Caregiver Burden in Parkinson Disease: A Scoping Review of the Literature from 2017-2022

Aamodt, Whitley W.; Kluger, Benzi M.; Mirham, Miray; Job, Anna; Lettenberger, Samantha E.; Mosley, Philip E.; Seshadri, Sandhya

doi:10.1177/08919887231195219

Cited by 8 publications

(2 citation statements)

References 128 publications

(222 reference statements)

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“…Although we could not determine the exact reasons for readmission in our cohort, other studies have demonstrated that readmissions among PD patients are associated with medical comorbidities, elective surgeries, and caregiver strain ( Shahgholi et al, 2017 ; Fullard et al, 2020 ). For example, persons with advanced PD become increasingly reliant on caregivers for support, and increasing physical dependence can lead to caregiver burden ( Lo Monaco et al, 2021 ; Aamodt et al, 2023b ). Caregiver burden and depression are associated with a higher risk of emergency department visits ( Rashid et al, 2023 ) and re-hospitalization among persons with PD ( Shahgholi et al, 2017 ), presumably when caregivers are overwhelmed and require additional support.…”

Section: Discussionmentioning

confidence: 99%

Unique characteristics of end-of-life hospitalizations in Parkinson disease

Aamodt,

Dahodwala,

Bilker

et al. 2023

Front. Aging Neurosci.

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IntroductionPersons with Parkinson disease (PD) are hospitalized at higher rates, have longer lengths of stay, and are more likely to die in the hospital than age-matched peers. Although prior studies have compared inpatient outcomes between persons with and without PD, little is known about inpatient outcomes across the PD trajectory, or whether hospitalizations occurring in the last 6 months of life differ from earlier hospitalizations.MethodsThis cross-sectional study compared Medicare Part A and B beneficiaries aged 65 and older with a qualifying PD diagnosis who were hospitalized in 2017: decedents who died between 7/1/2017 and 12/31/2017 from all causes and were hospitalized at least once in their last 6 months of life, and non-decedents who were hospitalized between 1/1/2017 and 6/30/2017 and lived 6 or more months after discharge. End-of-life (EoL) hospitalizations were defined as those occurring in the last 6 months of life. Descriptive analyses compared patient-level variables (e.g., demographics, comorbidities, treatment intensity) and encounter-level variables (e.g., length of stay, total charges) between groups. Multivariable logistic regression models also compared rates of intensive care unit (ICU) admission and 30-day readmission between hospitalized decedents and hospitalized non-decedents, adjusting for age, sex, race/ethnicity, rural residence, and Charlson Comorbidity Index Score.ResultsOf 26,492 Medicare decedents with PD, 16,187 (61.1%) were hospitalized in their last 6 months of life. Of 347,512 non-decedents with PD, 62,851 (18.1%) were hospitalized in a 6-month period. Hospitalized decedents were slightly older than hospitalized non-decedents (82.3 [SD 7.40] vs. 79.5 [SD 7.54] years) and had significantly more comorbidities. Compared to non-EoL hospitalizations, EoL hospitalizations were slightly longer (5 [IQR 3–9] vs. 4 [IQR 3–7] days) and more expensive based on total charges per admission ($36,323 [IQR 20,091-69,048] vs. $32,309 [IQR 18,789–57,756]). In covariate-adjusted regression models using hospitalized non-decedents as the reference group, hospitalized decedents were more likely to experience an ICU admission (AOR 2.36; CI 2.28–2.45) and 30-day readmission (AOR 2.43; CI 2.34–2.54).DiscussionHospitalizations occurring in the last 6 months of life among persons with PD in the United States are longer, more costly, and more resource intensive than earlier hospitalizations and may stem from medical comorbidities. Once hospitalized, ICU admission and 30-day readmission may aid in prognostication and serve as markers of transition to the EoL period.

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Section: Discussionmentioning

confidence: 99%

Unique characteristics of end-of-life hospitalizations in Parkinson disease

Aamodt,

Dahodwala,

Bilker

et al. 2023

Front. Aging Neurosci.

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“…Based on these findings and awaiting the results of an ongoing validation study of the MNCD classification and of its application in a prospective follow‐up cohort, early observations suggest that the MNCD classification could be a useful tool to apply in PD patients to identify the main symptoms of the disease and to monitor the progression of the disorder. Neuropsychiatric symptoms, such as visual hallucinations, depression, cognitive impairment and/or dementia, falls, disability, and a more advanced stage disease, have been identified as patient factors associated with caregiver burden in PD (Aamodt et al., 2023 ). All these data are collected in the MNCD classification with also a proposed staging and scoring that indicates the degree of severity, from least to most.…”

Section: Introductionmentioning

confidence: 99%

Staging Parkinson's disease according to the MNCD classification correlates with caregiver burden

Santos‐García,

de Deus Fonticoba,

Cores Bartolomé

et al. 2023

Brain and Behavior

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Background and objectiveRecently, we demonstrated that staging Parkinson's disease (PD) with a novel simple classification called MNCD, based on four axes (motor, non‐motor, cognition, and dependency) and five stages, correlated with disease severity and patients’ quality of life. Here, we analyzed the correlation of MNCD staging with PD caregiver's status.Patients and methodsData from the baseline visit of PD patients and their principal caregiver recruited from 35 centers in Spain from the COPPADIS cohort from January 2016 to November 2017 were used to apply the MNCD total score (from 0 to 12) and MNCD stages (from 1 to 5) in this cross‐sectional analysis. Caregivers completed the Zarit Caregiver Burden Inventory (ZCBI), Caregiver Strain Index (CSI), Beck Depression Inventory‐II (BDI‐II), PQ‐10, and EUROHIS‐QOL 8‐item index (EUROHIS‐QOL8).ResultsTwo hundred and twenty‐four PD patients (63 ± 9.6 years old; 61.2% males) and their caregivers (58.5 ± 12.1 years old; 67.9% females) were included. The frequency of MNCD stages was 1, 7.6%; 2, 58.9%; 3, 31.3%; and 4–5, 2.2%. A more advanced MNCD stage was associated with a higher score on the ZCBI (p < .0001) and CSI (p < .0001), and a lower score on the PQ‐10 (p = .001), but no significant differences were observed in the BDI‐II (p = .310) and EUROHIS‐QOL8 (p = .133). Moderate correlations were observed between the MNCD total score and the ZCBI (r = .496; p < .0001), CSI (r = .433; p < .0001), and BDI‐II (r = .306; p < .0001) in caregivers.ConclusionStaging PD according to the MNCD classification is correlated with caregivers’ strain and burden.

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Analysis of mortality in Parkinson disease in China: Exploration of recent and future trends

Lan,

Ren,

Song

et al. 2024

Aging Medicine

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ObjectivesParkinson disease (PD) is the third leading cause of mortality among middle‐aged and older individuals in China. This study aimed to explore the trends and distribution features of PD mortality in China from 2013 to 2021 and make predictions for the next few decades.MethodsRelevant data were obtained from the Chinese Center for Disease Control and Prevention Disease Surveillance Point system. The joinpoint regression model was used to evaluate trends. The R software was used to predict future trends.ResultsAge‐standardized mortality rate (ASMR) of PD increased from 0.59 per 100,000 individuals to 1.22 per 100,000 individuals from 2013 to 2021, with an average annual percent change (AAPC) of 9.50 (95% CI: 8.24–10.78). The all‐age ASMR of PD were higher in male individuals than in female individuals, and ASMR increased with age. The number of deaths and ASMR increased gradually from west to east and from rural to urban areas. Furthermore, ASMR is expected to increase to 2.66 per 100,000 individuals by 2040.ConclusionsThe heightened focus on the ASMR of PD among male individuals, urban areas, eastern China, and individuals aged ≥85 years has become a key determinant in further decreasing mortality, thereby exhibiting novel challenges to effective strategies for disease prevention and control.

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Caregiver Burden in Parkinson Disease: A Scoping Review of the Literature from 2017-2022

Cited by 8 publications

References 128 publications

Unique characteristics of end-of-life hospitalizations in Parkinson disease

Unique characteristics of end-of-life hospitalizations in Parkinson disease

Staging Parkinson's disease according to the MNCD classification correlates with caregiver burden

Analysis of mortality in Parkinson disease in China: Exploration of recent and future trends

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