Caregiver self-efficacy and associated factors among caregivers of patients with dementia with Lewy bodies and caregivers of patients with Alzheimer's disease

Background: Dementia with Lewy bodies (DLB) is characterized by neuropsychiatric symptoms, which can be distressing to caregivers. However, little is known about their subjective distress in terms of caregiver self-efficacy. Thus, we examined the differences in caregiver self-efficacy and their associated factors between DLB and Alzheimer's disease (AD) caregivers.

Methods: We conducted a comprehensive questionnaire for DLB and AD caregivers. Caregiver self-efficacy was evaluated using three domains (Self-Efficacy for Obtaining Respite: SE-OR, Self-Efficacy for Responding to Disruptive Patient Behaviours: SE-RDPB, Self-Efficacy for Controlling Upsetting Thoughts about Caregiving: SE-CUT) of the Revised Scale for Caregiving Self-Efficacy (RSCSE). In addition, data on the following features of caregivers were assessed: depression, sleep disturbance, caregiver burden, executive function, loneliness, social support, and distress associated with neuropsychiatric symptoms. The patients were assessed for general cognitive tasks, executive function, and neuropsychiatric symptoms.

Results: Compared with AD caregivers, DLB caregivers experienced a significantly higher burden in terms of not only various clinical factors, but also all three domains of caregiver self-efficacy. Among the caregiver-associated factors, different domains were predictors of self-efficacy in DLB and AD caregivers (distress due to sleep disturbances in DLB patients; distress due to delusions in AD patients). Among the patient-associated factors, different domains were also predictors of self-efficacy in DLB and AD caregivers (sleep disturbances in DLB patients; delusions in AD patients). Among both the caregivers and the patients, executive function was a significant predictor of one RSCSE domain (SE-CUT).

Conclusions: A reduction in caregiver self-efficacy may contribute to a severe subjective burden among DLB caregivers. Furthermore, two neuropsychiatric symptoms (delusions and sleep disturbances) affected caregiver self-efficacy differently depending on whether care was being provided to a DLB or AD patient. Understanding the association between specific neuropsychiatric symptoms and caregiver self-efficacy may be useful for conducting interventions for DLB patients.