • Orla Hardiman
    • 2
    • 4
  • Niall Pender
    • 1
    • 2
    • 5
  1. 1.Department of PsychologyBeaumont HospitalDublin 9Ireland
  2. 2.Academic Unit of NeurologyTrinity Biomedical Sciences InstituteDublinIreland
  3. 3.School of Nursing and Human SciencesDublin City UniversityDublinIreland
  4. 4.Department of NeurologyBeaumont HospitalDublin 9Ireland
  5. 5.Royal College of Surgeons in IrelandDublinIreland

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