Abstract
Background and aims: The burden perceived by caregivers of patients with dementia is a fundamental prognostic aspect in the history of the disease. The aim of this study was to demonstrate the internal consistency of the Caregiver Burden Inventory (CBI), a scale used to quantify burdens in different aspects of a caregiver’s life, and the influence of patients’ and caregivers’ characteristics on its different dimensions. Methods: In this cross-sectional study, 419 demented patients and their caregivers were evaluated in 16 geriatric centers in Italy. Cognitive status and behavioral disturbances were assessed by the Mini Mental State Examination (MMSE) and Neuropsychiatric Inventory (NPI), respectively. Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) were also evaluated. Comorbidity was assessed by the Cumulative Illness Rating Scale (CIRS). The severity of dementia was evaluated by the Clinical Dementia Rating (CDR) score. Caregiver distress due to the behavioral problems of the patient was assessed by the Neuropsychiatric Inventory-Distress, a subscale of the NPI wich evaluates stress caused by each behavioral disturbance of the patient, and by the Brief Symptom Inventory wich evaluates anxiety and depression. Burden was evaluated by the CBI. Results: The CBI showed very high internal consistency (Cronbach’s alpha value >0.80). Factor analysis showed that the items clustered into four dimensions, and not five as originally proposed. Multiple regression analysis revealed that patients’ behavioral disturbances and disability were the major predictors of the time-dependent burden; the psychophysical burden was explained mainly by caregiver anxiety and depression. Conclusions: The CBI proved to be an effective multidimensional tool for evaluating the impact of burden on many aspects of caregivers’ lives.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Russo J, Vitaliano PP, Breuer DD, Katon W, Becker J. Psychiatric disorders in spouse caregivers of care recipients with Alzheimer’s disease and matched controls: a diathesis-stress model of psychopathology. J Abnorm Psychol 1995; 104: 197–204.
Schulz R, O’Brien AT, Bookwala J, Fleissner K. Psychiatric and physical morbidity effects of dementia caregiving: prevalence, correlates, and causes. Gerontologist 1995; 35: 771–91.
George LK, Gwyther LP. Caregiver well-being: a multidimensional examination of family caregivers of demented adults. Gerontologist 1986; 26: 253–9.
Vitaliano PP, Young HM, Russo J, Romano J, Magana-Amato A. Does expressed emotion in spouses predict subsequent problems among care recipients with Alzheimer’s disease? J Gerontol 1993; 48: 202–9.
Teri L. Behavior and caregiver burden: behavioral problems in patients with Alzheimer’s disease and its association with caregiver distress. Alzheimer Dis Assoc Disord 1997; 11: S35–8.
Bédard M, Pedlar D, Martin N, Malott O, Stones M. Burden in caregivers of cognitively impaired older adults living in the community: methodological issues and determinants. Int Psychogeriatr 2000; 12: 307–32.
Novak M, Guest C. Application of a multidimensional caregiver burden inventory. Gerontologist 1989; 29: 798–803.
Caserta M, Lund DA, Wright SD. Exploring the Caregiver Burden Inventory (CBI): further evidence for a multidimensional view of burden. Int J Aging Hum Dev 1996; 43: 21–34.
Folstein MF, Folstein SE, McHugh PR. Mini Mental State: a practical method for grading the mental state of patients for the clinician. J Psychiatr Res 1975; 12: 189–98.
Cummings JL, Mega M, Gray K, Rosenberg-Thompson S, Carusi DA, Gombein J. The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology 1994; 44: 2308–14.
Katz S, Ford AB, Moskowitz R, Jackson BA, Jaffe MW. The index of ADL: a standardized measure of biological and psychosocial function. JAMA 1963; 185: 914–9.
Lawton M, Brody E. Assessment of older people: self maintaining and instrumental activities of daily living. Gerontologist 1969; 9: 179–86.
Parmalee PA, Thuras PD, Katz IR, et al. Validation of the cumulative illness rating scale in a geriatric residential population. J Am Geriatr Soc 1995; 43: 130–7.
Hughes CP, Berg L, Danzigher WL, Coben LA, Martin RL. A new clinical scale for the staging of dementia. Br J Psychiatry 1982; 140: 566–72.
Derogatis LR, Melisaratos N. The Brief Symptom Inventory: an introductory report. Psychol Med 1983; 13: 595–605.
Burns A. The burden of Alzheimer’s disease. Int J Neuropsy-chopharmacol 2000; 3: 31–8.
Zarit SH, Whitlatch CJ. Institutional placement: phases of the transition. Gerontologist 1992; 32, 665–72.
Baumgarten M, Battista RN, Infante-Rivard C, et al. The psychological and physical health of family member caring for an elderly person with dementia. J Clin Epidemiol 1992; 45: 61–70.
Clyburn LD, Stones MD, Hadjistavropoulos T, Tuokko H. Predicting caregiver burden and depression in Alzheimer’s disease. J Gerontol 2000; 55: S2–13.
Robinson J, Moen P, Dempster-McClain D. Women’s caregiving: changing profiles and pathways. J Gerontol 1995; 50: S362–73.
Yaffe K, Fox P, Newcomer R, et al. Patient and caregiver characteristics and nursing home placement in patients with dementia. JAMA 2002; 287: 2090–7.
Zarit SH, Reever KE, Bach-Peterson J. Relatives of the impaired elderly: correlates of feeling of burden. Gerontologist 1980; 20: 649–55.
Green JC, Smith R, Gardiner M, Timbury GC. Measuring behavioral disturbance of elderly demented patients in the community and its effect on relatives: a factor analytic study. Age Ageing 1982; 11: 121–6.
Kinney JM, Stephens MAP. Caregiving Hassles Scale: assessing the daily hassles of caring for a family member with dementia. Gerontologist 1989; 29: 328–32.
Donaldson C, Tarrier N, Burns A. Determinants of carer stress in Alzheimer’s disease. Int J Geriatr Psychiatry 1998; 13: 248–56.
Colvez A, Joel ME, Ponton-Sanchez A, Royer AC. Health status and work burden of Alzheimer patients’ informal caregivers: comparison of five different care programs in the European Union. Health Policy 2002; 60: 219–33.
Weiler PG, Chiriboga DA, Black SA. Comparison of mental status tests: implications for Alzheimer’s patients and their caregivers. J Gerontol 1994; 49: 544–51.
Parks SH, Pilsuk M. Caregiver burden: Gender and the psychological costs of caregiving. Am J Orthopsychiatry 1991; 61: 501–9.
Semple SJ. Conflict in Alzheimer’s caregiving families: its dimensions and consequences. Gerontologist 1992; 32: 648–55.
Haley WE, Brown SL, Levine EG. Family caregiver appraisals of patient behavioral disturbance in senile dementia. Clin Gerontol 1987; 6: 25–34.
Schneider J, Murray J, Barnerjee S, Mann A. Eurocare: A cross-national study of co-resident spouse carers for people with Alzheimer’s disease: I-factors associated with carer burden. Int J Geriatr Psychiatry 1999; 14: 651–61.
Gallant MP, Connell CM. Predictors of decreased self-care among spouse caregivers of older adults with dementing illnesses. J Aging Health 1997; 9: 373–95.
Author information
Authors and Affiliations
Consortia
Corresponding author
Additional information
For a list of members and affiliations, see Appendix B.
Rights and permissions
About this article
Cite this article
Marvardi, M., Mattioli, P., Spazzafumo, L. et al. The Caregiver Burden Inventory in evaluating the burden of caregivers of elderly demented patients: results from a multicenter study. Aging Clin Exp Res 17, 46–53 (2005). https://doi.org/10.1007/BF03337720
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/BF03337720