Journal List > Korean J Adult Nurs > v.31(4) > 1135954

Korean J Adult Nurs. 2019 Aug;31(4):351-364. Korean.
Published online Aug 23, 2019.
© 2019 Korean Society of Adult Nursing
Factors associated with Burden of Family Caregivers of Home-dwelling Elderly People with Dementia: A Systematic Review and Meta-analysis
Eun Kyung Kim,1 and Heeok Park2
1Researcher, Research Institute of Nursing Science, Keimyung University, Daegu, Korea.
2Associate Professor, College of Nursing · Research Institute of Nursing Science, Keimyung University, Daegu, Korea.

Corresponding author: Park, Heeok. College of Nursing, Keimyung University, 1095 Dalgubeol-daero, Dalseo-gu, Daegu 42601, Korea. Tel: +82-53-258-7655, Fax: +82-53-258-7616, Email:
Received Apr 23, 2019; Revised Jun 21, 2019; Accepted Jul 28, 2019.

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



This study was a systematic review and meta-analysis designed to investigate the variables related to burden of caregivers of people with dementia living at home.


In total, 24 studies were identified through a systematic review and 11 studies met the inclusion criteria for the meta-analysis. EMBASE, MEDLINE (Ovid-MEDLINE, Pubmed) and several Korean databases were searched until April 2018. ‘R 3.5.1’ version was used to analyze the correlated effect sizes.


According to the results, variables related to caregivers' burden were categorized into factors related to patients and factors related to family caregivers. The effect sizes of correlations between factors associated with patients and caregivers' burden were as follows: problematic behavior & cognition (memory) (.42), problematic behavior (.37), cognition (memory) (.35), stage of dementia (.31), and ability to perform daily life functions (−.27). Factors associated with family caregivers correlated with caregiver burden as follows: health status (−.40), relation (.33), education (.25), time of caring (.24), income (−.21), age (.20), job (−.17), duration of caring (.15), and religion (.14).


Based on the findings, family caregiver needs to preferentialy try to manage problematic behavior & cognition (memory) of dementia and health professionals need to provide comprehensive nursing interventions to improve health for patients with dementia but also family caregivers.

Keywords: Dementia; Caregivers; Meta-analysis; Systematic review



Table 1
Characteristics of Studies included in Systemic Review; for Patients
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Table 2
Characteristics of Studies included in Systemic Review; for Family Caregivers
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Table 3
Effect Size of Defensive Sub-variables related to Burden
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CONFLICTS OF INTEREST:The authors declared no conflict of interest.


  • Study conception and design acquisition - KEK and PH.

  • Data collection - KEK.

  • Analysis and interpretation of the data - KEK and PH.

  • Drafting - KEK.

  • Critical revision of the manuscript - PH.

  • Final approval - KEK and PH.


This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by Ministry of Education (No. 2017R1D1A3B03032896).

Appendix 1

Studies Included in Systematic Review and Meta-analysis

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A2. Campbell P, Wright J, Oyebode J, Job D, Crome P, Bentham P, et al. Determinants of burden in those who care for someone with dementia. International Journal of Geriatric Psychiatry. 2008;23(10):1078-85.

A3. Cheng S-T, Lam LCW, Kwok T. Neuropsychiatric symptom clusters of Alzheimer disease in Hong Kong Chinese: correlates with caregiver burden and depression. The American Journal of Geriatric Psychiatry. 2013;21(10):1029-37.

A4. Choi YO. A study on the care burden and service demand of the poverty families caring for the demented elderly. Journal of Korean Geriatric Psychiatry. 2005;9(2):122-31.

A5. Cho E, Cho E, Kim S. Effects of family relationship on burden of family caregivers of older adult with dementia. Journal of the Korean Gerontological Society. 2010;30(2):421-37.

A6. Han EJ, Na YK, Lee JS, Kwon J. Factors to influence the family caregivers' burden with the community-dwelling elderly under long-term care insurance system: comparison among sub-dimensions. Korea Social Policy Review. 2015;22(2):61-96.

A7. Han JW, Jeong H, Park JY, Kim TH, Lee DY, Lee DW, et al. Effects of social supports on burden in caregivers of people with dementia. International Psychogeriatrics. 2014;26(10):1639-48.

A8. Kong E-H, Cho E, Song M. The burden and caregiving satisfaction of primary family caregivers of older adults with dementia: cultural and non-cultural predictors. Journal of the Korean Gerontological Society. 2009;29(2):701-16.

A9. Lee E-H. Impact of family function in the burden of caregiving elderly dementia patients. Korean Journal of Gerontological Social Welfare. 2003;19:173-97.

A10. Lee H-J. Influencing factors and caregiving burden among primary caregiver for demented elderly. Korean Journal of Care Work. 2006a;2(1):33-60.

A11. Lee H-J. The effect of caregiver's burden for the dementia elderly by the use of daycare center. Journal of the Korean Gerontological Society. 2006b;26(2):329-46.

A12. Lee Y, Kim H, Cho I. Factors influencing care burdens of caregivers of elders with dementia who request dementia domiciliary welfare services. Journal of Korean Academy of Fundamentals of Nursing. 2008;15(3):274-83.

A13. Liu S, Li C, Shi Z, Wang X, Zhou Y, Liu S, et al. Caregiver burden and prevalence of depression, anxiety and sleep disturbances in Alzheimer's disease caregivers in China. Journal of Clinical Nursing. 2017;26(9-10):1291-300.

A14. Ma PS. A study on the people in charge of the demented-especially people in the day care center or short stay service. [master's thesis]. Seoul: Ewha Womans University; 1998. p. 1-93.

A15.Miller LA, Mioshi E, Savage S, Lah S, Hodges JR, Piguet O. Identifying cognitive and demographic variables that contribute to carer burden in dementia. Dementia and Geriatric Cognitive Disorders. 2013;36(1-2):43-9.

A16. Mioshi E, Foxe D, Leslie F, Savage S, Hsieh S, Miller L, et al. The impact of dementia severity on caregiver burden in frontotemporal dementia and Alzheimer disease. Alzheimer Disease & Associated Disorders. 2013;27(1):68-73.

A17. Onishi, J, Suzuki Y, Umegaki H, Nakamura A, Endo H, Iguchi A. Influence of behavioral and psychological symptoms of dementia (BPSD) and environment of care on caregivers' burden. Archives of Gerontology and Geriatrics. 2005;41(2):159-68.

A18. Rosdinom R, Zarina MZN, Zanariah MS, Marhani M, Suzaily W. Behavioural and psychological symptoms of dementia, cognitive impairment and caregiver burden in patients with dementia. Preventive Medicine. 2013;57:S67-9.

A19. Shin H, Youn J, Kim JS, Lee J-Y, Cho JW. Caregiver burden in Parkinson disease with dementia compared to Alzheimer disease in Korea. Journal of Geriatric Psychiatry and Neurology. 2012;25(4):222-6.

A20. Son YJ, Kang KS, Kim SJ. The home care need and the burden of a primary family care giver with senile dementia patients. Journal of Korean Academy of Community Health Nursing. 2000;11(2):423-40.

A21. Song M-Y, Choe G-G. The decision factor on primary caregiver's burden for senile dementia elderly. Korean Journal of Gerontological Social Welfare. 2007;37:131-60.

A22. Yoo IY, Kim M. Influencing factors on care burden in the caregivers of demented elderly. Journal of Korean Gerontological Nursing. 2006;8(1):45-57.

A23. You KS. A study on the care burden of family caregivers for senile dementia. Journal of Korean Public Health Nursing. 2001;15(1):125-47.

A24. Wang J, Xiao LD, He G-P, Ullah S, De Bellis A. Factors contributing to caregiver burden in dementia in a country without formal caregiver support. Aging & Mental health. 2014;18 (8):986-96.

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