Caregiver burden, depression, and anxiety in caregivers of dementia patients: A hospital-based cross-sectional study

Objectives: Caregiving of dementia patients is consistently associated with considerable psychological strain. The present study was undertaken to assess caregiver burden, depression, and anxiety among caregivers of dementia patients and to examine the relationship among these variables in a hospital setting. Material and Methods: A cross-sectional study was conducted at the Institute of Mental Health and Neurosciences-Kashmir (IMHANS-K). The study sample consisted of 65 caregivers (36 females and 29 males) of patients diagnosed with Alzheimer's disease, frontotemporal dementia, Lewy body dementia, and vascular dementia, all diagnosed by consultant psychiatrists using International Classification of Diseases, 10th Revision (ICD-10) criteria. Caregiver burden was assessed using the Zarit Burden Interview (ZBI), and anxiety and depressive symptoms were measured using the Hospital Anxiety and Depression Scale (HADS), with established cut-off scores of 0-7 (Normal), 8-10 (Borderline), and 11-21 (Elevated). The Shapiro-Wilk test confirmed non-normal distribution of all key variables, justifying the use of non-parametric tests. Data were analyzed using descriptive statistics, Chi-square test, Spearman's rank correlation, and regression analysis with a significance threshold of p < 0.05. Results: The mean ZBI score was 58.2 (standard deviation [SD] = 11.49), indicating moderate to severe caregiver burden. Mean HADS-Anxiety (HADS-A) and HADS-Depression (HADS-D) scores were 13.2 (SD = 3.33) and 11.2 (SD = 3.17), respectively, reflecting elevated emotional distress. Using HADS cut-off scores, 70.8% of caregivers scored in the elevated range for anxiety (HADS-A ≥ 11) and 46.2% in the elevated range for depression (HADS-D ≥ 11), while 50.8% experienced severe caregiver burden. Chi-square analysis revealed significant associations of caregiver burden with socioeconomic status (χ 2 = 19.70, p = 0.003), education level (χ 2 = 18.58, p = 0.005), and patient diagnosis (χ 2 = 14.00, p = 0.029), and of anxiety with socioeconomic status (χ 2 = 17.60, p = 0.007) and education (χ 2 = 22.20, p = 0.008). Spearman's correlation showed significant positive relationships among caregiver burden, anxiety, and depression (rho = 0.517 to 0.689, p < 0.001). Regression analysis identified both anxiety and depression as significant predictors of caregiver burden (Adjusted R 2 = 0.4371, p < 0.001). Conclusion: Caregivers of dementia patients endure considerable psychological distress. The significant interrelationship between caregiver burden, anxiety, and depressive symptoms underscores the need for routine psychological screening and targeted psychosocial interventions for caregivers in clinical settings.