Perceived caregiver stress in Alzheimer′s disease and mild cognitive impairment: A case control study

Abstract

Objectives:Cross sectional studies have reported a tremendous amount of stress in caregivers of patients with Alzheimer's disease (AD) and Mild Cognitive Impairment (MCI). The present study aimed at evaluating the perceived stress in caregivers of patients with AD and MCI compared to controls.Materials and Methods:Caregivers of patients diagnosed with Alzheimer's disease/Mild Cognitive Impairment were recruited at the Memory Clinic of Neurology Department of a Tertiary Care Hospital in Northern India. The controls included caregivers of patients with chronic medical and psychiatric disorders. Caregivers were interviewed using Perceived Stress Scale (PSS) and the patients were assessed using The Blessed Activity of Daily Living (ADL), Mini Mental State Examination (MMSE) and Clinical Dementia Rating scale. The perceived stress of caregivers was compared amongst both groups and correlated with the severity of illness and activities of daily living of the patients.Results:Caregivers of a total of 31 patients of AD/MCI (Males = 24, Females = 7), and 30 controls (Males = 18, Females = 12) were interviewed. PSS Score was 23.29 ± 7.17 in cases and 7.5 ± 3.12 in controls. ADL Score was 7.97±5.53 in cases and 0.00 in controls. There was a significant difference between the PSS and ADL scores between those with AD and controls (P < 0.0001). Caregivers of patients with MCI had lower PSS scores compared to AD caregivers but significantly higher scores compared to caregivers of other chronic disorders. Similarly, correlation between Perceived Stress and ADL was significant (P < 0.001).Conclusions:Present study shows that caregivers of patients with AD/MCI have a high perceived stress compared to caregivers of patients with other chronic illness.

Perceived caregiver stress in Alzheimer′s disease and mild cognitive impairment: A case control study

“…[ 2 3 ] One disadvantage of matching is that we cannot always find an exact match, a fact that is also agreed by the reader of this paper. We explained in the current paper[ 1 ] and also in our previous papers[ 4 ] of well-known sex bias in reporting dementia patients in India; hence, finding sex matching is difficult. Also, too much matching can make cases and controls too similar.…”

“…We thank the reader for having gone through the article[ 1 ] keenly and the editor for asking us to respond. We agree that choosing the right controls for the study is an important step in a case–control study.…”

“…We have studied perceived caregiver stress and not caregiver burden in the current study. While it is generally agreed and we too have mentioned that females are a major source of informal caregiving among Indian patients with dementia,[ 1 ] this question about gender is assumedly of little significance. In addition, the level of cognitive dysfunction and hours of caregiving have been linked with caregiver burden if readers mean the same rather than social and gender issues as per the available literature.…”

Choosing controls

“…Went through with interest article entitled “Perceived caregiver stress in Alzheimer's disease and mild cognitive impairment: A case–control study” published in Ann Indian Acad Neurol (2016;19:58-62). [ 1 ] The authors deserve credit for highlighting an important area of concern in patient management.…”

“…The authors conducted the present study in a case–control study design mode with caregivers of patients diagnosed with Alzheimer's disease/mild cognitive impairment (AD/MCI) identified as cases while the controls included caregivers of patients with chronic medical and psychiatric disorders. [ 1 ] Accordingly, a total of 31 patients of AD/MCI (males = 24, females = 7), and 30 controls (males = 18, females = 12) were interviewed. On the basis of this, the authors conclude that caregivers of patients with AD/MCI have a high perceived stress compared to caregivers of patients with other chronic illness.…”