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Dement Geriatr Cogn Dis Extra. 2014 Feb 19;4(1):51-64. doi: 10.1159/000358234. eCollection 2014 Jan.

Caregiver Burden in Alzheimer's Disease: Differential Associations in Adult-Child and Spousal Caregivers in the GERAS Observational Study.

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Eli Lilly and Company Limited, Windlesham, UK.
Lilly Italy, Florence, University of Rome 'Sapienza', Rome, Italy.
Karolinska Institute, Stockholm, Sweden.
Agencia Qualitat i Avaluació Sanitaries, Universitat de Barcelona, Barcelona, Spain.
University of Rome 'Sapienza', Rome, Italy.
Philipps University, Marburg, Germany.
Parc Santari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Barcelona, Spain.
RICE (The Research Institute for the Care of Older People), Bath, UK.
Toulouse University Hospital, INSERM 1027, Toulouse, France.



To examine factors influencing the caregiver burden in adult-child and spousal caregivers of community-dwelling patients with Alzheimer's disease (AD).


Baseline data from the 18-month, prospective, observational GERAS study of 1,497 patients with AD in France, Germany, and the UK were used. Analyses were performed on two groups of caregivers: spouses (n = 985) and adult children (n = 405). General linear models estimated patient and caregiver factors associated with subjective caregiver burden assessed using the Zarit Burden Interview.


The caregiver burden increased with AD severity. Adult-child caregivers experienced a higher burden than spousal caregivers despite spending less time caring. Worse patient functional ability and more caregiver distress were independently associated with a greater burden in both adult-child and spousal caregivers. Additional factors were differentially associated with a greater caregiver burden in both groups. In adult-child caregivers these were: living with the patient, patient living in an urban location, and patient with a fall in the past 3 months; in spouses the factors were: caregiver gender (female) and age (younger), and more years of patient education.


The perceived burden differed between adult-child and spousal caregivers, and specific patient and caregiver factors were differentially associated with this burden.


Adult-child caregiver; Alzheimer's disease; Europe; Observational study; Spousal caregiver

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