The moderated mediation effect of caregiving stress and social support in the relationship between behavioral and psychological symptoms of dementia and caregiver burden in Oman - a cross-sectional study

Q: What was the main aim of the study in Oman?

To investigate how caregiving stress mediates the link between BPSD and caregiver burden, and how social support moderates this relationship in an Omani context.

Q: How was caregiver burden measured?

Caregiver burden was measured using the Zarit Burden Interview (ZBI-22).

Q: What were the key findings about the role of caregiving stress and social support?

Caregiving stress acted as a significant mediator, while the effect was moderated by the availability of social support, linking BPSD severity more strongly to caregiver burden.

Sep 30, 2026

Uploaded by jay

Caregivers of people with behavioral and psychological symptoms of dementia (BPSD) experience high emotional, physical, and psychological distress that can undermine health and caregiving ability. Caregiver burden is influenced by multiple factors, including BPSD severity, caregiving-related stress, and access to social support. This cross-sectional study assessed moderated mediation effects of caregiving stress and social support on the BPSD–caregiver burden relationship in an Omani context.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages11

Reading Time28 min

AccessFree to download

Abstract

Background

Methods

Results

Conclusions

Introduction

Dementia burden and prevalence

Caregiver burden and psychological distress

BPSD-related impacts

Al Ghammari etal. BMC Geriatrics (2026) 26:21 BMC Geriatrics [https://doi.org/10.1186/s12877-025-06677-z](https://doi.org/10.1186/s12877-025-06677-z) RESEARCH Open Access The moderated mediation effect of caregiving stress and social support in the relationship between behavioral and psychological symptoms of dementia and caregiver burden in Oman: a cross-sectional study Asma Al Ghammari 1, Min Guo 1, Hamed Al Sinawi2, Hamida Al Harthi3, Yueheng Yin 1, Shuzhen Niu 1, Enfang Shan 1 and Xianwen Li 1* Abstract Background Caregivers of individuals presenting behavioral and psychological symptoms of dementia (BPSD) experience substantial emotional, physical, and psychological distress, potentially compromising their health status and caregiving capacity. This burden manifests through a complex interplay offactors, including symptom severity, caregiving-related stress levels, and social support accessibility. Our study investigated the moderated mediation effects of caregiving stress and social support on the BPSD-caregiver burden relationship within the Omani context. Methods This cross-sectional study included 100 caregivers of patients with BPSD from Al Masarra Hospital and Sultan Qaboos University Hospital in Oman. Validated instruments were used: Zarit Burden Interview (ZBI-22) for caregiver burden, Abe’s BPSD Score (ABS) for neuropsychiatric symptoms, Caregiver Reaction Scale (CRS) for caregiving stress, and Multidimensional Scale of Perceived Social Support (MSPSS) for social support. Results The proposed model demonstrated a sound fit (PCMIN/DF = 2 . 612) . Statistical analysis revealed a significant positive correlation between BPSD severity and caregiver burden (p < 0. 01) . Caregiving stress emerged as a significant mediator in this relationship, with its effect moderated by social support availability. Furthermore, caregiver burden showed significant associations with dementia progression stage (β = 0 .42, p < 0. 001) and intensity of care requirements (β = 0 . 38, p < 0. 01) . Conclusions The research highlights the complex nature of caregiver burden in BPSD, indicating that caregiver stress increases the connection between BPSD and burden, while social support moderates this association. Specific interventions must incorporate stress reduction approaches, address patient-specific care needs, and enhance caregiver support systems to effectively reduce burden. *Correspondence: Xianwen Li[xwli0201@njmu.edu.cn](xwli0201@njmu.edu.cn) Full list of author information is available at the end of the article © The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creati](http://creati)[vecommons.org/l](vecommons.org/l)icenses/by-nc-nd/4.0/. Al Ghammari et al. BMC Geriatrics (2026) 26:21 Page 2 of 11 Keywords BPSD, Dementia, Alzheimer disease, Caregiver burden, Caregiving stress, Social support, Mediation analyses, Moderated mediation Introduction Dementia is a progressive neurological disorder that causes a decline in cognitive functions [1]. It impacts not only the live

FAQs

What was the main aim of the study in Oman?

To investigate how caregiving stress mediates the link between BPSD and caregiver burden, and how social support moderates this relationship in an Omani context.

How was caregiver burden measured?

Caregiver burden was measured using the Zarit Burden Interview (ZBI-22).

What were the key findings about the role of caregiving stress and social support?

Caregiving stress acted as a significant mediator, while the effect was moderated by the availability of social support, linking BPSD severity more strongly to caregiver burden.

Sep 30, 2026

Uploaded by jay