The impact of social support on caregiver burden in dementia

Abstract

Objectives: As the prevalence of dementia increases rapidly, care burden of dementia has been main issue in the global society. There have been variable psychosocial interventions for reduction of caregiver burden, the systematic research about determinants of care burden or mechanism of social intervention has not been accomplished yet. We aimed to establish evidences for designing effective psychosocial intervention for dementia care burden by classifying care burden into psychological and non-psychological burden and indentifying specific type of social supports influencing each burden and mechanism of each support.

Methods: We evaluated 731 community-dwelling dementia patients by comprehensive diagnostic protocol and caregiver burden of their caregivers from the National Survey of Dementia Care (NaSDeC). We used the center for epidemiologic studies depression scale-short form (CES-D10) as a measure of psychological burden. We developed the measure of non-psychological burden by factor analysis of Zarit burden inventory-short form. (np-ZBI-s) To identify specific type of social supports influencing on each burden, we employed stepwise multiple regression analysis. Then, we estimated the maximum effect of each support on reducing care burden by assuming that full range of social support was applied to the caregivers. To explore the mechanism of specific type of social support on each burden, the direct and indirect effect of social support were obtained using path analysis.

Results: Among the types of social supports, positive social interaction and affectionate support reduced psychological burden via direct and indirect paths. Tangible support reduced the non-psychological burden via direct and indirect paths. About maximum 20% of psychological burden could be changed by positive social interaction, 10.3% by affectionate support. Tangible support brought maximal change of the non-psychological burden by 15.1%.

Conclusion: In order to reduce caregiver burden in dementia effectively, the tailored intervention to specific domain of care burden would improve the burden effectively.