Caregiving burden and out-of-home mobility of cognitively impaired care-recipients based on GPS tracking

Background: Out-of-home mobility refers to the realization of trips outside the home, by foot or by other means of transportation. Although out-of-home mobility is important for the well-being of older people with cognitive impairment, its importance for their caregivers is not clear. This study aims to clarify the relationship between caregiving burden and out-of-home mobility of care-recipients using Global Positioning Systems (GPS) technology. Methods: Seventy-six dyads (care-recipients and caregivers) were recruited from a psychogeriatric center, where they underwent cognitive assessment, followed by psychosocial interviews at home. Care-recipients received GPS tracking kits to carry for a period of four weeks, whenever they left home. Mobility data and diagnostic and psychosocial data were examined in relation to caregiver burden. Results: The strongest predictors of burden were care-recipients lower cognitive status and more time spent walking out-of-home. An interaction was found between cognitive status and time spent walking in relation to caregiver burden. The relationship between walking and burden was stronger among caregivers of carerecipients with dementia than caregivers of care-recipients with no cognitive impairment or mild cognitive impairment. Care-recipients behavioral and emotional states were also positively related to caregiver burden. Conclusions: The findings stress the importance of maintaining older persons out-of-home mobility during cognitive decline.