In September 2019 researchers from Turkey and Italy published their review of the medical scientific literature to assess the potential influence of symptoms experienced by individuals with Alzheimer’s disease on caregiver stress and vice versa. The researchers stated that individuals with Alzheimer’s disease usually need high levels of care in all activities of daily living, most of them provided by family members, friends, or informal carers. As these carers have to cope with both age-related conditions and dementia-related factors, it is therefore more difficult and stressful looking after individuals with Alzheimer’s disease than it is looking after older adults affected by other conditions. It appears that neuropsychiatric symptoms, such as anxiety, agitation, disinhibition, aggressive behavior, and sleep disturbances increase the caregivers feeling of burden, and are also associated with a decline in their own general health, quality of life, and social isolation. This feeling of burden also worsens the relationship between the carer and individual with Alzheimer’s disease which in turn may increase the frequency and severity of the neuropsychiatric symptoms. Predictors of an increase in the feeling of burden appear to be being a woman, a spouse, an older individual with immature coping mechanisms, social isolation, insufficient knowledge about dementia, a poor relationship with the individual prior to them developing Alzheimer’s, and expressing a high number of negative emotions, eg anger, frustration, guilt, nervousness and fear.
Isik AT et al. Bidirectional Relationship Between Caregiver Burden and Neuropsychiatric Symptoms in Patients With Alzheimer’s Disease: A Narrative Review. Int J Geriatr Psychiatry. 2019 Sep;34(9):1326-1334.