INFLUENCE OF FEELINGS OF BURDEN ON THE CAREGIVERS PERCEPTION OF THE PATIENTS FUNCTIONAL STATUS

We studied the correlation between the caregiver's feelings of burden and the cognitive, behavioral and functional impairment of demented pa tients. We attempted to show the influence of caregiver's feelings of burden on their perception of the patients' functional status and to e stablish the predictors of feelings of burden. Twenty-five probable Al zheimer disease patients (NINCDS-ADRDA criteria) were assessed on cogn itive measures and functional status (DAFS). The caregiver's index of burden (CIB), obtained from an adapted version of the Zarit Burden Int erview, was correlated with the caregiver's report on the patient's in strumental activities of daily living (IADL) and physical self-mainten ance functions (ADL); total and partial DAFS scores, and patient's cog nitive and behavioral problems rated with the Functional Dementia Scal e (FDS). The CIB correlated with the caregiver's report on the patient 's behavioral disturbances (r = 0.71, p < 0.001) and physical self-mai ntenance activities (r = 0.62, p < 0.001), but not with cognitive impa irment, IADL and the DAFS. The patients showed better functional perfo rmance in the direct assessment than in that reported by their caregiv ers (mainly in shopping, feeding, dressing, and ambulation). Thus, bur den may foster a growing intolerance of the caregiver, inducing an und erestimation of the patient's actual functional competence. The caregi ver's report on the patient's behavioral problems was the best predict or of feelings of burden (F = 19,9, p < 0.001). We emphasized the util ity of the DAFS for a more objective assessment of functional status, treatment of the patient's behavioral problems to lessen the caregiver 's feeling of burden, and the assessment and control of the caregiver' s burden to highlight the need for medical assistance or support group s.