Neuropsychiatric symptoms in Latino elders with dementia or cognitive impairment without dementia and factors that modify their association with caregiver depression

Purpose: The purpose of this study was to determine neuropsychiatric symptom frequency and intensity in demented and cognitively impaired but not demented Latino elderly persons, evaluate whether overall neuropsychiatric symptom intensity is associated with higher levels of caregiver depression, and identify factors that modify the relationship between neuropsychiatric symptoms and caregiver depression. Design and Methods: Ninety-five elderly Latinos with dementia or cognitive impairment but not dementia (CIND), all of whom were identified through an ongoing epidemiological cohort study, and their informal caregivers participated in the study. Caregivers were interviewed in their homes, in either Spanish or English. The Neuropsychiatric Inventory was used to assess neuropsychiatric disturbances. Results: For most neuropsychiatric symptoms, prevalence and intensity were significantly higher in the demented group compared with the CIND group. The overall neuropsychiatric symptom intensity score was significantly associated with caregiver depression. The strength and direction of the association of neuropsychiatric symptoms with caregiver depression was found to vary by three factors: whether the caregiver was the care recipient's spouse, whether the care recipient had dementia or CIND, and the care recipient's age. Implications: Neuropsychiatric symptoms may play a significant role in caregiver depression among Latino families. However, the impact of neuropsychiatric disturbances on Latino caregivers may differ depending on characteristics of both the caregiver and care recipient. The adverse impact of neuropsychiatric symptoms on caregivers of elderly persons with CIND has not been previously reported and deserves further study.