Activities of daily living function and neuropsychiatric symptoms of people with dementia and caregiver burden: The mediating role of caregiving hours

Objective: Due to the presence of neuropsychiatric behaviors and the decreased ability for activities of daily living (ADLs), family caregivers experience high burden levels in caring for people with dementia (PWD). This study sought to test the mediating role of caregiving hours in association with PWDs' ability for basic activities of daily living (BADL) function or neuropsychiatric behaviors and caregiver burden. Methods: This study used two waves of survey data, collected between 2013 and 2016, from 186 PWD-caregiver dyads in a dementia clinic at a teaching hospital in southern Taiwan. Two sets of multiple linear regression models were used to analyze the relationships between the changes in patients' BADL function, patients' neuropsychiatric behaviors, caregiving hours in ADL (including BADL and Instrumental ADL), and caregiver burden (measured using Zarit Burden Interview). Bootstrapping methods were used to detect the mediating effects of caregiving hours in ADL if the 95% confidence interval (CI) did not cover 0. Results: Caregiving hours in BADL mediated the relationship of PWDs' BADL function and caregiver burden (effect = -0.0137, 95% bootstrap CI = -0.0379, -0.0003). However, such mediating effects were not found in the relationship of PWDs' neuropsychiatric behaviors and caregiver burden. Conclusions: In order to relieve caregiver burden, respite care services for caregivers for PWD should target services that assist with PWD's BADL.