Table 3.
Factors associated with the risk of abusive behavior in family caregivers of people with dementia
| Model 1 |
Model 2 |
Model 3 |
||||
|---|---|---|---|---|---|---|
| Only psychological | Physical | Only psychological | Physical | Only psychological | Physical | |
| Patients’ factors | ||||||
| Age (years) | 0.99 (0.96–1.02) | 0.98 (0.94–1.02) | 0.99 (0.95–1.04) | 0.97 (0.91–1.03) | 0.99 (0.95–1.04) | 0.97 (0.91–1.03) |
| Education (years) | 0.95 (0.91–1.00) | 1.00 (0.94–1.06) | 0.94 (0.89–0.99)* | 0.99 (0.92–1.07) | 0.94 (0.89–0.99)* | 0.99 (0.91–1.07) |
| Sex (male) | 1.31 (0.81–2.09) | 1.35 (0.70–2.60) | 1.02 (0.55–1.88) | 0.66 (0.26–1.71) | 1.01 (0.54–1.88) | 0.67 (0.26–1.74) |
| Non-Alzheimer type of dementia | 1.15 (0.71–1.82) | 2.10 (1.12–3.94)* | 1.14 (0.68–1.92) | 2.04 (1.04–4.00)* | 1.15 (0.68–1.93) | 2.04 (1.04–4.00)* |
| Severity of dementiaa | ||||||
| Mild (CDR=1) | 1.17 (0.72–1.89) | 1.15 (0.57–2.33) | 0.88 (0.52–1.49) | 0.83 (0.38–1.78) | 0.89 (0.52–1.51) | 0.82 (0.38–1.77) |
| Moderate (CDR=2) | 0.94 (0.49–1.80) | 1.05 (0.42–2.59) | 0.63 (0.31–1.30) | 0.66 (0.24–1.80) | 0.65 (0.31–1.35) | 0.65 (0.23–1.83) |
| Severe (CDR≥3) | 0.44 (0.15–1.32) | 0.90 (0.24–3.28) | 0.26 (0.08–0.85)* | 0.53 (0.13–2.15) | 0.27 (0.08–0.88)* | 0.55 (0.13–2.29) |
| Duration of illness (years) | 1.14 (1.05–1.23)** | 1.16 (1.06–1.28)** | 1.01 (0.89–1.15) | 1.06 (0.90–1.24) | 1.01 (0.89–1.15) | 1.06 (0.90–1.24) |
| Cumulative Illness Rating Scale (points) | 0.99 (0.93–1.06) | 0.97 (0.88–1.06) | 0.99 (0.92–1.05) | 0.96 (0.87–1.05) | 0.99 (0.92–1.05) | 0.96 (0.87–1.05) |
| Moderate to severe BPSDb | 1.67 (1.08–2.58)* | 2.58 (1.31–5.08)** | 1.49 (0.93–2.39) | 2.38 (1.15–4.93)* | 1.49 (0.93–2.39) | 2.33 (1.12–4.84)* |
| Caregivers’ factors | ||||||
| Age (years) | 0.99 (0.96–1.03) | 1.00 (0.95–1.06) | 0.99 (0.95–1.03) | 1.00 (0.95–1.06) | ||
| Education (years) | 1.02 (0.95–1.08) | 1.01 (0.92–1.10) | 1.02 (0.95–1.08) | 1.00 (0.92–1.10) | ||
| Sex (male caregiver) | 1.08 (0.65–1.81) | 0.62 (0.26–1.45) | 1.08 (0.64–1.80) | 0.62 (0.27–1.46) | ||
| Kinship (spouses) | 1.36 (0.41–4.54) | 1.13 (0.20–6.25) | 1.40 (0.41–4.71) | 1.13 (0.20–6.32) | ||
| Low household incomec | 1.84 (1.09–3.10)* | 2.82 (1.35–5.89)** | 1.83 (1.09–3.09)* | 2.84 (1.36–5.93)** | ||
| DOCAD (years) | 1.16 (1.00–1.34)* | 1.14 (0.96–1.36) | 1.16 (1.00–1.33)* | 1.14 (0.96–1.37) | ||
| DOCBD (years) | 0.99 (0.98–1.00) | 1.00 (0.98–1.02) | 0.99 (0.98–1.00) | 1.00 (0.98–1.02) | ||
| Longer daily caring time (hours) | 1.04 (0.99–1.10) | 1.04 (0.97–1.11) | 1.05 (0.99–1.10) | 1.04 (0.97–1.11) | ||
| Severe perceived care burdend | 4.44 (2.15–9.16)*** | 6.28 (1.71–23.05)** | 4.45 (2.15–9.19)*** | 6.24 (1.69–22.97)** | ||
| Improper attitude to dementiae | 0.98 (0.58–1.63) | 1.01 (0.49–2.07) | 0.97 (0.58–1.62) | 0.98 (0.47–2.03) | ||
| Poor knowledge about dementiaf | 1.59 (0.94–2.69) | 2.11 (1.05–4.21)* | 1.59 (0.94–2.69) | 2.07 (1.04–4.15)* | ||
| Environmental factors | ||||||
| Living area (rural) | 1.00 (0.54–1.84) | 0.75 (0.28–2.00) | ||||
| National long term care insurance | 1.10 (0.61–1.97) | 1.02 (0.46–2.27) | ||||
| Models | ||||||
| -2 Log likely-hood | 442.39 | 413.32 | 412.33 | |||
| Degrees of freedom (df) | 20 | 42 | 46 | |||
| p | 0.0015 | <0.0001 | <0.0001 | |||
*
p<0.05,
**
p<0.01,
***
p<0.001,
a
compared to very mild dementia (CDR = 0.5),
b
defined by neuropsychiatric inventory profile according to Choi et al., [33]
c
monthly household income below 1,763 USD,
d
zarit burden interview-short form score of 12 or higher,
e
dementia Attitude Scale for Stability score of 25 percentile or less,
f
dementia attitude scale for knowledge score of 25 percentile or less.
CDR: Clinical Dementia Rating, BPSD: Behavioral and Psychological Symptoms of Dementia, DOCAD: duration of care after dementia diagnosis, DOCBD: duration of care before dementia diagnosis