Integrating piecewise multilevel modeling and interactive visualization to examine caregiver burden in Lewy body...

Family caregivers of people with Lewy body dementia (LBD) experience substantial psychological distress. This study examined psychological predictors of caregiver burden and integrated interactive visualization to interpret longitudinal findings.

Secondary data were analyzed from the eight-week, single-arm pre-post Virtual Online Communities for Aging Life Experiences Lewy Body Dementia (VOCALE-LBD) intervention. Thirty-nine family caregivers (mean age = 67.6 years; 69.2% female) completed assessments of burden, self-efficacy, perceived stress, and loneliness at baseline, post-intervention (week 8), and follow-up (week 12). Piecewise multilevel models assessed changes in burden and within- and between-person psychological predictors. An R/Shiny application visualized longitudinal patterns.

Caregiver burden declined significantly during the intervention phase (b = -0.23, p = 0.014), but increased during follow-up (b = 0.52, p = 0.013). Higher average self-efficacy was associated with steeper burden reductions during the intervention (b = -0.37, adjusted p = 0.012). Higher average perceived stress (p < 0.001) and within-person increases in loneliness (p = 0.005) were associated with greater burden. Interactive visualization highlighted longitudinal heterogeneity.

Caregiver burden decreased during intervention but partially rebounded afterward. Self-efficacy, perceived stress and loneliness were associated with burden trajectories. Integrating multilevel modeling with interactive visualization may facilitate interpretation of longitudinal heterogeneity.