Vascular dementia versus dementia of Alzheimer's type: Do they have differential effects on caregivers' burden?

Objectives. We investigated homecare patients with dementia of Alzheimer's type (DAT; n = 36) or vascular dementia (VD; n = 36) and their care-providi ng relatives regarding clinical and psychosocial Variables to determine whe ther DAT and VD impose different burdens on caregivers. Method All patients were diagnosed according to ICD-10 criteria. The diagno ses were confirmed by internal medical, clinical-neurological, and psychiat ric parameters. The severity of the dementias was graded according to the G lobal Deterioration Scale (GDS). Caregiving relatives responded to the Beha vioral Pathology in Alzheimer's Disease Rating Scale (BAD), the Blessed Dem entia Scale (BDS), and the Screen for Caregiver Burden (SCB). Results. Analyses revealed that caregivers' burden (SCB), disease symptoms and personality changes of patients (BAD), and the patients' inability to c ope with everyday tasks (BDS) were sharply higher for DAT than for VD patie nts in the group with severe dementia. Concerning patients with mild or mod erately severe disease, scores in the DAT group were similar or lower than those in the VD group. Conclusion. In early stages, VD patients impose a greater burden on relativ es than do patients with DAT. In severe stages this relationship undergoes a reversal, with relatives of DAT patients experiencing the burden more adv ersely than those of VD patients. The differences in the onset and course c haracteristics, as well as the specific differences between these two types of dementia with respect to caregiver burden factors, call for their diagn ostic separation and the development of specific homecare support systems f or family caregivers.