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Vol.21 No.1
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가족보호자의 간병 부담감, 우울 및 신체증상에 치매환자의 내현화 문제행동이 미치는 영향

The Effects of Internalizing Behavior Problems of Patients with Dementia in Predicting Family Caregivers’ Burden, Depressive and Physical Symptoms

한국심리학회지: 건강 / The Korean Journal of Health Psychology, (P)1229-070X; (E)2713-9581
2016, v.21 no.1, pp.65-89
https://doi.org/10.17315/kjhp.2016.21.1.004
김태현 (연세대학교)
박수현 (연세대학교)
김태현, & 박수현. (2016). 가족보호자의 간병 부담감, 우울 및 신체증상에 치매환자의 내현화 문제행동이 미치는 영향. 한국심리학회지: 건강, 21(1), 65-89, https://doi.org/10.17315/kjhp.2016.21.1.004
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초록

본 연구에서는 치매환자 가족보호자들이 경험하는 간병 부담감과 우울 및 신체증상의 수준을 확인하고, 가족보호자들의 심리적, 신체적 건강에 부정적인 영향을 미치는 치매환자의 문제행동 증상을 유형별로 탐색하였다. 이를 위해 치매 진단을 받은 환자를 간병하는 가족보호자 101명을 대상으로 간병 부담감(Burden Interview; BI), 우울증상(Center for Epidemiologic Studies Depression Scale; CES-D), 신체증상(Physical Health Questionnaire; PHQ)과 더불어 한국판 노인행동평가 척도(Older Adult Behavior Checklist; OABCL)를 사용하여 가족보호자가 보고한 치매환자의 문제행동 증상을 측정하였다. 분석 결과, 치매환자의 문제행동은 가족보호자의 건강관련 지표와 부적 상관관계를 보임과 동시에 보호자들의 부담감과 우울 및 신체증상을 예측하는 것으로 나타났으며, 특히 치매환자의 외현화 문제행동과 함께 내현화 문제행동이 동반되어서 나타날 경우, 가족보호자들의 부담감(R2 : .218 ➝ .257)과 우울(R2 : .274 ➝ .334) 및 신체증상(R2 : .324 ➝ .356)에 미치는 영향력이 증가하는 것으로 확인되었다. 이러한 결과는 치매환자가 외현화 문제행동과 내현화 문제행동이 동반될 경우, 이들을 간병하는 가족보호자들의 심리적, 신체적 건강수준이 더욱 저하된다는 사실을 의미하며, 치매환자의 외현화 문제행동 외에도 내현화 문제행동 증상에 대한 관심과 중재의 필요성을 시사한다. 이와 같이 본 연구에서 나타난 의의와 시사점을 바탕으로 치매환자의 문제행동 증상에 관한 후속연구의 필요성에 대해 논의하였다.

keywords
치매, 가족보호자, 간병 부담감, 우울증상, 신체증상, 치매환자의 문제행동, dementia, family caregiver, caregiver burden, depressive symptoms, physical symptoms, behavior problems

Abstract

In the present study, we confirmed caregiver burden, depressive symptoms, and physical symptoms among family caregivers of dementia patients ; in addition, we determined dementia patient`s behavior problems that affect caregiver’s psychological and physical health by type. A total of 101 dementia family caregivers were asked to complete questionnaires assessing caregiver burden(Burden Interview; BI), depressive symptoms(Center for Epidemiologic Studies Depression Scale; CES-D), physical symptoms (Physical Health Questionnaire; PHQ), and dementia patient`s behavior problems using Older Adult Behavior Checklists(OABCL). In hierarchical regression analysis, the presence of internalizing behavior problems in addition to externalizing behavior problems were significantly higher predictors of caregiver burden, depressive symptoms, and physical symptoms. Thus, family caregivers experienced deteriorated psychological and physical health as a result of externalizing behavior problems accompanied by internalizing behavior problems. The study results suggested the necessity for concern and intervention targeting internalizing behavior problems. Implications for improving psychological and physical health of dementia patient`s family caregivers and suggestions for future research are discussed.

keywords
치매, 가족보호자, 간병 부담감, 우울증상, 신체증상, 치매환자의 문제행동, dementia, family caregiver, caregiver burden, depressive symptoms, physical symptoms, behavior problems

참고문헌

1.

강영실 (2000). 재가 치매노인의 문제행동에 관한 연구. 지역사회간호학회지, 11, 453-469.

2.

강제욱, 이정호, 이동우, 김민지(2007). 치매환자 부양자성격 특성과 부양자 부담의 연관성. 대한노인병학회지, 11, 2211-2228.

3.

강태화, 윤은자, 전미순 (2014). 치매노인 주부양자의 부담감 유형. 주관성연구, 28, 53-73.

4.

고석범, 양동원, 정성우, 최영빈, 김범생. (2002). 한국판Neuropsychiatric Inventory 로 분석한 피질하 혈관성치매와 알쯔하이머병의 행동장애 패턴의 차이. 대한신경과학회지, 20, 353-358.

5.

곽용태, 양영순, 구민성 (2014). 알츠하이머병에서의 우울증. 대한치매학회지, 13, 27-36.

6.

김민영, 이진, 김영아, 오경자 (2015). 한국판 노인 행동평가척도 타인보고용 (OABCL) 의 평정자 집단에따른 측정동등성 분석. 한국심리학회지: 임상, 34, 505-527.

7.

김장래, 길주현, 조아라, 이지연, 이동우, 김민숙 (2011). 초기 치매 및 치매의 위험이 있는 노인에서 일상생활 수행능력의 예측 지표. 한국심리치료학회지, 3, 1-13.

8.

김태유, 김수영, 김재우, 김응규, 박경원, 성상민, 손태홍, 유봉구, 윤수진, 윤성민, 이상찬, 최문성, 홍태용, 부산 경남치매학회 (2005). 알쯔하이머병과 혈관성치매 환자의 부양부담 차이. 대한신경과학회지, 23, 463-470.

9.

김창현 (2000). BPSD의 행동장애. 노인정신의학, 4, 17-23.

10.

권용철, 박종한 (1989). 노인용 한국판 Mini-mental state examination (MMSE-K) 의 표준화 연구. 신경정신의학회지, 28, 125-135.

11.

문미숙, 박지혁 (2014). 과제지향적 훈련이 치매 환자의수단적 일상생활활동에 미치는 영향: 사례연구. 신경재활치료과학, 3, 67-77.

12.

박재설, 류경희, 강연욱, 나덕렬 (2008). 치매환자 보호자에 의해서 보고된 알츠하이머치매와 혈관치매의증상: 한국판 치매설문지 제작을 위한 기초연구. 한국심리학회지: 임상, 27, 515-528.

13.

보건복지부. (2013). 2012년 치매유병률조사.

14.

서경현, 천경임 (2009). 치매환자 가족부양자의 부양부담과 건강 및 삶의 질에 대한 사회지원의 중재효과. 한국심리학회지: 문화 및 사회문제, 15, 339-357.

15.

성미라, 이명선, 이동영, 장혜영 (2013). 재가 치매 노인환자를 돌보는 가족원의 극복 경험. 대한간호학회지, 43, 389-398.

16.

신송재, 이재신 (2011). 인지행동치료가 치매환자의 배회행동과 보호자 부담감에 미치는 영향. 고령자·치매작업치료학회지, 5, 33-45.

17.

오희, 석소현 (2009). 치매노인 주 부양가족의 건강상태, 부양부담감 및 삶의 질 연구. 정신간호학회지, 18, 157-166.

18.

유인영, 김명희 (2006). 치매노인 부양자의 부양부담감영향요인. 노인간호학회지, 8, 47-57.

19.

이동진, 고태성 (2010). 뇌졸중 후 우울 증상과 인지, 신체 기능 및 일상생활동작과의 관련성. 특수교육재활과학연구, 49, 159-178.

20.

이성욱 (2004). 치매노인의 병전 성격적 특성, 환경적특성과 문제행동과의 관계. 고신대학교 대학원 석사학위논문.

21.

이슬아, 이미현, 지연경, 한지원, 박재영, 김태희, 김기응(2013). 치매노인 주부양자의 심리적 조호부담 경감을 위한 인지행동적 집단프로그램 개발: 예비연구. 한국심리학회지: 임상, 32, 853-874.

22.

이은희, 윤가현, 이정숙 (2006). 치매노인 주부양자의 부양스트레스 감소를 위한 인지행동 집단상담 프로그램의 효과. 한국심리학회지: 임상, 25, 341-360.

23.

이형석, 김도관, 고혜정, 구형모, 권의정, 김지혜 (2004). 치매 환자 보호자의 스트레스 평가: 기억 및 행동문제점검-개정판 (Revised-Memory and Behavior Problem Checklist: R-MBPC) 과 부담조사(Burden Interview: BI) 의 신뢰도 및 타당도. 한국심리학회지: 임상, 23, 1029-1050.

24.

장은실 (2013). 재가치매노인과 가족조호자의 사회적 지지와 우울과의 상호작용. 중앙대학교 박사학위 논문.

25.

전겸구, 최상진, 양병창 (2001). 통합적 한국판 CES-D 개발. 한국심리학회지: 건강, 6, 59-76.

26.

조맹제, 김기웅, 김명희, 김문두, 김종조, 김신겸, 김정란(2008). 치매노인유병률 조사. 서울: 보건복지가족부.

27.

조맹제, 김계희 (1993). 주요우울증 환자 예비평가에서The Center for Epidemiologic Studies Depression Scale (CES-D) 의 진단적 타당성 연구. 신경정신의학, 32, 381-399.

28.

조윤희, 김광숙 (2010). 연구 논문: 재가 치매노인의 증상에 따른 가족의 부담감 및 전문적 도움 요구. 한국노년학, 30, 369-383.

29.

조은영, 조은희, 김소선 (2010). 연구 논문: 가족 상호관계가 치매노인 가족원의 부담감에 미치는 영향. 한국노년학, 30, 421-437.

30.

최선미, 최지민, 김순은 (2014). 고령화 사회에 대한 인식유형과 정책적 시사점. 행정논총, 52, 230-257.

31.

통계청 (2012). 장래인구추계.

32.

한윤희, 임애진, 김성례, 김지영, 감경윤 (2011). 뇌졸중후 우울변화가 인지 및 상지기능회복에 미치는 영향. 대한작업치료학회지, 19, 39-51

33.

Aalten, P., de Vugt, M. E., Lousberg, R., Korten, E., Jaspers, N., Senden, B., et al. (2003). Behavioral problems in dementia: A factor analysis of the Neuropsychiatric Inventory. Dementia and Geriatric Cognitive Disorders, 15, 99-105.

34.

Achenbach, T. M., Newhouse, P. A., & Rescorla, L. (2004). Manual for the ASEBA older adult forms and profiles. Burlington, VT: University of Vermont, Research Center for Children, Youth, &Families.

35.

Andersen, C. K., Wittrup-Jensen, K. U., Lolk, A., Andersen, K., & Kragh-Sørensen, P. (2004). Ability to perform activities of daily living is the main factor affecting quality of life in patients with dementia. Health and Quality of Life Outcomes, 2, 52.

36.

Andren, S., & Elmståhl, S. (2008). The relationship between caregiver burden, caregivers’ perceived health and their sense of coherence in caring for elders with dementia. Journal of Clinical Nursing, 17, 790-799.

37.

Asada, T., Kinoshita, T., & Kakuma, T. (2000). Analysis of behavioral disturbances among community-dwelling elderly with Alzheimer disease. Alzheimer Disease and Associated Disorders, 14, 160-167.

38.

Balducci, C., Mnich, E., McKee, K. J., Lamura, G., Beckmann, A., Krevers, B., & Öberg, B. (2008). Negative impact and positive value in caregiving:Validation of the COPE index in a six-country sample of carers. The Gerontologist, 48, 276-286.

39.

Ballard, C. G., Margallo-Lana, M., Fossey, J., Reichelt, K., Myint, P., Potkins, D., et al. (2001). A 1-year follow-up study of behavioral and psychological symptoms in dementia among people in care environments. The Journal of Clinical Psychiatry, 62, 631-636.

40.

Bédard, M., Kuzik, R., Chambers, L., Molloy, D. W., Dubois, S., & Lever, J. A. (2005). Understanding burden differences between men and women caregivers: the contribution of care-recipient problem behaviors. International Psychogeriatrics, 17, 99-118.

41.

Berger, G., Bernhardt, T., Weimer, E., Peters, J., Kratzsch, T., & Frolich, L. (2005). Longitudinal study on the relationship between symptomatology of dementia and levels of subjective burden and depression among family caregivers in memory clinic patients. Journal of Geriatric Psychiatry & Neurology, 18, 119-128.

42.

Beeri, M., Werner, P., Davidson, M., & Noy, S. (2002). The cost of behavioral and psychological symptoms of dementia (BPSD) in community dwelling Alzheimer's disease patients. International Journal of Geriatric Psychiatry, 17, 403-408.

43.

Benke, T., Delazer, M., Sanin, G., Schmidt, H., Seiler, S., Ransmayr, G., et al. (2013). Cognition, gender, and functional abilities in Alzheimer’s disease:how are they related. Journal of Alzheimer`s Disease, 35, 247-252.

44.

Bergvall, N., Brinck, P., Eek, D., Gustavsson, A., Wimo, A., Winblad, B., et al. (2011). Relative importance of patient disease indicators on informal care and caregiver burden in Alzheimer's disease. International Psychogeriatrics, 23, 73-85.

45.

Bierman, E. J. M., Comijs, H. C., Jonker, C., & Beekman, A. T. F. (2007). Symptoms of anxiety and depression in the course of cognitive decline. Dementia and Geriatric Cognitive Disorders, 24, 213-219

46.

Black, W., & Almeida, O. P. (2004). A systematic review of the association between the behavioral and psychological symptoms of dementia and burden of care. International Psychogeriatrics, 16, 295-315.

47.

Borsje, P., Wetzels, R. B., Lucassen, P. L., Pot, A. M., & Koopmans, R. T. (2014). Neuropsychiatric symptoms in patients with dementia in primary care: a study protocol. BMC Geriatrics, 14, 32.

48.

Brodaty, H., Draper, B. M., & Low, L. F. (2003). Behavioural and psychological symptoms of dementia: a seven-tiered model of service delivery. Medical Journal of Australia, 178, 231-235.

49.

Brodaty, H., Green, A., & Koschera, A. (2003). Meta analysis of psychosocial interventions for caregivers of people with dementia. Journal of the American Geriatrics Society, 51, 657-664.

50.

Brodaty, H., & Luscombe, G. (1998). Psychological morbidity in caregivers is associated with depression in patients with dementia. Alzheimer Disease and Associated Disorders, 12, 62-70.

51.

Cerejeira, J., Lagarto, L., & Mukaetova-Ladinska, E. B. (2012). Behavioral and psychological symptoms of dementia. Frontiers in Neurology, 3, 1-21.

52.

Chappel, N. L., & Penning, M. (1996). Behavioural problems and distress among caregivers of people with dementia. Ageing and Society, 16, 57–73.

53.

Cheung, D. S., Chien, W. T., & Lai, C. K. (2011). Conceptual framework for cognitive function enhancement in people with dementia. Journal of Clinical Nursing, 20, 1533-1541.

54.

Choi, S. H., Na, D. L., Kwon, H. M., Yoon, S. J., Jeong, J. H., & Ha, C. K. (2000). The Korean version of the neuropsychiatric inventory: a scoring tool for neuropsychiatric disturbance in dementia patients. Journal of Korean Medical Science. 15, 609-615.

55.

Choi, S. H., Na, D. L., Lee, B. H., Hahm, D. S., Jeong, J. H., Yoon, S. J., et al. (2001). Estimating the validity of the Korean version of expanded clinical dementia rating (CDR) scale. Journal of the Korean Neurological Association, 19, 585-591.

56.

Cipher, D. J., & Clifford, P. A. (2004). Dementia, pain, depression, behavioral disturbances, and ADLs:toward a comprehensive conceptualization of quality of life in long-term care. International Journal of Geriatric Psychiatry, 19, 741-748.

57.

Cohen-Mansfield, J., Dakheel-Ali, M., Marx, M. S., Thein, K., & Regier, N. G. (2015). Which unmet needs contribute to behavior problems in persons with advanced dementia?. Psychiatry Research, 228, 59-64.

58.

Collins, L. G., & Swartz, K. (2011). Caregiver care. American Family Physician, 83, 1309-1317.

59.

Cooper, C., Katona, C., Orrell, M., & Livingston, G. (2008). Coping strategies, anxiety and depression in caregivers of people with Alzheimer's disease. International Journal of Geriatric Psychiatry, 23, 929-936.

60.

Covinsky, K. E., Newcomer, R., Fox, P., Wood, J., Sands, L., Dane, K., et al. (2003). Patient and caregiver characteristics associated with depression in caregivers of patients with dementia. Journal of general internal medicine, 18, 1006-1014.

61.

Cummings, J. L., Meg, M., Gray, K., Rosenberg, T. S., & Carusi, D. A. (1994). The Neuropsychiatric Inventory: Comprehensive assessment of psychopathology in dementia. Neurology, 44, 2308-2314.

62.

Danhauer, S. C., McCann, J. J., Gilley, D. W., Beckett, L. A., Bienias, J. L., & Evans, D. A. (2004). Do behavioral disturbances in persons with Alzheimer's disease predict caregiver depression over time. Psychology and Aging, 19, 198-202.

63.

Dauphinot, V., Delphin-Combe, F., Mouchoux, C., Dorey, A., Bathsavanis, A., Makaroff, Z., et al. (2015). Risk factors of caregiver burden among patients with Alzheimer's disease or related disorders: A cross-sectional study. Journal of Alzheimer's Disease, 44, 907-916.

64.

De Frias, C. M., Tuokko, H., & Rosenberg, T. (2005). Caregiver physical and mental health predicts reactions to caregiving. Aging & Mental Health, 9, 331-336.

65.

Desai, A., & Grossberg, G. (2001). Review of rivastigmine and its clinical applications in Alzheimer's disease and related disorders. Expert Opinion on Pharmacotherapy, 2, 653-666.

66.

Donaldson, C., Tarrier, N., & Burns, A. (1998). Determinants of carer stress in Alzheimer’s disease. International Journal of Geriatric Psychiatry, 13, 248-256.

67.

Douglas, S., James, I., & Ballard, C. (2004). Non-pharmacological interventions in dementia. Advances in Psychiatric Treatment, 10, 171-177.

68.

Etters, L., Goodall, D., & Harrison, B. E. (2008). Caregiver burden among dementia patient caregivers: a review of the literature. Journal of the American Academy of Nurse Practitioners, 20, 423-428.

69.

Fauth, E. B., & Gibbons, A. (2014). Which behavioral and psychological symptoms of dementia are the most problematic? Variability by prevalence, intensity, distress ratings, and associations with caregiver depressive symptoms. International Journal of Geriatric Psychiatry, 29, 263-271.

70.

Finkel, S. (2000). Introduction to behavioural and psychological symptoms of dementia (BPSD). International Journal of Geriatric Psychiatry, 15, 2-4.

71.

Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). “Mini-mental state”: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189-198.

72.

Fulop, T., Larbi, A., Witkowski, J. M., McElhaney, J., Loeb, M., Mitnitski, A., et al. (2010). Aging, frailty and age-related diseases. Biogerontology, 11, 547-563.

73.

Gallicchio, L., Siddiqi, N., Langenberg, P., & Baumgarten, M. (2002). Gender differences in burden and depression among informal caregivers of demented elders in the community. International Journal of Geriatric Psychiatry, 17, 154-163.

74.

Gaugler, J. E., Edwards, A. B., Femia, E. E., Zarit, S. H., Stephens, M. A. P., Townsend, A., & Greene, R. (2000). Predictors of institutionalization of cognitively impaired elders family help and the timing of placement. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 55, 247-255.

75.

Gaugler, J. E., Kane, R. L., Kane, R. A., & Newcomer, R. (2005). The longitudinal effects of early behavior problems in the dementia caregiving career. Psychology and Aging, 20, 100-116.

76.

Gaugler, J. E., Mittelman, M. S., Hepburn, K., & Newcomer, R. (2009). Predictors of change in caregiver burden and depressive symptoms following nursing home admission. Psychology and Aging, 24, 385-396.

77.

Haro, J. M., Kahle-Wrobleski, K., Bruno, G., Belger, M., Dell’Agnello, G., Dodel, R., & Argimon, J. M. (2014). Analysis of burden in caregivers of people with Alzheimer’s disease using self-report and supervision hours. The Journal of Nutrition, Health & Aging, 18, 677-684.

78.

Heok, K. E., & LI, T. S. (1997). Stress of caregivers of dementia patients in the Singapore Chinese family. International Journal of Geriatric Psychiatry, 12, 466-469.

79.

Hooker, K., Bowman, S. R., Coehlo, D. P., Lim, S. R., Kaye, J., Guariglia, R., et al. (2002). Behavioral change in persons with dementia relationships with mental and physical gealth of caregivers. The Journals of Gerontology Series B:Psychological Sciences and Social Sciences, 57, 453-460.

80.

Huang, S. S., Lee, M. C., Liao, Y. C., Wang, W. F., & Lai, T. J. (2012). Caregiver burden associated with behavioral and psychological symptoms of dementia (BPSD) in Taiwanese elderly. Archives of Gerontology and Geriatrics, 55, 55-59.

81.

Johnson, M. M., Wackerbarth, S. B., & Schmitt, F. A. (2001). Revised memory and behavior problems checklist. Clinical Gerontologist, 22, 87-108.

82.

Knapp, M., Iemmi, V., & Romeo, R. (2013). Dementia care costs and outcomes: A systematic review. International Journal of Geriatric Psychiatry, 28, 551-561.

83.

Kolanowski, A. M., Strand, G., & Whall, A. (1997). A pilot study of the relation of premorbid characteristics to behavior in dementia. Journal of Gerontological Nursing, 23, 21-30.

84.

Lee, S. B., & Kwon, O. D. (2015). Factors Affecting Care Worker’s Burden of Patients with Dementia. Journal of the Korean Neurological Association, 33, 162-167.

85.

Leggett, A. N., Zarit, S., Taylor, A., & Galvin, J. E. (2010). Stress and burden among caregivers of patients with Lewy body dementia. The Gerontologist, 51, 76-85.

86.

Lyketsos, C. G., Lopez, O., Jones, B., Fitzpatrick, A. L., Breitner, J., & DeKosky, S. (2002). Prevalence of neuropsychiatric symptoms in dementia and mild cognitive impairment: results from the cardiovascular health study. Jama, 288, 1475-1483.

87.

Lyketsos, C. G., Steele, C., Galik, E., Rosenblatt, A., Steinberg, M., Warren, A., et al. (2014). Physical aggression in dementia patients and its relationship to depression. American Journal of Psychiatry, 156, 66-71.

88.

Mahoney, F. I., & Barthel, D. W. (1965). Functional evaluation: The Barthel Index. Maryland State Medical Journal, 14, 61–65.

89.

McClive-Reed, K. P., & Gellis, Z. D. (2011). Anxiety and related symptoms in older persons with dementia: directions for practice. Journal of Gerontological Social Work, 54, 6-28.

90.

Miyamoto, Y., Ito, H., Otsuka, T., & Kurita, H. (2002). Caregiver burden in mobile and nonmobile demented patients: A comparative study. International Journal of Geriatric Psychiatry, 17, 765-773.

91.

Nishio, D., Takahashi, H., Hayashi, T., Hirano, Y., Minakawa, T., & Kigawa, H. (2015). Factors Influencing the Burden on Caregivers of Stroke Patients with Hemiplegia Living at Home. International Journal of Physical Medicine &Rehabilitation, 3, 1-5.

92.

Neundorfer, M. M., McClendon, M. J., Smyth, K. A., Stuckey, J. C., Strauss, M. E., & Patterson, M. B. (2001). A longitudinal study of the relationship between levels of depression among persons with Alzheimer’s disease and levels of depression among their family caregivers. Journal of Gerontology B: Psychological Sciences and Social Sciences, 56, 301-313.

93.

Nogales-González, C., Romero-Moreno, R., Losada, A., Márquez-González, M., & Zarit, S. H. (2015). Moderating effect of self-efficacy on the relation between behavior problems in persons with dementia and the distress they cause in caregivers. Aging & Mental Health, 30, 1-9.

94.

Onishi, J., Suzuki, Y., Umegaki, H., Nakamura, A., Endo, H., & Iguchi, A. (2005). Influence of behavioral and psychological symptoms of dementia (BPSD) and environment of care on caregivers’ burden. Archives of Gerontology and Geriatrics, 41, 159-168.

95.

Ornstein, K., & Gaugler, J. E. (2012). The problem with “problem behaviors”: A systematic review of the association between individual patient behavioral and psychological symptoms and caregiver depression and burden within the dementia patient–caregiver dyad. International Psychogeriatrics, 24, 1536-1552.

96.

Papastavrou, E., Kalokerinou, A., Papacostas, S. S., Tsangari, H., & Sourtzi, P. (2007). Caring for a relative with dementia: Family caregiver burden. Journal of Advanced Nursing, 58, 446-457.

97.

Pearlin, L. I., Mullan, J. T., Semple, S. J., & Skaff, M. M. (1990). Caregiving and the stress process:An overview of concepts and their measures. The Gerontologist, 30, 583-594.

98.

Pinquart, M., & Sörensen, S. (2007). Correlates of physical health of informal caregivers: a meta-analysis. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 62, 126-137.

99.

Potter, R., Ellard, D., Rees, K., & Thorogood, M. (2011). A systematic review of the effects of physical activity on physical functioning, quality of life and depression in older people with dementia. International Journal of Geriatric Psychiatry, 26, 1000-1011.

100.

Prado-Jean, A., Couratier, P., Druet-Cabanac, M., Nubukpo, P., Bernard-Bourzeix, L., Thomas, P., et al. (2010). Specific psychological and behavioral symptoms of depression in patients with dementia. International Journal of Geriatric Psychiatry, 25, 1065-1072.

101.

Proitsi, P., Hamilton, G., Tsolaki, M., Lupton, M., Daniilidou, M., Hollingworth, P., et al. (2011). A multiple indicators multiple causes (MIMIC)model of behavioural and psychological symptoms in dementia (BPSD). Neurobiology of Aging, 32, 434-442.

102.

Razani, J., Kakos, B., Orieta‐Barbalace, C., Wong, J. T., Casas, R., Lu, P., et al. (2007). Predicting caregiver burden from daily functional abilities of patients with mild dementia. Journal of the American Geriatrics Society, 55, 1415-1420.

103.

Richardson, T. J., Lee, S. J., Berg-Weger, M., & Grossberg, G. T. (2013). Caregiver health: Health of caregivers of alzheimer’s and other dementia patients. Current Psychiatry Reports, 15, 1-7.

104.

Rocca, P., Leotta, D., Liffredo, C., Mingrone, C., Sigaudo, M., Capellero, B., et al. (2010). Neuropsychiatric symptoms underlying caregiver stress and insight in Alzheimer’s disease. Dementia and Geriatric Cognitive Disorders, 30, 57-63.

105.

Roche, V. (2009). The hidden patient: addressing the caregiver. The American Journal of The Medical Sciences, 337, 199-204.

106.

Schat, A. C., Kelloway, E. K., & Desmarais, S. (2005). The physical health questionnaire (PHQ):Construct validation of a self-report scale of somatic symptoms. Journal of Occupational Health Psychology, 10, 363-381.

107.

Schaller, S., Mauskopf, J., Kriza, C., Wahlster, P., & Kolominsky‐Rabas, P. L. (2015). The main cost drivers in dementia: a systematic review. International Journal of Geriatric Psychiatry, 30, 111-129.

108.

Sands, L. P., Ferreira, P., Stewart, A. L., Brod, M., & Yaffe, K. (2004). What explains differences between dementia patients' and their caregivers'ratings of patients' quality of life? The American Journal of Geriatric Psychiatry, 12, 272-280

109.

Senanarong, V., Cummings, J. L., Fairbanks, L., Mega, M., Masterman, D. M., O’connor, S. M., & Strickland, T. L. (2004). Agitation in Alzheimer’s disease is a manifestation of frontal lobe dysfunction. Dementia and Geriatric Cognitive Disorders, 17, 14-20.

110.

Seitz, D. P., Gill, S. S., Herrmann, N., Brisbin, S., Rapoport, M. J., Rines, J., et al. (2013). Pharmacological treatments for neuropsychiatric symptoms of dementia in long-term care: a systematic review. International Psychogeriatrics, 25, 185-203.

111.

Shah, A., & Suh, G. H. (2005). A case for judicious use of risperidone and olanzapine in behavioral and psychological symptoms of dementia (BPSD). International Psychogeriatrics, 17, 12-22.

112.

Shah, S., Vanclay, F., & Cooper, B. (1989). Improving the sensitivity of the Barthel Index for stroke rehabilitation. Journal of Clinical Epidemiology, 42, 703-709.

113.

Shaji, K. S., George, R. K., Prince, M. J., & Jacob, K. S. (2009). Behavioral symptoms and caregiver burden in dementia. Indian Journal of Psychiatry, 51, 45-49.

114.

Shim, S. H., Kang, H. S., Kim, J. H., & Kim, D. K. (2016). Factors Associated with Caregiver Burden in Dementia: 1-Year Follow-Up Study. Psychiatry Investigation, 13, 43-49.

115.

Sink, K. M., Holden, K. F., & Yaffe, K. (2005). Pharmacological treatment of neuropsychiatric symptoms of dementia: A review of the evidence. JAMA, 293, 596-608.

116.

Smith, G. R., Williamson, G. M., Miller, L. S., & Schulz, R. (2011). Depression and quality of informal care: A longitudinal investigation of caregiving stressors. Psychology and Aging, 26, 584-591.

117.

So, H. Y., Ju, K. O., Jung, M. H., & Kim, H. Y. (2004). Cognitive function of the urban elderly. The Korean Journal of Rehabilitation Nursing, 7, 179-187.

118.

Spector, A., Thorgrimsen, L., Woods, B. O. B., Royan, L., Davies, S., Butterworth, M., & Orrell, M. (2003). Efficacy of an evidence-based cognitive stimulation therapy programme for people with dementia Randomised controlled trial. The British Journal of Psychiatry, 183, 248-254.

119.

Springate, B. A., & Tremont, G. (2014). Dimensions of caregiver burden in dementia: impact of demographic, mood, and care recipient variables. The American Journal of Geriatric Psychiatry, 22, 294-300.

120.

Stalder, T., Tietze, A., Steudte, S., Alexander, N., Dettenborn, L., & Kirschbaum, C. (2014). Elevated hair cortisol levels in chronically stressed dementia caregivers. Psychoneuroendocrinology, 47, 26-30.

121.

Sung, M. S., Jang, H. J., Lee, K. W., & Kim, Y. I. (2001). The development and effect of a CD ROM based caring program for the family caregivers among the Korean demented elderly. Journal of Korean Society of Medical Informatics, 7, 45-55.

122.

Tan, L. L., Wong, H. B., & Allen, H. (2005). The impact of neuropsychiatric symptoms of dementia on distress in family and professional caregivers in Singapore. International Psychogeriatrics, 17, 253-263.

123.

van den Heuvel, E. T., de Witte, L. P., Schure, L. M., Sanderman, R., & Meyboom-de Jong, B. (2001). Risk factors for burn-out in caregivers of stroke patients, and possibilities for intervention. Clinical Rehabilitation, 15, 669-677.

124.

Vitlic, A., Lord, J. M., Arlt, W., Oliver, C., & Phillips, A. C. (2015). T cell immunity and caregiving stress in young and older caregivers. Healthy Aging Research, 4, 15.

125.

Verkaik, R., van Weert, J., & Francke, A. L. (2005). The effects of psychosocial methods on depressed, aggressive and apathetic behaviors of people with dementia: a systematic review. International Journal of Geriatric Psychiatry, 20, 301-314.

126.

Weissman, M. M., Merikangas, K. R., Priya, W., Kidd, K. K., Prusoff, B. A., Leckman, J. F., et al. (1986). Understanding the clinical heterogeneity of major depression using family data. Archives of General Psychiatry, 43, 430-434.

127.

Zarit, S. H. (2010). The burden interview. Retrieved July 6, 2010, from http://www.mapi-research.fr/t_03_serv_dist_ReviewZBI.htm

128.

Zarit, S. H., Orr, N. K., & Zarit, J. M. (1985). The hidden victims of Alzheimer's disease: Families under stress. NY: New York University Press.

129.

Zhu, C. W., & Sano, M. (2006). Economic considerations in the management of Alzheimer's disease. Clinical Interventions in Aging, 1, 143-154.

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