Examining the association between neuropsychiatric symptoms among people with dementia and caregiver mental health: are caregiver burden and affiliate stigma mediators?

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Chen, Y-J, Su, J-A, Chen, J-S, Liu, C-h, Griffiths, MD ORCID: https://orcid.org/0000-0001-8880-6524, Tsai, H-C, Chang, C-C and Lin, C-Y, 2023. Examining the association between neuropsychiatric symptoms among people with dementia and caregiver mental health: are caregiver burden and affiliate stigma mediators? BMC Geriatrics, 23 (1): 27. ISSN 1471-2318

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Official URL: https://doi.org/10.1186/s12877-023-03735-2

Abstract

Background: Neuropsychiatric disturbances are common manifestations of dementia disorders and are associated with caregiver burden and affiliate stigma. The present study investigated affiliate stigma and caregiver burden as mediators for the association between neuropsychiatric symptoms of people with dementia (PWD) and caregiver mental health such as depression and anxiety.

Methods: A cross-sectional survey study was carried out with 261 dyads of PWD and informal caregivers from the outpatient department of a general hospital in Taiwan. The survey included the Caregiver Burden Inventory (CBI), the Affiliate Stigma Scale (ASS), the Taiwanese Depression Questionnaire (TPQ), and the Beck Anxiety Inventory (BAI). Mediation models were tested using the Hayes’ PROCESS macro (Model 4 for parallel mediation model; Model 6 for sequentially mediation model).

Results: Caregiver burden, affiliate stigma, caregiver depression, and caregiver anxiety were significantly associated with neuropsychiatric symptoms. After controlling for several potentially confounding variables, it was found that PWD’s neuropsychiatric symptoms, caregiver burden and affiliate stigma significantly explained 52.34% of the variance in caregiver depression and 37.72% of the variance in caregiver anxiety. The parallel mediation model indicated a significantly indirect path from PWD’s neuropsychiatric symptoms to caregiver mental health through caregiver burden and affiliate stigma, while the direct effect was not significant. Moreover, there was a directional association between caregiver burden and affiliate stigma in the sequential mediation model.

Conclusions: These findings show that it is imperative to improve caregivers’ perception of those with dementia to reduce internalized stigma and to improve caregivers’ mental health. Implementation of affiliate stigma assessment in clinical practice would allow distinctions to be made between the impact of affiliate stigma and the consequences of caregiver burden to help inform appropriate intervention.

Item Type:	Journal article
Publication Title:	BMC Geriatrics
Creators:	Chen, Y.-J., Su, J.-A., Chen, J.-S., Liu, C.-H., Griffiths, M.D., Tsai, H.-C., Chang, C.-C. and Lin, C.-Y.
Publisher:	Springer Science and Business Media LLC
Date:	16 January 2023
Volume:	23
Number:	1
ISSN:	1471-2318
Identifiers:	Number Type 10.1186/s12877-023-03735-2 DOI 1637969 Other
Rights:	© The Author(s) 2023. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
Divisions:	Schools > School of Social Sciences
Record created by:	Laura Ward
Date Added:	23 Jan 2023 11:30
Last Modified:	23 Jan 2023 11:30
URI:	https://irep.ntu.ac.uk/id/eprint/48037