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P4–217: Identification of risk factors involved in institutionalization process of dementia patients in Brazil
Author(s) -
Ferretti Ceres Eloah L.,
Bertolucci Paulo Henrique F.,
Minett Thais S.C.
Publication year - 2006
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2006.05.1957
Subject(s) - institutionalisation , dementia , caregiver burden , medicine , logistic regression , nursing homes , activities of daily living , gerontology , cognition , risk factor , quality of life (healthcare) , psychiatry , nursing , disease , pathology
sion over time in a memory clinic population of non-institutionalized patients. Methods: 45 dementia patients in a memory clinic and their caregivers were followed over 2 years. Cognition, function, and behavioral/ psychological symptoms were repetitively assessed by GDS, MMSE, SKT, Geriatric Depression Screening scale, IADL/PSMS scale, BEHAVE-AD and NOSGER. Caregivers’ depression and subjective burden were evaluated by the Geriatric Depression Screening scale or Beck Depression Inventory and the Caregiver Burden Interview. The relationship of patient variables to caregiver variables was analyzed statistically using regression analysis and cluster analysis. Results: Global dementia severity, functional impairment, and behavioral disturbances increased significantly over observation period. Caregivers’ burden remained stable, and severe depression decreased over time. In general, dementia-related symptoms were significantly and strongly associated with caregiver burden, but less so with caregiver depression. Functional and behavioral deficits showed stronger association with caregiver burden in more advanced than in mild dementia. Although several facets of patients’ symptomatology and the total number of caregivers with any depression increased over time, the mean severity of depression remained mild to moderate, and the proportion of severe depression even decreased over time. Conclusions: Global severity of dementia, functional status and behavioral deficits in general are the most important patient factors for caregiver burden. Caregiver burden and depression appear to be different concepts, because depression in dementia carers is not as strongly related to patients’ factors as is caregiver burden. This has treatment implications both for patients and for caregivers.