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. 2020;77(3):1107-1115.
doi: 10.3233/JAD-200647.

The Trajectory of Caregiver Burden and Risk Factors in Dementia Progression: A Systematic Review

Affiliations

The Trajectory of Caregiver Burden and Risk Factors in Dementia Progression: A Systematic Review

Robin van den Kieboom et al. J Alzheimers Dis. 2020.

Abstract

Background: Caring for patients with dementia at home is often a long-term process, in which the independence of the patient declines, and more responsibility and supervision time is required from the informal caregiver.

Objective: In order to minimize and reduce caregiver burden, it is important to explore its trajectory and the accompanying risk factors as dementia progresses; the objective of this systematic review.

Methods: PRISMA guidelines were followed in this systematic review. Three databases, PubMed, PsycINFO, and EMbase, were systematically searched in November 2019 using specific keywords.

Results: 1,506 hits emerged during the systematic search but only eleven articles actually met the inclusion criteria for this review. The trajectory of caregiver burden is highly variable and depends on multiple factors. Important risk factors included: patients' behavioral and neuropsychiatric symptoms, and their decline in functioning in (I)ADL; the caregiver's age, gender, and physical and mental health; and, within the dyads (patient/caregiver), cohabitation and kinship.

Conclusion: There is no one-size-fits-all for predicting how caregiver burden will change over time, but specific factors (like being a spouse and increased behavioral impairment and decline in functional status in the patient) may heighten the risk. Other factors, not yet comprehensively included in the published studies, might also prove to be important risk factors. Future research in the field of reducing caregiver burden is recommended to integrate the patient, caregiver, and context characteristics in the trajectory of caregiver burden, and to assess more clearly the phase of the dementia progression and use of external resources.

Keywords: Caregiver burden; dementia; informal caregiver; longitudinal study; progression; systematic review.

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Conflict of interest statement

Authors’ disclosures available online (https://www.j-alz.com/manuscript-disclosures/20-0647r1).

Figures

Fig. 1
Fig. 1
Search and analysis strategy.

References

    1. Patterson C (2018) World Alzheimer Report 2018. The state of the art of dementia research: New frontiers. Alzheimer’s Disease International, London.
    1. Etters L, Goodall D, Harrinson BE (2008) Caregiver burden among dementia patient caregivers: A review of the literature, J Am Acad Nurse Pract 20, 423–428. - PubMed
    1. Lim J, Griva K, Goh J, Chionh H, Yap P (2011) Coping strategies influence caregiver outcome among Asian family caregivers of persons with dementia in Singapore, Alzheimer Dis Assoc Disord 21, 34–41. - PubMed
    1. Zarit S, Todd P, Zarit J (1986) Subjective burden of husband and wives as caregivers: A longitudinal study, Gerontol Soc Am 26, 260–266. - PubMed
    1. Van der Lee J, Bakker T, Duivenvoorden H, Dröes R (2014) Multivariate models of subjective caregiver burden in dementia: A systematic review, Ageing Res Rev 15, 76–93. - PubMed

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