The contribution of caregiver psychosocial factors to distress associated with behavioural and psychological symptoms in dementia

Int J Geriatr Psychiatry. 2017 Jan;32(1):76-85. doi: 10.1002/gps.4447. Epub 2016 Feb 18.


Objective: The objective of the study is to examine caregiver factors as predictors of BPSD-related distress and their potential mechanisms.

Method: Informal caregivers of people with dementia (n = 157) recruited from 28 community mental health teams in six NHS Trusts across England completed questionnaires regarding psychosocial factors (relationship quality, competence, guilt, health-related quality of life in the caregiver and person with dementia, reactivity to behavioural and psychological symptoms in dementia [BPSD] and burden) and frequency of BPSD. Analyses of BPSD-related distress include hierarchical multiple regression, mediation, moderation and path analysis.

Results: Caregiver psychosocial factors explained 56% of the variance in BPSD-related distress. After controlling for these factors, frequency of BPSD was not a significant predictor of BPSD-related distress. Caregiver reactivity to BPSD, burden, competence and relationship quality directly influenced BPSD-related distress. Guilt influenced distress indirectly via competence, burden and reactivity to BPSD. The final model accounted for 41% of the variance in BPSD-related distress and achieved a good fit to the data (χ2 = 23.920, df = 19, p = 0.199).

Conclusions: Caregiver psychosocial factors including sense of competence, guilt, burden and reactivity to BPSD contribute to BPSD-related distress. Tailored interventions for managing behaviour problems in family settings could focus on these factors associated with BPSD-related distress to minimise distress in families. Copyright © 2016 John Wiley & Sons, Ltd.

Keywords: behavioural symptoms; caregivers; dementia; path analysis; psychological stress; psychosocial factors; regression analysis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Behavioral Symptoms / psychology*
  • Caregivers / psychology*
  • Caregivers / standards*
  • Clinical Competence
  • Dementia / psychology*
  • England
  • Female
  • Guilt
  • Humans
  • Male
  • Middle Aged
  • Quality of Life
  • Stress, Psychological*
  • Surveys and Questionnaires
  • Workload