PMID- 22350526
OWN - NLM
STAT- MEDLINE
DCOM- 20120716
LR  - 20211021
IS  - 1179-1969 (Electronic)
IS  - 1170-229X (Linking)
VI  - 29
IP  - 3
DP  - 2012 Mar 1
TI  - Does pharmacological treatment of neuropsychiatric symptoms in Alzheimer's 
      disease relieve caregiver burden?
PG  - 167-179
LID - 10.2165/11599140-000000000-00000 [doi]
AB  - Caregiving for patients with Alzheimer's disease (AD) is associated with negative 
      outcomes for the caregiver such as depression, anxiety, medical illness, poorer 
      general health and mortality, which further translate into adverse outcomes for 
      the patient. The burden experienced by caregivers of AD patients, both 
      professional and informal, has been found to be positively related to the 
      presence and severity of the patients' neuropsychiatric symptoms, also referred 
      to as the behavioural and psychological symptoms of dementia (BPSD). As such, 
      management of BPSD may help in alleviating caregiver burden. The purpose of this 
      review is to summarize the current literature on the effects of pharmacological 
      interventions for BPSD on the burden of AD patient caregivers. A literature 
      review was conducted, using keywords related to dementia, drug treatment, 
      caregiving and BPSD. Studies were included if they were a randomized controlled 
      trial of a currently marketed drug in AD patients, and included a measure of 
      caregiver burden and BPSD. Twenty-four articles met the eligibility criteria for 
      this review. Cognitive enhancers (cholinesterase inhibitors, memantine) were 
      associated with decreased caregiver burden in some studies, though it is unclear 
      whether the improvements were related to changes in BPSD or cognition and 
      function. Antipsychotics have been associated with decreased caregiver burden in 
      some studies, though variability may be related to disease severity. Other drug 
      treatments, including antidepressants, have also been shown to have inconsistent 
      effects on caregiver burden. Besides the small number of clinical trials that 
      included a measure of caregiver burden, there is large variability in the 
      literature due to differing conceptualizations of caregiver burden and the lack 
      of a recognized gold standard for caregiving burden assessment. It is therefore 
      difficult to draw strong conclusions about whether the pharmacological management 
      of BPSD relieves caregiver burden. Given the importance of caregiver burden and 
      its negative consequences for the caregiver and the patient, future clinical 
      trials should pay more attention to this crucial outcome.
FAU - Levy, Karen
AU  - Levy K
AD  - Sunnybrook Health Sciences Centre, Neuropsychopharmacology Research Group, 2075 
      Bayview Avenue, Suite FG05, Toronto, Ontario, Canada, M4N 3M5.
FAU - Lanctot, Krista L
AU  - Lanctot KL
AD  - Sunnybrook Health Sciences Centre, Neuropsychopharmacology Research Group, 2075 
      Bayview Avenue, Suite FG05, Toronto, Ontario, Canada, M4N 3M5. 
      krista.lanctot@sunnybrook.ca.
AD  - Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada. 
      krista.lanctot@sunnybrook.ca.
AD  - Department of Pharmacology, University of Toronto, Toronto, ON, Canada. 
      krista.lanctot@sunnybrook.ca.
AD  - Department of Psychiatry, University of Toronto, Toronto, ON, Canada. 
      krista.lanctot@sunnybrook.ca.
FAU - Farber, Shale B
AU  - Farber SB
AD  - Sunnybrook Health Sciences Centre, Neuropsychopharmacology Research Group, 2075 
      Bayview Avenue, Suite FG05, Toronto, Ontario, Canada, M4N 3M5.
FAU - Li, Abby
AU  - Li A
AD  - Sunnybrook Health Sciences Centre, Neuropsychopharmacology Research Group, 2075 
      Bayview Avenue, Suite FG05, Toronto, Ontario, Canada, M4N 3M5.
FAU - Herrmann, Nathan
AU  - Herrmann N
AD  - Sunnybrook Health Sciences Centre, Neuropsychopharmacology Research Group, 2075 
      Bayview Avenue, Suite FG05, Toronto, Ontario, Canada, M4N 3M5.
AD  - Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
AD  - Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - New Zealand
TA  - Drugs Aging
JT  - Drugs & aging
JID - 9102074
RN  - 0 (Antidepressive Agents)
RN  - 0 (Antipsychotic Agents)
RN  - 0 (Nootropic Agents)
SB  - IM
MH  - Alzheimer Disease/*drug therapy/*psychology
MH  - Antidepressive Agents/therapeutic use
MH  - Antipsychotic Agents/therapeutic use
MH  - *Caregivers/psychology
MH  - *Cost of Illness
MH  - Humans
MH  - Nootropic Agents/therapeutic use
MH  - *Quality of Life
MH  - Stress, Physiological
MH  - Stress, Psychological/prevention & control
EDAT- 2012/02/22 06:00
MHDA- 2012/07/17 06:00
CRDT- 2012/02/22 06:00
PHST- 2012/02/22 06:00 [entrez]
PHST- 2012/02/22 06:00 [pubmed]
PHST- 2012/07/17 06:00 [medline]
AID - 10.2165/11599140-000000000-00000 [pii]
AID - 10.2165/11599140-000000000-00000 [doi]
PST - ppublish
SO  - Drugs Aging. 2012 Mar 1;29(3):167-179. doi: 10.2165/11599140-000000000-00000.