Hostname: page-component-848d4c4894-m9kch Total loading time: 0 Render date: 2024-05-08T06:04:42.727Z Has data issue: false hasContentIssue false

Comparing the neuropsychiatric inventory and the revised memory and behavior problems checklist for associations with caregiver burden and depressive symptoms

Published online by Cambridge University Press:  15 January 2014

Mark A. Jackson*
Affiliation:
Department of Family, Consumer, and Human Development, Utah State University, Logan, Utah, USA
Elizabeth B. Fauth
Affiliation:
Department of Family, Consumer, and Human Development, Utah State University, Logan, Utah, USA
Christian Geiser
Affiliation:
Department of Psychology, Utah State University, Logan, Utah, USA
*
Correspondence should be addressed to: Mark A. Jackson, Doctoral Candidate, Utah State University, 238 N 400 E Apt. BSMT, Logan, UT 84321, USA. Phone: +1-435-512-9777. Email: mark.jackson@aggiemail.usu.edu.

Abstract

Background:

Few empirical studies compare the ability of prominent measures of behavioral and psychological symptoms of dementia (BPSD) to explain key caregiver outcomes. We compared the respective abilities of the Neuropsychiatric Inventory (NPI) and the Revised Memory and Behavior Problems Checklist (RMBPC) to detect associations between BPSD and caregiver depressive symptoms. Our results may facilitate measurement decisions for researchers and clinicians.

Methods:

The NPI and the RMBPC, which measure BPSD frequency and corresponding caregiver appraisals, were administered to 164 caregivers of persons with dementia to compare the measures’ ability to explain caregiver depressive symptoms. Depressive symptoms were measured using the Geriatric Depression Scale (GDS), and caregiver burden was measured (using the Zarit Burden Interview) as a mediator between BPSD frequency/appraisal and caregiver depressive symptoms. Path analysis using Mplus facilitated the comparison between the RMBPC and the NPI.

Results:

Significant indirect associations were present when NPI frequency, NPI appraisal, RMBPC frequency, and RMBPC appraisal were modeled separately with burden and depressive symptoms, although indirect relationships are not associated with increases in R2. Only RMBPC appraisal produced both a significant direct association with depressive symptoms and a significant increase in R2 when modeled separately (β = 0.24, p < 0.01; ΔR2 = 0.04, p < 0.05). When all independent variables were modeled together, only RMBPC appraisal demonstrated significant direct (β = 0.23, p < 0.01) and indirect associations.

Conclusion:

The RMBPC might be more suitable than the NPI in studies measuring BPSD to explain key caregiver outcomes such as depressive symptoms.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2014 

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

Aiken, L. S. and West, S. G. (1991). Multiple Regression: Testing and Interpreting Interactions. Newbury Park, CA: Sage.Google Scholar
Bachner, Y. G. and O'Rourke, N. (2007). Reliability generalization of responses by care providers to the Zarit Burden Interview. Aging and Mental Health, 11, 678685. doi:10.1080/13607860701529965.Google Scholar
Ballard, C., Lowery, K., Powell, I., O'Brien, J. and James, I. (2000). Impact of behavioral and psychological symptoms of dementia on caregivers. International Psychogeriatrics, 12, 93105. doi:10.1017/S1041610200006840.Google Scholar
Bentler, P. M. (1990). Comparative fit indexes in structural models. Psychological Bulletin, 107, 238246. doi:10.1037//0033-2909.107.2.238.Google Scholar
Cameron, J. I., Cheung, A. M., Streiner, D. L., Coyte, P. C., Singh, M. D. and Stewart, D. E. (2008). Factor structure and reliability of the Brain Impairment Behavior Scale. Journal of Neuroscience Nursing, 40, 4047. doi:10.1097/01376517-200802000-00007.Google Scholar
Clyburn, L. D., Stones, M. J., Hadjistavropoulos, T. and Tuokko, H. (2000). Predicting caregiver burden and depression in Alzheimer's disease. Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, 55, 213. doi:10.1093/geronb/55.1.S2.Google Scholar
Cummings, J. L. (1997). The Neuropsychiatric Inventory: assessing psychopathology in dementia patients. Neurology, 48(5, Suppl. 6), 10S16S. doi:10.1212/WNL.48.5_Suppl_6.10S.Google Scholar
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, 2308–2308. doi:10.1212/WNL.44.12.2308.CrossRefGoogle ScholarPubMed
De Jonghe, J. F., Kat, M. G., Kalisvaart, C. J. and Boelaarts, L. (2003). Neuropsychiatric Inventory Questionnaire (NPI-Q): a validity study of the Dutch form. Tijdschrift voor Gerontologie en Geriatrie, 34, 7477.Google Scholar
Draper, B., Brodaty, H., Low, L. F., Richards, V., Paton, H. and Lie, D. (2002). Self‐destructive behaviors in nursing home residents. Journal of the American Geriatrics Society, 50, 354358. doi:10.1046/j.1532-5415.2002.50070.x.Google Scholar
Family Caregiver Alliance. (2012). Fact sheet: Selected Caregiver Statistics. San Francisco, CA: Family Caregiver Alliance.Google Scholar
Harvey, P. D. et al. (2005). The validation of a caregiver assessment of dementia: the Dementia Severity Scale. Alzheimer Disease and Associated Disorders, 19, 186194. doi:10.1097/01.wad.0000189034.43203.60.Google Scholar
Jeglic, E. L., Pepper, C. M., Ryabchenko, K. A., Griffith, J. W., Miller, A. B. and Johnson, M. D. (2005). A caregiving model of coping with a partner's depression. Family Relations, 54, 3745. doi:10.1111/j.0197-6664.2005.00004.x.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, 210215.Google Scholar
Lazarus, R. S. and Folkman, S. (1984). Stress, Appraisal, and Coping. New York, NY: Springer.Google Scholar
McCurry, S. M., Vitiello, M. V., Gibbons, L. E., Logsdon, R. G. and Teri, L. (2006). Factors associated with caregiver reports of sleep disturbances in persons with dementia. American Journal of Geriatric Psychiatry, 14, 112120. doi:10.1097/01.JGP.0000192499.25940.da.Google Scholar
Muthén, L. K. and Muthén, B. O. (2010). Mplus User's Guide. Los Angeles, CA: Muthén and Muthén.Google Scholar
Ostwald, S. K., Hepburn, K. W., Caron, W., Burns, T. and Mantell, R. (1999). Reducing caregiver burden: a randomized psychoeducational intervention for caregivers of persons with dementia. Gerontologist, 39, 299309. doi:10.1093 /geront/39.3.299.CrossRefGoogle ScholarPubMed
Paukert, A. L. et al. (2010). Peaceful Mind: an open trial of cognitive-behavioral therapy for anxiety in persons with dementia. International Psychogeriatrics, 22, 10121021. doi:10.1017/S1041610210000694.Google Scholar
Pearlin, L. I., Menaghan, E. G., Lieberman, M. A. and Mullan, J. T. (1981). The stress process. Journal of Health and Social Behavior, 22, 337356. doi:10.2307/2136676.Google Scholar
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, 583594. doi:10.1093/geront/30.5.583.Google Scholar
Preschl, B., Wagner, B., Forstmeier, S. and Maercker, A. (2011). E-health interventions for depression, anxiety disorder, dementia, and other disorders in old age: a review. Journal of Cybertherapy and Rehabilitation, 4, 371385.Google Scholar
Pruchno, R. A. and Resch, N. L. (1989). Aberrant behaviors and Alzheimer's disease: mental health effects on spouse caregivers. Journal of Gerontology, 44, S177182. doi:10.1093/geronj/44.5.S177.Google Scholar
Robert, P., Ferris, S., Gauthier, S., Ihl, R., Winblad, B. and Tennigkeit, F. (2010). Review of Alzheimer's disease scales: is there a need for a new multi-domain scale for therapy evaluation in medical practice? Alzheimer's Research and Therapy, 2, 2436. doi:10.1186/alzrt48.CrossRefGoogle Scholar
Teri, L., Huda, P., Gibbons, L., Young, H. and van Leynseele, J. (2005). STAR: a dementia-specific training program for staff in assisted living. Gerontologist, 45, 686693. doi:10.1093/geront/45.5.686.Google Scholar
Teri, L., Truax, P., Logsdon, R., Uomoto, J., Zarit, S. and Vitaliano, P. P. (1992). Assessment of behavioral problems in dementia: the revised memory and behavior problems checklist. Psychology and Aging, 7, 622631. doi:10.1037/0882-7974.7.4.622.Google Scholar
World Health Organization. (2012). Dementia: A Public Health Priority. Geneva, Switzerland: World Health Organization.Google Scholar
Yesavage, J. A., Brink, T. L., Rose, T. L., Lum, O., Huang, V., Adey, M. and Leirer, V. O. (1983). Development and validation of a geriatric depression screening scale: a preliminary report. Journal of Psychiatric Research, 17, 3749. doi:10.1093/geronb/54B.1.P12.Google Scholar
Zarit, S. H., Reever, K. E. and Bach-Peterson, J. (1980). Relatives of the impaired elderly: correlates of feelings of burden. Gerontologist, 20, 649655. doi:10.1093/geront/20.6.649.Google Scholar