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. 2022;89(3):993-1002.
doi: 10.3233/JAD-215648.

Sex, Neuropsychiatric Profiles, and Caregiver Burden in Alzheimer's Disease Dementia: A Latent Class Analysis

Maitée Rosende-Roca  1 , Pilar Cañabate  1 , Mariola Moreno  1 , Silvia Preckler  1 , Susana Seguer  1 , Ester Esteban  1 , Juan Pablo Tartari  1 , Liliana Vargas  1 , Leire Narvaiza  1 , Vanesa Pytel  1 , Urszula Bojaryn  1 , Emilio Alarcon  1 , Antonio González-Pérez  1 , Miren Jone Gurruchaga  1 , Lluís Tárraga  1   2 , Agustín Ruiz  1   2 , Marta Marquié  1   2 , Mercè Boada  1   2 , Sergi Valero  1   2
Affiliations

Sex, Neuropsychiatric Profiles, and Caregiver Burden in Alzheimer's Disease Dementia: A Latent Class Analysis

Maitée Rosende-Roca et al. J Alzheimers Dis. 2022.

Abstract

Background: Neuropsychiatric symptoms (NPS) in Alzheimer's disease (AD) can be disruptive for patients and their families.

Objective: We aimed to classify patients based on NPS and to explore the relationship of these classes with sex and with caregiver burden.

Methods: The study cohort comprised individuals with AD dementia diagnosed at Ace Alzheimer Center in Barcelona, Spain, between 2011-2020. NPS were ascertained by using the Neuropsychiatric Inventory-Questionnaire. Latent class analysis was used to identify clusters of individuals sharing a similar NPS profile. We evaluated the caregiver burden using the Zarit Burden Interview. Multivariable regression models were used to obtain adjusted estimates of the association between sex, NPS classes, and caregiver burden.

Results: A total of 1,065 patients with AD dementia and their primary caregivers were included. We classified patients into five different classes according to their NPS profile: "Affective", "High-behavioral-disturbance", "Negative-affect", "Affective/deliriant", and "Apathy". We found that age, sex, and type of AD diagnosis differed greatly across classes. We found that patients from the "High-behavioral-disturbance" (OR = 2.56, 95% CI: 1.00-6.56), "Negative-affect" (OR = 2.72, 95% CI: 1.26-3.64), and "Affective/deliriant" (OR = 2.14, 95% CI: 1.26-3.64) classes were over two times more likely to have a female caregiver than those in "Apathy" class. These three classes were also the ones associated to the greatest caregiver burden in the adjusted analyses, which seems to explain the increased burden observed among female caregivers.

Conclusion: Caregiver burden is highly dependent on the patient's NPS profiles. Female caregivers provide care to patients that pose a greater burden, which makes them more susceptible to become overwhelmed.

Keywords: Alzheimer’s disease; caregiver burden; gender; neurobehavioral manifestations; sex; women.

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Conflict of interest statement

Authors’ disclosures available online (https://www.j-alz.com/manuscript-disclosures/21-5648r4).

Figures

Fig. 1
Fig. 1
Profile plots represent estimated conditional probabilities (y-axis) observed in the latent class analysis (LCA) for the domains of the Neuropsychiatric Inventory-Questionnaire (NPI-Q; x-axis), displaying the 5-class solution.
See this image and copyright information in PMC

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