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Aging Ment Health. 2017 Jun;21(6):651-657. doi: 10.1080/13607863.2016.1146871. Epub 2016 Feb 16.

The effects of behavioral and psychological symptoms on caregiver burden in frontotemporal dementia, Lewy body dementia, and Alzheimer's disease: clinical experience in China.

Liu S1,2, Jin Y2,3, Shi Z1,2, Huo YR4, Guan Y1,2, Liu M2, Liu S1,2, Ji Y1,2.

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a Department of Neurology , Tianjin Huanhu Hospital , Tianjin , China.
b Tianjin Key Laboratory of Cerebral Vascular and Neurodegenerative Diseases , Tianjin Huanhu Hospital , Tianjin , China.
c Department of Nursing Management , Tianjin Huanhu Hospital , Tianjin , China.
d School of Medicine , University of New South Wales , Kensington , NSW , Australia.



Caregivers of individuals with neurodegenerative diseases, including frontotemporal dementia (FTD), Lewy body dementia (DLB), and Alzheimer's disease (AD), experience high levels of psychological and physical stress, likely due to behavioral and psychological symptoms of dementia (BPSD). This study is the first to simultaneously evaluate the effects of BPSD on caregiver burden in these three types of dementia.


A total of 214 dementia patients, including probable FTD (n = 82), DLB (n = 22), and AD (n = 110), as well as their primary caregivers, were assessed using psychological inventories and cognitive evaluation. The FTD group was further divided into the three established clinical variants: behavioral variant frontotemporal dementia (bvFTD, n = 51), non-fluent variant primary progressive aphasia (nfvPPA, n = 15), and semantic variant primary progressive aphasia (svPPA, n = 16). Cognitive impairment and neuropsychiatric symptoms were assessed using the Mini Mental State Examination, Montreal Cognitive Assessment, Clock Drawing Test, and Neuropsychiatric Inventory (NPI), respectively. Caregiver burden was assessed using the Zarit Burden Inventory (ZBI).


FTD patients had higher NPI and ZBI scores than DLB and AD patients, whose scores were similar. Logistic regression analysis revealed that the factors influencing caregiver burden for each group were: FTD: total NPI scores, agitation, and aberrant motor behavior; bvFTD: total NPI scores; DLB: total NPI scores; and AD: total NPI scores, onset age, apathy, and ADL. Caregivers of bvFTD patients had the highest levels of burden, which were significantly greater than for caregivers of nfvPPA, svPPA, DLB, and AD patients.


BPSD was highly correlated with emotional burden in caregivers of FTD, DLB, and AD patients. The highest burden was observed in bvFTD caregivers.


Behavioral and psychological symptoms of dementia (BPSD); China; DLB; FTD; caregiver burden

[Indexed for MEDLINE]

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