Caregiver burden in mild cognitive impairment due to Alzheimer's disease-a longitudinal study

Caregivers of people with mild forms of cognitive decline, namely mild cognitive impairment (MCI), are subjected to caregiver burden. In recent years, a major breakthrough was the possibility of diagnosing Alzheimer's disease (AD) reliably in patients that present with MCI, as required for the use of the recently approved anti-amyloid therapies. We aimed to examine the caregiver burden in caregivers of patients with MCI due to AD, describe how caregiver burden evolves with time, and determine caregiver baseline factors that might predict the progression of burden.

Twenty-five dyads of community-dwelling patients and caregivers were consecutively recruited from a memory outpatient clinic, after receiving the diagnosis of MCI due to AD. Caregiver burden was measured with the Zarit Burden Inventory (ZBI), life satisfaction with Satisfaction With Life Scale, depressive symptoms with the Centre for Epidemiological Studies-Depression Scale (CES-D), anxiety symptoms with the State Anxiety Subscale of the State-Trait Anxiety Inventory (STAI) and patient neuropsychiatric symptoms with the Neuropsychiatric Inventory (NPI).

At baseline, the mean ZBI score was 24.5 ± 15.2 and correlated positively with caregiver CES-D and STAI scores and with patient neuropsychiatric symptoms (NPI-frequency × severity) and distress felt by the caregiver (NPI-distress). At follow-up (17.7 ± 9.4 months) the mean ZBI score increased to 31.4 ± 16.3 (P < 0.001); however, no baseline caregiver or patient characteristics were identified associated with the evolution of caregiver burden.

Caregivers of patients who received a diagnosis of MCI due to AD report substantial burden, that increased with time. Future studies should investigate caregiver characteristics that may predict burden progression and help delineate strategies to minimise it.