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Impact of Frontal Systems Behavioral Functioning in Dementia on Caregiver Burden

Received March 28, 2005; revised December 2, 2005; accepted January 27, 2006. Drs. Davis and Tremont are affiliated with the Rhode Island Hospital Department of Psychiatry, and Brown Medical School Department of Psychiatry and Human Behavior, Providence, Rhode Island. Address correspondence to Dr. Davis, Rhode Island Hospital Neuropsychology Program, Physicians Office Building, Suite 430, 593 Eddy Street, Providence, RI 02903; jdavis3{at}lifespan.org (e-mail).

Behavioral problems in the dementia patient are some of the strongest predictors of caregiver burden, though the impact of specific types of behavioral problems on burden is limited. This study investigated the contribution of frontal systems behavioral functioning (i.e., apathy, executive dysfunction, and disinhibition) on caregiver burden. Seventy-two family caregivers completed the Frontal Systems Behavior Scale and measures of mood, perceived burden, and patient ratings of functional impairment. Regression analyses indicated that frontal systems behavioral problems were predictive of caregiver burden after controlling for dementia severity and caregiver depression. Analyses of subscales revealed that executive dysfunction and disinhibition were predictors of caregiver burden. Results argue for including strategies for managing frontal systems behavioral problems, particularly executive dysfunction and disinhibition, in dementia caregiver interventions.

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