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.