Predictors of Informal Caregiver Burden in Parkinson’s: A Systematic Review

Background: Caregivers of people with Parkinson’s disease are at risk of experiencing caregiver
burden. Understanding contributing factors is required to develop appropriate
targeted interventions and support for this group. This systematic review provides an
updated appraisal and synthesis of quantitative studies assessing predictors of
burden among informal caregivers of people with Parkinson’s.
Method: Five electronic databases (APA PsycINFO, CINAHL, MEDLINE, Web of Science, and
Cochrane Library) were systematically searched (from inception until July 2024),
supplemented by hand-searches. Study quality was assessed using the cross-
sectional JBI Critical Appraisal Checklist. Results were synthesised narratively.
Results: Forty-one studies were included. Predictors of increased burden included greater
impact of motor symptoms on ADLs, greater severity of neuropsychiatric symptoms,
poorer quality of life of the person with Parkinson’s, and poorer caregiver mental
health. Demographics, presence of motor symptoms, motor complications, and
general cognitive function did not predict burden. Evidence was inconclusive for
several variables including disease stage and duration, motor symptom severity,
functional ability, overall non-motor symptoms, mental health of the person with
Parkinson’s, and caregivers’ involvement and protective factors.
Conclusion: Several areas for potential future intervention are indicated, although
methodological weaknesses within the literature constrain the robustness of
conclusions. Key areas for future research include exploring understudied variables
(caregiver personality and coping style, relationship quality, and positive aspects of
caregiving) that may be important predictors of burden, specifying and utilising a
more consistent definition of “informal caregiver”, and recruiting younger and non-
spousal caregivers and more diverse samples regarding disease severity.