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      A validation of the Croatian version of Zarit Burden Interview and clinical predictors of caregiver burden in informal caregivers of patients with dementia: a cross-sectional study


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          To validate the Croatian version of the Zarit Burden Interview (ZBI) and to investigate the predictors of perceived burden.


          This cross-sectional study involved 131 dyads of one informal caregiver family member and one patient with dementia visiting primary care practices (Health Care Center Zagreb-West; 10/2017-9/2018). Patient-related data were collected with the Mini-Mental-State-Examination, Barthel-index, and Neuropsychiatric-Inventory-Questionnaire (NPI-Q); caregiver-related data with the ZBI, and general information on caregivers and patients with a structured questionnaire. Principal-axis-factoring with varimax-rotation was used for factor analysis.


          The caregivers' mean age was 62.1 ± 13 years. They were mostly women (67.9%) and patients' children (51.1%). Four dimensions of ZBI corresponding to personal strain, frustration, embarrassment, and guilt were assessed and explained 56% variance of burden. Internal consistency of ZBI (α = 0.87) and its dimensions (α 1 = 0.88, α 2 = 0.83, α 3 = 0.72, α 4 = 0.75) was good. Stronger cognitive and functional impairment of patients was associated only with personal strain, whereas more pronounced neuropsychiatric symptoms and the need for daily care were associated with more dimensions. Longer caregiver education suppressed embarrassment and promoted guilt. Guilt was higher in younger caregivers, caregivers of female patients, patients' children, and non-retired caregivers. In multivariate analysis significant predictors of higher overall burden were male sex of the patient, higher NPI-Q, the need for daily-care services, shorter duration of caregiving, non-spouse relationship, higher number of hours caring per-week, and anxious-depressive symptoms in a caregiver.


          The Croatian version of ZBI is reliable and valid. Our data confirm that ZBI is a multidimensional construct. Caregivers may benefit from individually tailored interventions.

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          Most cited references40

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          The Neuropsychiatric Inventory: Comprehensive assessment of psychopathology in dementia

          Neurology, 44(12), 2308-2308
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            The global prevalence of dementia: a systematic review and metaanalysis.

            The evidence base on the prevalence of dementia is expanding rapidly, particularly in countries with low and middle incomes. A reappraisal of global prevalence and numbers is due, given the significant implications for social and public policy and planning. In this study we provide a systematic review of the global literature on the prevalence of dementia (1980-2009) and metaanalysis to estimate the prevalence and numbers of those affected, aged ≥60 years in 21 Global Burden of Disease regions. Age-standardized prevalence for those aged ≥60 years varied in a narrow band, 5%-7% in most world regions, with a higher prevalence in Latin America (8.5%), and a distinctively lower prevalence in the four sub-Saharan African regions (2%-4%). It was estimated that 35.6 million people lived with dementia worldwide in 2010, with numbers expected to almost double every 20 years, to 65.7 million in 2030 and 115.4 million in 2050. In 2010, 58% of all people with dementia lived in countries with low or middle incomes, with this proportion anticipated to rise to 63% in 2030 and 71% in 2050. The detailed estimates in this study constitute the best current basis for policymaking, planning, and allocation of health and welfare resources in dementia care. The age-specific prevalence of dementia varies little between world regions, and may converge further. Future projections of numbers of people with dementia may be modified substantially by preventive interventions (lowering incidence), improvements in treatment and care (prolonging survival), and disease-modifying interventions (preventing or slowing progression). All countries need to commission nationally representative surveys that are repeated regularly to monitor trends. Copyright © 2013 The Alzheimer's Association. Published by Elsevier Inc. All rights reserved.
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                Author and article information

                Croat Med J
                Croat Med J
                Croatian Medical Journal
                Croatian Medical Schools
                December 2020
                : 61
                : 6
                : 527-537
                [1 ]Health Care Center Zagreb-West, Zagreb, Croatia
                [2 ]Department of Medical Informatics, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
                [3 ]Sveti Ivan Psychiatric Hospital, Zagreb, Croatia
                [4 ]Hematology Department, Dubrava University Hospital, Zagreb, Croatia
                [5 ]University of Zagreb School of Medicine, Zagreb, Croatia
                Author notes
                Correspondence to:
Jelena Lucijanić
Health Care Center Zagreb-West
Prilaz baruna Filipovića 11
10000, Zagreb, Croatia
 jemileti@ 123456yahoo.com
                Copyright © 2020 by the Croatian Medical Journal. All rights reserved.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                : 08 July 2020
                : 21 November 2020
                Research Article



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