Dimensions of Caregiver Burden in Dementia: Impact of Demographic, Mood, and Care Recipient Variables

Objective: While typically examined as a unitary construct, there is evidence that caregiver burden may be composed of several dimensions. The purpose of this study was to examine the factor structure of the Zarit Burden Interview (ZBI) in a sample of dementia caregivers and to explore the relationship between these factors and demographic, mood, and care recipient variables. Design: Cross-sectional. Setting: Academic medical center. Participants: 206 spousal or adult child caregivers for patients with mild to moderate dementia residing in the community. Measurements: Caregiver measures included the ZBI, Center for Epidemiologic Studies Depression Scale, and the Burns Relationship Satisfaction Scale. Patient measures included scores on the Dementia Rating Scale, Lawton-Brody Activities of Daily Living scale, and Revised Memory and Behavior Problems Checklist. Results: Factor analysis revealed three dimensions of caregiver burden: direct impact of caregiving upon caregivers' lives, guilt, and frustration/embarrassment. Caregiver depression and age emerged as unique predictors of the first two factors. Caregivers' satisfaction with their relationship with the patient and patients' functional independence also uniquely predicted the direct impact of caregiving upon caregivers' lives. Patients' behavioral problems and caregivers' level of relationship satisfaction with the care recipient served as unique predictors of frustration/embarrassment. Conclusions: Findings demonstrate the multidimensionality of caregiver burden among dementia caregivers. Given the unique predictors of each dimension of burden, caregivers may benefit from different types of tailored interventions specific to the subtype of burden they are experiencing.