Caregiver-Care Recipient Relationship Closeness is Associated With Neuropsychiatric Symptoms in Dementia

Elizabeth K. Vernon, Bryce Cooley, William Rozum, Gail B. Rattinger, Stephanie Behrens, Joshua Matyi, Elizabeth Fauth, Constantine G Lyketsos, Jo Ann T. Tschanz

Research output: Contribution to journalArticle

Abstract

Objective: Closer caregiver-care recipient (CG-CR) relationships are associated with better cognitive and functional abilities, activities of daily living (in persons with dementia), and lower informal care costs. Methods: Due to the difficulty in treating neuropsychiatric symptoms (NPSs) and their detrimental effects on caregivers and care recipients, we examined whether closeness of CG-CR relationships was associated with overall NPS severity or with specific NPS symptom domains in care recipients. In a longitudinal population-based study in Cache County, Utah, the 12-item Neuropsychiatric Inventory (NPI-12) was assessed in 300 CG-CR dyads. Caregivers reported current relationship closeness using the Whitlatch Relationship Closeness Scale. Linear mixed models examined associations between CG-CR closeness and NPI-12 total score or selected symptom domains over time (observation period: 2002–2012). Results: In unadjusted linear mixed models, higher closeness scores were associated with a five-point lower NPI-12 score and a one-point lesser increase in NPI-12 per year. NPI scores also showed lower affective cluster scores (two points) and lesser increase in psychosis cluster (approximately 0.5 points per year) and agitation/aggression (0.16 points per year) for each unit increase in closeness. When controlling for NPI caregiver distress, associations between closeness and NPSs diminished to a 0.5-point lesser increase in total NPI-12 score per year. Adjusted models for NPI domains/clusters showed −0.32 points per year for the psychosis cluster, −0.11 points per year for agitation/aggression, and −0.67 overall for the affective cluster. Conclusion: Higher CG-CR closeness, a potentially modifiable factor, is associated with lower NPS severity and may provide a target for intervention.

Original languageEnglish (US)
JournalAmerican Journal of Geriatric Psychiatry
DOIs
StateAccepted/In press - Jan 1 2019

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Caregivers
Dementia
Aggression
Psychotic Disorders
Linear Models
Aptitude
Activities of Daily Living
Patient Care
Observation
Costs and Cost Analysis
Equipment and Supplies
Population

Keywords

  • Alzheimer disease
  • caregiver and care recipient
  • Dementia
  • neuropsychiatric symptoms
  • relationship closeness

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Psychiatry and Mental health

Cite this

Vernon, E. K., Cooley, B., Rozum, W., Rattinger, G. B., Behrens, S., Matyi, J., ... Tschanz, J. A. T. (Accepted/In press). Caregiver-Care Recipient Relationship Closeness is Associated With Neuropsychiatric Symptoms in Dementia. American Journal of Geriatric Psychiatry. https://doi.org/10.1016/j.jagp.2018.11.010

Caregiver-Care Recipient Relationship Closeness is Associated With Neuropsychiatric Symptoms in Dementia. / Vernon, Elizabeth K.; Cooley, Bryce; Rozum, William; Rattinger, Gail B.; Behrens, Stephanie; Matyi, Joshua; Fauth, Elizabeth; Lyketsos, Constantine G; Tschanz, Jo Ann T.

In: American Journal of Geriatric Psychiatry, 01.01.2019.

Research output: Contribution to journalArticle

Vernon, Elizabeth K. ; Cooley, Bryce ; Rozum, William ; Rattinger, Gail B. ; Behrens, Stephanie ; Matyi, Joshua ; Fauth, Elizabeth ; Lyketsos, Constantine G ; Tschanz, Jo Ann T. / Caregiver-Care Recipient Relationship Closeness is Associated With Neuropsychiatric Symptoms in Dementia. In: American Journal of Geriatric Psychiatry. 2019.
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AU - Behrens, Stephanie

AU - Matyi, Joshua

AU - Fauth, Elizabeth

AU - Lyketsos, Constantine G

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