From Assessment to Impact: Predicting Caregiver Burden through Cognitive Dispersion

Abstract Objective Older adults with neurodegenerative diseases often experience cognitive deficits and may demonstrate reduced independence, leading to increased reliance on caregivers for assistance. Understanding the link between cognitive deficits and caregiver burden stands to improve care planning. This study aims to create a tool for predicting caregiver burden based on cognitive dispersion (CD) in neuropsychological performance. Method Participants include 674 clinically referred patients (52.1% female; Mean age = 75.33 ± 7.28). Participants were categorized as Subjective Memory Impairment (SMI; n = 129), Mild Neurocognitive Disorder (MildND; n = 218) or Major Neurocognitive Disorder (MajorND; n = 327) by a licensed neuropsychologist using a comprehensive battery. CD was measured across memory, language, executive function, and attention domains. The Zarit Burden Interview (ZBI) was analyzed using a total score and subscores based on personal strain and role strain. Results Analyses of variance revealed significant differences in CD between diagnostic groups (F(2,671) = 44.556; p < 0.001). Linear regressions displayed positive relationships between ZBI total score, personal strain, and role strain across groups combined (F(1,672) > 4.027; p < 0.05); however, when evaluating the same relationships within groups, only the relation between CD and ZBI role strain was found (F(1,117) = 4.180; p = 0.0431) in the SMI group. Conclusion Greater CD was associated with increased caregiver burden. While diagnostic groups displayed significant differences in CD, caregiver burden was only demonstrated in the SMI group in terms of role strain. These findings highlight the potential utility of cognitive dispersion as an early indicator of caregiver strain, particularly in subjective cognitive decline.