From Sensory Loss to Caregiver Burden: The Mediating Role of Neuropsychiatric Symptoms in Lewy Body Disease

Sensory impairment is common in Lewy Body Disease (LBD) and may affect patients by contributing to neuropsychiatric symptoms, while also affecting caregivers and caregiver burden (Mori et al., 2000; Readman et al., 2026). However, this relationship in LBD remains poorly understood. This study investigated whether sensory impairment in LBD patients was associated with caregiver burden and whether neuropsychiatric symptoms could explain this relationship. A cross-sectional study was conducted in 57 individuals with LBD, including participants with Mild Cognitive Impairment and Dementia. Greater hearing impairment was associated with greater neuropsychiatric symptom severity in the overall sample (β = −.325, p = .030) and in participants with dementia (β = -.556, p = .002). Neuropsychiatric symptom severity was also associated with greater caregiver burden in the overall sample (β =.309, p = .035) and in the MCI group (β =.706, p = .004). Mediation analysis showed a significant indirect relationship through neuropsychiatric symptom severity in the total sample (BootSE = 0.409, 95% bootstrap CI [−1.613, −0.147]). The Patient and Public Involvement (PPI) consultation offered an additional perspective on the caregiving experience, suggesting that quantitative measures address important aspects of caregiving, but they may not capture its full complexity and multidimensionality. These findings highlight the potential role of sensory difficulties not only as clinical features of the disease, but also as factors that may contribute to the caregiving experience through neuropsychiatric manifestations. At the same time, caregivers’ perspectives highlight the need for more comprehensive approaches to assess their burden, emphasizing the importance of integrating both quantitative evidence and lived experience in LBD research.