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Effects of social supports on burden in caregivers of people with dementia

Published online by Cambridge University Press:  09 July 2014

Ji Won Han
Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
Hyeon Jeong
Department of Psychiatry, Mirae Hospital, Gimje, South Korea
Jae Young Park
Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
Tae Hui Kim
Department of Psychiatry, Yonsei University Wonju Severance Christian Hospital, Wonju, South Korea
Dong Young Lee
Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea Department of Psychiatry, Seoul National University, College of Medicine, Seoul, South Korea
Dong Woo Lee
Department of Neuropsychiatry, Inje University Sanggye Paik Hospital, Seoul, South Korea
Seung-Ho Ryu
Department of Psychiatry, School of Medicine, Konkuk University, Konkuk University Medical Center, Seoul, South Korea
Shin-Kyeom Kim
Department of Neuropsychiatry, Soonchunhyang University Bucheon Hospital, Bucheon, South Korea
Jong Chul Yoon
Department of Neuropsychiatry, Kyunggi Provincial Hospital for the Elderly, Yongin, South Korea
JinHyeong Jhoo
Department of Neuropsychiatry, Kangwon National University Hospital, Chuncheon, South Korea
Jeong Lan Kim
Department of Psychiatry, Chungnam National University Hospital, Daejeon, South Korea
Seok Bum Lee
Department of Psychiatry, Dankook University Hospital, Cheonan, South Korea
Jung Jae Lee
Department of Psychiatry, Dankook University Hospital, Cheonan, South Korea
Kyung Phil Kwak
Department of Psychiatry, Dongguk Medical Center, Gyeongju, South Korea
Bong-Jo Kim
Department of Psychiatry, Gyeongsang National University, School of Medicine, Jinju, South Korea
Joon Hyuk Park
Department of Neuropsychiatry, Jeju National University Hospital, Jeju, South Korea
Ki Woong Kim*
Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea Department of Psychiatry, Seoul National University, College of Medicine, Seoul, South Korea Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, Seoul, South Korea
Correspondence should be addressed to: Ki Woong Kim, MD, PhD, Department of Neuropsychiatry, Seoul National University College of Medicine and Seoul National University Bundang Hospital, 166 Gumiro, Bundanggu, Seongnamsi, Gyeonggido 463–707, South Korea. Phone: +82-31-787-7432; Fax: +82-31-787-4058. Email:



Social support programs for dementia caregivers were widely used in order to reduce care burden. We investigated which types of social supports can reduce psychological and non-psychological burdens of dementia caregivers, and explored the mechanism of those social supports.


We evaluated 731 community-dwelling dementia patients and their caregivers from the National Survey of Dementia Care in South Korea. We investigated the five types of social supports (emotional support, informational support, tangible support, positive social interaction, affectionate support) using the Medical Outcomes Study Social Support Survey in each caregiver. The mechanisms of specific types of social support on psychological/non-psychological burden were examined using path analysis.


Positive social interaction and affectionate support reduced psychological burden via direct and indirect paths. Tangible support reduced the non-psychological burden via direct and indirect paths. Informational support and emotional support were not helpful for reducing psychological or non-psychological burden. A maximum of 20% of psychological burden could be relieved by positive social interaction and 10.3% of that could be reduced by affectionate support. Tangible support was associated with a 15.1% maximal improvement in non-psychological burden.


In order to reduce caregiver burden in dementia effectively, psychosocial interventions should be tailored to target type of caregiver burden.

Research Article
Copyright © International Psychogeriatric Association 2014 

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Acton, G. J. and Kang, J. (2001). Interventions to reduce the burden of caregiving for an adult with dementia: a meta-analysis. Research in Nursing and Health, 24, 349360.CrossRefGoogle ScholarPubMed
Ankri, J., Andrieu, S., Beaufils, B., Grand, A. and Henrard, J. C. (2005). Beyond the global score of the Zarit Burden Interview: useful dimensions for clinicians. International Journal of Geriatric Psychiatry, 20, 254260.CrossRefGoogle Scholar
American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn. Washington, DC: American Psychiatric Association.Google Scholar
Bedard, M., Molloy, D. W., Squire, L., Dubois, S., Lever, J. A. and O’Donnell, M. (2001). The Zarit Burden Interview: a new short version and screening version. Gerontologist, 41, 652657.CrossRefGoogle ScholarPubMed
Brodaty, H., Green, A. and Koschera, A. (2003). Meta-analysis of psychosocial interventions for caregivers of people with dementia. Journal of the American Geriatric Society, 51, 657664.CrossRefGoogle ScholarPubMed
Carver, C. S. (1997). You want to measure coping but your protocol's too long: consider the brief COPE. International Journal of Behavioral Medicine, 4, 92100.CrossRefGoogle ScholarPubMed
Chu, H. et al. (2011). The effects of a support group on dementia caregivers’ burden and depression. Journal of Aging and Health, 23, 228241.CrossRefGoogle ScholarPubMed
Cummings, J. L., Mega, M., Gray, K., Rosenberg-Thompson, S., Carusi, D. A. and Gornbein, J. (1994). The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology, 44, 23082314.CrossRefGoogle ScholarPubMed
Davis, K. L. et al. (1997). The Caregiver Activity Survey (CAS): development and validation of a new measure for caregivers of persons with Alzheimer's disease. International Journal of Geriatric Psychiatry, 12, 978988.3.0.CO;2-1>CrossRefGoogle Scholar
Gelinas, I., Gauthier, L., McIntyre, M. and Gauthier, S. (1999). Development of a functional measure for persons with Alzheimer's disease: the disability assessment for dementia. The American Journal of Occupational Therapy: Official Publication of the American Occupational Therapy Association, 53, 471.CrossRefGoogle ScholarPubMed
Hughes, C. P., Berg, L., Danziger, W. L., Coben, L. A. and Martin, R. L. (1982). A new clinical scale for the staging of dementia. British Journal of Psychiatry, 140, 566572.CrossRefGoogle Scholar
Irwin, M., Artin, K. H. and Oxman, M. N. (1999). Screening for depression in the older adult: criterion validity of the 10-item Center for Epidemiological Studies Depression Scale (CES-D). Archives of Internal Medicine, 159, 17011704.CrossRefGoogle Scholar
Joling, K. J. et al. (2010). Incidence of depression and anxiety in the spouses of patients with dementia: a naturalistic cohort study of recorded morbidity with a 6-year follow-up. American Journal of Geriatric Psychiatry, 18, 146153.CrossRefGoogle ScholarPubMed
Kohout, F. J., Berkman, L. F., Evans, D. A. and Cornoni-Huntley, J. (1993). Two shorter forms of the CES-D (Center for Epidemiological Studies Depression) depression symptoms index. Journal of Aging and Health, 5, 179193.CrossRefGoogle ScholarPubMed
Lavretsky, H., Siddarth, P. and Irwin, M. R. (2010). Improving depression and enhancing resilience in family dementia caregivers: a pilot randomized placebo-controlled trial of escitalopram. American Journal of Geriatric Psychiatry, 18, 154162.CrossRefGoogle ScholarPubMed
Lee, J. H. et al. (2002). Development of the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet (CERAD-K). The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 57, P47.CrossRefGoogle Scholar
Marriott, A., Donaldson, C., Tarrier, N. and Burns, A. (2000). Effectiveness of cognitive-behavioural family intervention in reducing the burden of care in carers of patients with Alzheimer's disease. British Journal of Psychiatry, 176, 557562.CrossRefGoogle ScholarPubMed
McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D. and Stadlan, E. M. (1984). Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology, 34, 939944.CrossRefGoogle Scholar
O’Connor, M. L. and McFadden, S. H. (2010). Development and psychometric validation of the Dementia Attitudes scale. International Journal of Alzheimer's Disease, 2010, 454218. doi:10.4061/2010/454218 CrossRefGoogle Scholar
Miller, M. D. et al. (1992). Rating chronic medical illness burden in geropsychiatric practice and research: application of the Cumulative Illness Rating Scale. Psychiatry Research, 41, 237248.CrossRefGoogle ScholarPubMed
Ministry of Health and Welfare (2011). The National Survey of Dementia Care in Korea (NaSDeCK): 11–1352000–000576–15. Republic of Korea: Ministry of Health and Welfare.Google Scholar
Roman, G. C. et al. (1993). Vascular dementia: diagnostic criteria for research studies. Report of the NINDS-AIREN International Workshop. Neurology, 43, 250260.CrossRefGoogle ScholarPubMed
Schoenmakers, B., Buntinx, F. and DeLepeleire, J. (2010). Supporting the dementia family caregiver: the effect of home care intervention on general well-being. Aging & Mental Health, 14, 4456.CrossRefGoogle ScholarPubMed
Schulz, R., Newsom, J., Mittelmark, M., Burton, L., Hirsch, C. and Jackson, S. (1997). Health effects of caregiving: the caregiver health effects study: an ancillary study of the Cardiovascular Health Study. Annals of Behavioral Medicine, 19, 110116.CrossRefGoogle ScholarPubMed
Selwood, A., Johnston, K., Katona, C., Lyketsos, C. and Livingston, G. (2007). Systematic review of the effect of psychological interventions on family caregivers of people with dementia. Journal of Affective Disorders, 101, 7589.CrossRefGoogle ScholarPubMed
Sherbourne, C. D. and Stewart, A. L. (1991). The MOS social support survey. Social Science & Medicine, 32, 705714.CrossRefGoogle ScholarPubMed
Sorensen, S., Duberstein, P., Gill, D. and Pinquart, M. (2006). Dementia care: mental health effects, intervention strategies, and clinical implications. Lancet Neurology, 5, 961973.CrossRefGoogle ScholarPubMed
Stern, Y. et al. (1994). Assessing patient dependence in Alzheimer's disease. Journal of Gerontology, 49, M216.CrossRefGoogle ScholarPubMed
Sutcliffe, C. and Larner, S. (1988). Counselling carers of the elderly at home: a preliminary study. British Journal of Clinical Psychology, 27, 177178.CrossRefGoogle ScholarPubMed
Zhang, S., Edwards, H., Yates, P., Guo, Q. and Li, C. (2013). Partial mediation role of self-efficacy between positive social interaction and mental health in family caregivers for dementia patients in Shanghai. PLoS One, 8, e83326.CrossRefGoogle ScholarPubMed
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