Hostname: page-component-78c5997874-lj6df Total loading time: 0 Render date: 2024-11-11T02:59:39.809Z Has data issue: false hasContentIssue false
  • English
  • Français

Attitudes towards Alzheimer's disease as a risk factor for caregiver burden

Published online by Cambridge University Press:  04 May 2011

L. Zawadzki ,
K. Mondon ,
N. Peru ,
C. Hommet ,
T. Constans ,
Ph. Gaillard  and
V. Camus
L. Zawadzki*
Affiliation:
CHRU de Tours, Tours, France
K. Mondon
Affiliation:
CHRU de Tours, Tours, France
N. Peru
Affiliation:
CHRU de Tours, Tours, France
C. Hommet
Affiliation:
CHRU de Tours, Tours, France Université François Rabelais de Tours, Tours, France UMR INSERM U930 and CNRS FRE2448, Université François Rabelais de Tours, Tours, France
T. Constans
Affiliation:
CHRU de Tours, Tours, France Université François Rabelais de Tours, Tours, France
Ph. Gaillard
Affiliation:
CHRU de Tours, Tours, France Université François Rabelais de Tours, Tours, France
V. Camus
Affiliation:
CHRU de Tours, Tours, France Université François Rabelais de Tours, Tours, France UMR INSERM U930 and CNRS FRE2448, Université François Rabelais de Tours, Tours, France
*
Correspondence should be addressed to: Dr. Luc Zawadzki, Clinique Psychiatrique Universitaire and CMRR, CHRU de Tours, Boulevard Tonnellé, 37044 Tours Cedex 01, France. Phone: + 33 2 3437 8952; Fax + 33 2 4747 9701. Email: l.zawadzki@chu-tours.fr.
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: There is abundant literature on the determinants of caregiver burden in Alzheimer's disease (AD), but little is known about the possible implication of specific patterns of a caregiver's attitudes towards the disease that could increase their risk of – or protect them from – emotional distress and burden. The aim of this study was to test the hypothesis that negative attitudes towards AD are associated with an increased level of burden experienced by caregivers of AD patients.

Methods: Family caregivers of 51 patients with AD were asked to complete a questionnaire regarding their attitudes towards AD. In addition, we assessed the level of their quality of life, anxiety and depression as well as their perceived level of burden. In parallel, we documented the patients’ characteristics: global cognitive efficiency (Mini-Mental State Examination), behavioral and affective symptoms (Neuropsychiatric Inventory) and functional level (Instrumental Activities of Daily Living).

Results: The score of caregiver burden was positively correlated with negative attitudes such as authoritarianism (r = 0.41, p < 0.01) and social restrictiveness (r = 0.49, p < 0.001) as well as emotional reactions of anxiety (r = 0.44, p < 0.01) and aggressiveness (r = 0.47, p < 0.001). In addition, scores of social restrictiveness, rejection and anxiety were significantly higher in women than in men.

Conclusion: These results may have implications in terms of the prevention of caregiver burden. In particular, educational and support programs for caregivers should not be limited to developing their knowledge and skills but should also target attitudes towards the disease.

Keywords

family caregiversdementiaburdenattitudeAlzheimer's disease
Type
Research Article
Information
International Psychogeriatrics , Volume 23 , Issue 9 , November 2011 , pp. 1451 - 1461
Copyright
Copyright © International Psychogeriatric Association 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Abric, J.-C. (2003). Les représentations sociales: aspects théoriques. In Abric, J.-C., Pratiques sociales et représentations (pp. 11–36), Paris: PUF.Google Scholar
Angermeyer, M. C. and Matschinger, H. (1996). The effect of personal experience with mental illness on the attitude towards individuals suffering from mental disorders. Social Psychiatry and Psychiatric Epidemiology, 31, 321–326.CrossRefGoogle ScholarPubMed
Berger, G., Bernhardt, T., Weimer, E., Peters, J., Kratzsch, T. and Frolich, L. (2005). Longitudinal study on the relationship between symptomatology of dementia and levels of subjective burden and depression among family caregivers in memory clinic patients. Journal of Geriatric Psychiatry and Neurolology, 18, 119–128.CrossRefGoogle ScholarPubMed
Black, W. and Almeida, O. P. (2004). A systematic review of the association between the behavioral and psychological symptoms of dementia and burden of care. International Psychogeriatrics, 16, 295–315.CrossRefGoogle ScholarPubMed
Bolognini, M., Bettschart, W., Zehnder-Gubler, M. and Rossier, L. (1989). The validity of the French version of the GHQ-28 and PSYDIS in a community sample of 20 year olds in Switzerland. European Archives of Psychiatry and Neurological Sciences, 238, 161–168.CrossRefGoogle Scholar
Burgener, S. C. and Berger, B. (2008). Measuring perceived stigma in persons with progressive neurological disease. Dementia, 7, 31–53.CrossRefGoogle Scholar
Chou, K. R., LaMontagne, L. L. and Hepworth, J. T. (1999). Burden experienced by caregivers of relatives with dementia in Taiwan. Nursing Research, 48, 206–214.CrossRefGoogle ScholarPubMed
Cocco, E., Gatti, M., de Mendonca Lima, C. A. and Camus, V. (2003). A comparative study of stress and burnout among staff caregivers in nursing homes and acute geriatric wards. International Journal of Geriatric Psychiatry, 18, 78–85.CrossRefGoogle ScholarPubMed
Coen, R. F., Swanwick, G. R., O'Boyle, C. A. and Coakley, D. (1997). Behaviour disturbance and other predictors of carer burden in Alzheimer's disease. International Journal of Geriatric Psychiatry, 12, 331–336.3.0.CO;2-J>CrossRefGoogle ScholarPubMed
Cossette, S., Levesque, L. and Laurin, L. (1995). Informal and formal support for caregivers of a demented relative: do gender and kinship make a difference? Research in Nursing and Health, 18, 437–451.CrossRefGoogle Scholar
Coyne, A. C., Reichman, W. E. and Berbig, L. J. (1993). The relationship between dementia and elder abuse. American Journal of Psychiatry, 150, 643–646.Google ScholarPubMed
Croog, S. H., Sudilovsky, A., Burleson, J. A. and Baume, R. M. (2001). Vulnerability of husband and wife caregivers of Alzheimer disease patients to caregiving stressors. Alzheimer Disease and Associated Disorders, 15, 201–210.CrossRefGoogle ScholarPubMed
Cummings, J. L., Mega, M., Gray, K., Rosenberg-Thompson, S., Carusi, D. A. and Gornbein, J. (1994). The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology, 44, 2308–2314.CrossRefGoogle ScholarPubMed
Donaldson, C. and Burns, A. (1999). Burden of Alzheimer's disease: helping the patient and caregiver. Journal of Geriatric Psychiatry and Neurolology, 12, 21–28.CrossRefGoogle ScholarPubMed
Donaldson, C., Tarrier, N. and Burns, A. (1997). The impact of the symptoms of dementia on caregivers. British Journal of Psychiatry, 170, 62–68.CrossRefGoogle ScholarPubMed
Donaldson, C., Tarrier, N. and Burns, A. (1998). Determinants of carer stress in Alzheimer's disease. International Journal of Geriatric Psychiatry, 13, 248–256.3.0.CO;2-0>CrossRefGoogle ScholarPubMed
Farran, C. J. (1997). Theoretical perspectives concerning positive aspects of caring for elderly persons with dementia: stress/adaptation and existentialism. Gerontologist, 37, 250–256.CrossRefGoogle ScholarPubMed
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.CrossRefGoogle ScholarPubMed
Gallicchio, L., Siddiqi, N., Langenberg, P. and Baumgarten, M. (2002). Gender differences in burden and depression among informal caregivers of demented elders in the community. International Journal of Geriatric Psychiatry, 17, 154–163.CrossRefGoogle ScholarPubMed
Goldberg, D. P. and Hillier, V. F. (1979). A scaled version of the General Health Questionnaire. Psychological Medicine, 9, 139–145.CrossRefGoogle ScholarPubMed
Graham, N. et al. . (2003). Reducing stigma and discrimination against older people with mental disorders: a technical consensus statement. International Journal of Geriatric Psychiatry, 18, 670–678.CrossRefGoogle ScholarPubMed
Heok, K. E. and Li, T. S. (1997). Stress of caregivers of dementia patients in the Singapore Chinese family. International Journal of Geriatric Psychiatry, 12, 466–469.3.0.CO;2-U>CrossRefGoogle ScholarPubMed
Hodgson, P. H., Wood, V. A. and Langton-Hewer, R. (1996). Identification of stroke carers ‛at risk': a preliminary study of the predictors of carers' psychological well-being at one year post stroke. Clinical Rehabilitation, 10, 337–346.CrossRefGoogle Scholar
Israël, L. (1996). Évaluation de l'autonomie, les activités instrumentales de la vie quotidienne (IADL). In Guelfi, J.D. (ed.), L'évaluation clinique standardisée en psychiatrie, vol. 2 (pp. 477–480). Paris: Éd. Méd Pierre Fabre.Google Scholar
Kaufer, D. I. et al. . (1998). Assessing the impact of neuropsychiatric symptoms in Alzheimer's disease: the Neuropsychiatric Inventory Caregiver Distress Scale. Journal of the American Geriatrics Society, 46, 210–215.CrossRefGoogle ScholarPubMed
Lawton, M. P. and Brody, E. M. (1969). Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist, 9, 179–186.CrossRefGoogle ScholarPubMed
McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D. and Stadlan, E. M. (1984). Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology, 34, 939–944.CrossRefGoogle ScholarPubMed
Mui, A. C. (1995). Caring for frail elderly parents: a comparison of adult sons and daughters. Gerontologist, 35, 86–93.CrossRefGoogle ScholarPubMed
Ngatcha-Ribert, L. (2004). [Alzheimer's disease and society: an analysis of its social representation]. Psychologie and Neuropsychiatrie du Vieillissement, 2, 49–66.Google ScholarPubMed
Noonan, A. E. and Tennstedt, S. L. (1997). Meaning in caregiving and its contribution to caregiver well-being. Gerontologist, 37, 785–794.CrossRefGoogle ScholarPubMed
Pearlin, L. I., Mullan, J. T., Semple, S. J. and Skaff, M. M. (1990). Caregiving and the stress process: an overview of concepts and their measures. Gerontologist, 30, 583–594.CrossRefGoogle ScholarPubMed
Purk, J. K. and Richardson, R. A. (1994). Older adult stroke patients and their spousal caregivers. Family and Society, 75, 608–615.CrossRefGoogle Scholar
Sartorius, N. and Schulze, H. (2005). Reducing the Stigma of Mental Illness: A Report from a Global Programme of the World Psychiatric Association. Cambridge: Cambridge University Press.CrossRefGoogle Scholar
Seligman, M. (1975). Helplessness: On Development, Depression and Death. San Francisco: Freeman.Google Scholar
Steeman, E., Abraham, I. and Godderis, J. (1997). Risk profiles for institutionalization in a cohort of elderly people with dementia or depression. Archives of Psychiatric Nursing, 11, 293–303.CrossRefGoogle ScholarPubMed
Taylor, S. M. and Dear, M. J. (1981). Scaling community attitudes toward the mentally ill. Schizophrenia Bulletin, 7, 225–240.CrossRefGoogle ScholarPubMed
Thomas, P. et al. . (2006). Dementia patients' caregivers' quality of life: the PIXEL study. International Journal of Geriatric Psychiatry, 21, 50–56.CrossRefGoogle ScholarPubMed
Werner, P. (2006). Lay perceptions regarding the competence of persons with Alzheimer's disease. International Journal of Geriatric Psychiatry, 21, 674–680.CrossRefGoogle ScholarPubMed
Werner, P. and Davidson, M. (2004). Emotional reactions of lay persons to someone with Alzheimer's disease. International Journal of Geriatric Psychiatry, 19, 391–397.CrossRefGoogle ScholarPubMed
Yaffe, K. et al. . (2002). Patient and caregiver characteristics and nursing home placement in patients with dementia. JAMA, 287, 2090–2097.CrossRefGoogle ScholarPubMed
Zarit, S. H., Orr, N. K. and Zarit, J. M. (1985). Understanding the stress of caregivers: planning an intervention. In Zarit, S.H., Orr, N.K. and Zarit, J.M., The Hidden Victims of Alzheimer's Disease: Families under Stress. New York: New York University Press.Google Scholar