Determinants of burden among family caregivers of persons with dementia: Observational study using multiple monitoring methods

Abstract

Background: Supporting persons with dementia and their caregivers is a global public health priority. However, current research typically relies on subjective caregiver reports, lacking the integration of objective physiological indicators. Objective: To identify the determinants of caregiver burden among family caregivers of persons with dementia, guided by a biopsychosocial framework. Methods: Seventy-five dyads of persons with dementia and their caregivers participated in this study. The determinants of caregiver burden, including biological, psychological, and social factors, were assessed using sweat patches, actigraphy, and surveys, and analyzed using hierarchical multiple regression analysis. Results: The mean caregiver burden score was 42.32. Hierarchical multiple regression analysis showed that psychological factors explained 39.3% of the variance in caregiver burden. A 17.5% increase was observed by the addition of biological factors, accounting for 56.8% of the variance. Among the biological factors, high level of pro-inflammatory cytokine tumor necrosis factor-alpha in persons with dementia was significantly associated with increased caregiver burden. In contrast, long total sleep time was associated with decreased caregiver burden. Amidst psychological factors, not only increased depressive symptoms but also severe behavioral and psychological symptoms of dementia in individuals with dementia were significantly associated with increased caregiver burden. Conclusions: These findings highlight the importance of tailored interventions that address both biological and psychological factors to reduce caregiver burden and improve care outcomes. Additionally, by alleviating caregiver burden, these interventions may also support ageing-in-place, allowing persons with dementia to remain in familiar environments within their communities.