{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T18:49:36Z","timestamp":1787942976805,"version":"build-2784847793"},"reference-count":47,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T00:00:00Z","timestamp":1770336000000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R01 AG1620901"],"award-info":[{"award-number":["R01 AG1620901"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National Institute for Neurological Research","award":["LX22NPO5107"],"award-info":[{"award-number":["LX22NPO5107"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Dementia is more prevalent in Puerto Rico than in the U.S. mainland, increasing demands for caregiving. However, research on the mental health impact of dementia caregiving among island Puerto Ricans is sparse. We examined caregiver burden and depressive symptoms among Puerto Rican dementia caregivers while also considering behavioral and psychological symptoms of dementia (BPSD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using data from the Puerto Rican Elder: Health Conditions (PREHCO) study (Wave 3), 132 caregivers of PREHCO participants requiring care completed an ancillary data collection, of whom 101 cared for PREHCO participants with dementia. Measures included the 15-item Geriatric Depression Scale (depressive symptoms), Neuropsychiatric Inventory Questionnaire (NPI-Q; BPSD), and Zarit Burden Interview (ZBI-6; caregiver burden).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Caregivers were 63\u2009\u00b1\u200910\u2009years of age on average, and 77% were women. Exploratory factor analysis yielded two BPSD factors: Emotional Dysfunction\/Behavioral Instability and Perceptual Disturbances\/Apathy. In linear regression models adjusted for age, sex, education, marital status, self-rated health, hours of caregiving per week, and perceived social support, caregiver burden was positively associated with depressive symptoms (\u03b2\u2009=\u20090.68, p &amp;lt; .001), as were BPSD factors Emotional Dysfunction\/Behavioral Instability (\u03b2\u2009=\u20090.50, p &amp;lt; .001) and Perceptual Disturbances\/Apathy (\u03b2\u2009=\u20090.50, p &amp;lt; .001). Only Perceptual Disturbances\/Apathy significantly moderated this association (\u03b2\u2009=\u20090.24, p = .032), with the burden\u2013depression link strengthening as BPSD increased. Appetite\/Eating Symptoms (\u03b2\u2009=\u20090.42, p = .007) emerged as the main BPSD item driving this moderation effect.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>In this Puerto Rico-based sample, perceptual disturbances\/apathy, and appetite\/eating symptoms specifically, were most likely to magnify the caregiver burden-depressive symptoms link.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/geronb\/gbag014","type":"journal-article","created":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T12:21:09Z","timestamp":1770034869000},"source":"Crossref","is-referenced-by-count":1,"title":["Burden and well-being among dementia caregivers in Puerto Rico: the role of behavioral and psychological symptoms of dementia"],"prefix":"10.1093","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-1904-3528","authenticated-orcid":false,"given":"Junyub","family":"Lim","sequence":"first","affiliation":[{"name":"Edson College of Nursing and Health Innovation, Arizona State University , Phoenix, Arizona,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ross","family":"Andel","sequence":"additional","affiliation":[{"name":"Edson College of Nursing and Health Innovation, Arizona State University , Phoenix, Arizona,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3416-6434","authenticated-orcid":false,"given":"Frank","family":"Puga","sequence":"additional","affiliation":[{"name":"School of Nursing, University of Alabama at Birmingham , Birmingham, Alabama,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda P","family":"Aranda","sequence":"additional","affiliation":[{"name":"Suzanne Dworak-Peck School of Social Work, Edward R. 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