Factors associated with increased caregivers' burden in several cognitive stages of Alzheimer's disease

Abstract

Aim:To investigate factors associated with caregiver burden (CB) in persons caring for older adults with various cognitive stages of Alzheimer's disease (AD).Methods: Participants were 1127 outpatients and their caregivers. Participants comprised 120 older adults with normal cognition (NC), 126 with amnestic mild cognitive impairment (aMCI) and 881 with AD. AD patients were subclassified into four groups by Mini-Mental State Examination (MMSE) score: AD29-24 (n = 117), AD23-18 (n = 423), AD17-12 (n = 254) and AD11-0 (n = 87). Participants and their caregivers underwent comprehensive geriatric assessment batteries including Zarit Burden Interview (ZBI) Barthel Index, Lawton Index, Dementia Behavior Disturbance Scale (DBD) to evaluate CB, Instrumental and Basic Activity of Daily Living (IADL/BADL), and Behavioral and Psychological Symptoms of Dementia (BPSD). The comorbidity of geriatric syndrome and the living situation of the patient/caregiver were also assessed.Results: ZBI score was higher in patients with lower MMSE score. Multivariate regression analysis identified that DBD was consistently associated with CB in all patients; symptoms related to memory deficit were related to CB in aMCI; differential IADL, such as inability to use a telephone, use transportation, manage finances, shop, cook and take responsibility for own medication, were related to CB in AD29-24, AD23-18 and AD17-12, and geriatric syndrome including falls and motor disturbance, sleep problems, urinary incontinence, and fatigue was related to CB in AD23-18 and AD17-12.Conclusions: Multiple factors including BPSD, impaired life function and geriatric syndrome were cognitive stage-dependently associated with CB. Preventive treatment of BPSD and comorbidity, and effective assistance for IADL deficits could contribute to alleviation of CB. Geriatr Gerontol Int 2014; 14 (Suppl. 2): 45-55.

Improving Quality of Life in Caregivers of Alzheimer Dementia Patients- A Stepwise Approach

“…[37] ZBI scores were higher in patients with lower MMSE scores, and Dementia Behavior Disturbance Scale (DBD) score was associated with caregiver burden in all patients. [38] Symptoms related to memory deficit were correlated to caregiver burden in amnestic mild cognitive impairment, and differential IADL, such as inability to use a telephone, use transportation, manage finances, shop, cook and take responsibility for own medication, were related to caregiver burden in patients with MMSE scores between 29 and 12. [38] Geriatric syndrome with falls and motor disturbance, sleep problems, urinary incontinence, and fatigue was related to caregiver burden in patients with MMSE score between 23 and 12.…”

“…[38] Symptoms related to memory deficit were correlated to caregiver burden in amnestic mild cognitive impairment, and differential IADL, such as inability to use a telephone, use transportation, manage finances, shop, cook and take responsibility for own medication, were related to caregiver burden in patients with MMSE scores between 29 and 12. [38] Geriatric syndrome with falls and motor disturbance, sleep problems, urinary incontinence, and fatigue was related to caregiver burden in patients with MMSE score between 23 and 12. [38] ZBI scores indicated in bivariate regression analyses that caregiver burden was related to age, diagnosis, memory, impulse control and emotion recognition, while in stepwise multivariate regression independent significant contributions were patient age, memory and emotion recognition, explaining 23% of the variance.…”

“…[38] Geriatric syndrome with falls and motor disturbance, sleep problems, urinary incontinence, and fatigue was related to caregiver burden in patients with MMSE score between 23 and 12. [38] ZBI scores indicated in bivariate regression analyses that caregiver burden was related to age, diagnosis, memory, impulse control and emotion recognition, while in stepwise multivariate regression independent significant contributions were patient age, memory and emotion recognition, explaining 23% of the variance. [39] ZBI is used in detecting differences in caregiver burden during pharmacological treatment of AD patients.…”

Sintomas neuropsiquiátricos de idosos com Doença de Alzheimer e características comportamentais dos cuidadore

“…[42][43][44] A maioria das pesquisas se concentra nas consequências dos problemas comportamentais do paciente na vida do cuidador, apenas alguns estudos têm abordado a questão de saber se as características do cuidador preveem os SNPs no paciente. É aceito, então, que os SNPs contribuem para a sobrecarga e depressão dos cuidadores, mas a relação é susceptível de ser bidirecional.…”

Quality improvement in neurology

“…In 2014, unpaid caregivers provided nearly 18 billion hours of care to people with dementia, often at nontrivial cost to their own health and well-being. 8 After passage of the National Alzheimer's Project Act of 2011, an Advisory Council for Alzheimer's Research, Care, and Services convened to advise the Department of Health and Human Services; the National Plan it produced in 2012 featured a prominent call for quality measures for the care of patients with dementia. Measurement of quality in care practices and services for persons with dementia and their caregivers remained an integral part of the Advisory Council's work in 2016.…”