Relationship Between Executive Functions and Burnout in Familial Caregivers of Alzheimer Disease Patients During the COVID-19 Pandemic in a Puerto Rico Sample.

Stephanie Torres-Ramos, Ponce Health Sciences University, Ponce, United States
Mary Moreno-Torres, Ponce Health Sciences University, Ponce, United States
Javier Hernandez-Justiniano, Ponce Health Sciences University, Ponce, United States
Glariangeliz Tapia, Ponce Health Sciences University, Ponce, United States


The assistance to Alzheimer's Disease (AD) patients is primarily provided by familial caregivers, who play an important role in managing the patient's needs. Studies suggest these caregivers suffer from burnout that may have increased during the COVID-19 pandemic. This study has two objectives: 1) To determine the relationship between burnout levels and general executive functions (EF) in familial caregivers of AD patients, and 2) To determine the relationship between the impact of the COVID-19 pandemic and the EF scales among family caregivers of AD patients. Little is known about the impact of burnout on the EF of the familial caregivers of AD patients in Puerto Rico and Latino communities. This is important to address as Medicaid and Medicare deficits, catastrophic events, and COVID-19 have left some Latino communities in economic crisis. The lack of available capital to provide basic services makes it difficult for public programs to prioritize investment in home care services.

Participants and Methods:

The participants of this study were 30 familial caregivers of AD patients. The total age ranged from 25 to 85 years (M = 52.2). Familial caregivers were from Puerto Rico, any gender, and social and economic background.  A non-probabilistic sampling by convenience was used in the study. The following instruments were used: The Comprehensive Executive Function Inventory Self-Reported Spanish Version (CEFI) to measure EF self-perceived difficulties, the Zarit Burden Interview (ZBI) to measure self-perceive burnout, and a Semi-structured Questionnaire (SSQ). The investigator created the SSQ to measure how the COVID-19 pandemic impacted EF before and after. Data collection was carried out through an online survey using REDCap. A correlational-descriptive analysis was carried out.


The results of this study revealed a weak negative correlation between burnout and general EF (r = -.182, p = .335), where higher levels of caregiver burnout were associated with lower EF total scores but were not statistically significant. A weak to moderate correlation between attention (r = -.548, p = .002), organization (r = -.559, p = .001), initiation (r = -581, p = <.001), emotional regulation (r = -.378, p = .040) with the COVID-19 pandemic was found but not statistically significant. However, the sum of the total scores before and after showed that even before the COVID-19 pandemic, most subjects had compromised EF. This moderate correlation is worth reviewing in further studies.


The impact of exposure to short and long-term stress is related to deficits in cognitive domains, putting caregivers at risk of neurocognitive decline. The COVID-19 pandemic exposed vulnerabilities in the healthcare system and services for people with dementia and their caregivers. Research, policy development, and education are recommended to prevent caregiver burnout and promote health equity since statistics show Latinos have an eight-month delay in dementia diagnosis. Aspects related to self-report inventory limitations and the sense of Familismo in Latino communities will be discussed in more detail in the presentation. Therefore, the authors suggest researching the impact of burnout in the EF of familial caregivers of AD patients in Latino communities with standardized neuropsychological measures to develop interventions for this population.

Category: Dementia (Alzheimer's Disease)

Keyword 1: caregiver burden
Keyword 2: executive functions