TY - JOUR
T1 - Caregiver-Care Recipient Relationship Closeness is Associated With Neuropsychiatric Symptoms in Dementia
AU - Vernon, Elizabeth K.
AU - Cooley, Bryce
AU - Rozum, William
AU - Rattinger, Gail B.
AU - Behrens, Stephanie
AU - Matyi, Joshua
AU - Fauth, Elizabeth
AU - Lyketsos, Constantine G.
AU - Tschanz, Jo Ann T.
N1 - Funding Information:
This study was supported by National Institute on Aging grants R01AG21136, R01AG11380, and P50AG005146 to the Johns Hopkins Alzheimer's Disease Research Center. The authors are grateful to the investigators of the Cache County Study on Memory in Aging and the participants and caregivers of the Dementia Progression Study.
Publisher Copyright:
© 2018 American Association for Geriatric Psychiatry
PY - 2019/4
Y1 - 2019/4
N2 - 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.
AB - 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.
KW - Alzheimer disease
KW - Dementia
KW - caregiver and care recipient
KW - neuropsychiatric symptoms
KW - relationship closeness
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U2 - 10.1016/j.jagp.2018.11.010
DO - 10.1016/j.jagp.2018.11.010
M3 - Article
C2 - 30616905
AN - SCOPUS:85059067357
VL - 27
SP - 349
EP - 359
JO - American Journal of Geriatric Psychiatry
JF - American Journal of Geriatric Psychiatry
SN - 1064-7481
IS - 4
ER -