The Caregiver Burden Inventory in evaluating the burden of caregivers of elderly demented patients: results from a multicenter study.

BACKGROUND AND AIMS: The burden perceived by caregivers of patients with dementia is a fundamental prognostic aspect in the history of the disease. The aim of this study was to demonstrate the internal consistency of the Caregiver Burden Inventory (CBI), a scale used to quantify burdens in different aspects of a caregiver's life, and the influence of patients' and caregivers' characteristics on its different dimensions. METHODS: In this cross-sectional study, 419 demented patients and their caregivers were evaluated in 16 geriatric centers in Italy. Cognitive status and behavioral disturbances were assessed by the Mini Mental State Examination (MMSE) and Neuropsychiatric Inventory (NPI), respectively. Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) were also evaluated. Comorbidity was assessed by the Cumulative Illness Rating Scale (CIRS). The severity of dementia was evaluated by the Clinical Dementia Rating (CDR) score. Caregiver distress due to the behavioral problems of the patient was assessed by the Neuropsychiatric Inventory-Distress, a subscale of the NPI which evaluates stress caused by each behavioral disturbance of the patient, and by the Brief Symptom Inventory which evaluates anxiety and depression. Burden was evaluated by the CBI. RESULTS: The CBI showed very high internal consistency (Cronbach's alpha value > 0.80). Factor analysis showed that the items clustered into four dimensions, and not five as originally proposed. Multiple regression analysis revealed that patients' behavioral disturbances and disability were the major predictors of the time-dependent burden; the psychophysical burden was explained mainly by caregiver anxiety and depression. CONCLUSIONS: The CBI proved to be an effective multidimensional tool for evaluating the impact of burden on many aspects of caregivers' lives.

Changes in anthropometric measures in men and women across the life-span: findings from the InCHIANTI study.

OBJECTIVES: To describe the age distribution of anthropometric parameters in a population-based sample of older persons. METHODS: Cross-sectional survey of a population-based sample of persons over a wide age-range living in the Chianti area, Italy, between 1998 to 2000. Total cohort: 1453 men and women, of whom 424 younger than 65 and 1029 aged 65 years or older. Participation rate: 69.4% in < 65 yrs and 91.6% in > or = 65 yrs. Analytical cohort: anthropometric measures were available for 1266 subjects. RESULTS: Height and weight declined with increasing age in both sexes. In men, Body mass index (BMI) increased with age up to age 45-54 and then it declined. In women, it reached its maximum at age 65-74 and remained higher than in men in each corresponding age group above 65 years of age. Waist-to-hip ratio (WHR) progressively increased in men up to age 55-64 and then slightly declined. In women WHR steadily increased over the entire age range. CONCLUSIONS: Height and weight decline with age, regardless to differences in body size attributable to secular trend. In both sexes, important fat redistribution occurs between 45 and 54 years and in older women the increase in WHR mostly reflects a reduction of fat deposits in the hips. This information may be relevant for a correct interpretation of changes in WHR in older persons. However, these findings were obtained in a cross-sectional study and should be verified in a longitudinal perspective.