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[P4–389]: REDUCING AND PREVENTING CAREGIVERS’ BURDEN: THE EFFICACY OF DEMENTIA CARE MANAGEMENT FOR INFORMAL DEMENTIA CAREGIVERS
Author(s) -
Zwingmann Ina,
Thyrian Jochen René,
Michalowsky Bernhard,
Wucherer Diana,
DreierWolfgramm Adina,
Hoffmann Wolfgang
Publication year - 2017
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.2017.06.2260
Subject(s) - dementia , caregiver burden , intervention (counseling) , medicine , randomized controlled trial , cluster randomised controlled trial , family caregivers , delphi method , gerontology , psychology , nursing , disease , surgery , pathology , statistics , mathematics
Impairment (MCI) and even prior to MCI. How best to measure early functional changes, and whether self-report or informantreport are differentially sensitive remains under debate. In the present study we examined the utility of selfand informant-reported functional abilities in predicting risk of transitioning from normal cognition to MCI or transition from MCI to dementia. Methods:Participants of this study were part of a longitudinal, observational research cohort at the University of California, Davis Alzheimer’s Disease Center (ADC). Older adult participants had been diagnosed with normal cognition or MCI at study baseline, had an informant who could complete informant-based ratings, and had at least one follow-up visit (average of 3-4 years). Participants and informants each completed the Everyday Cognition (ECog) scale, a questionnaire-based instrument designed to measure early and mild everyday functional changes across six cognitively-relevant domains (Everyday Memory, Language, Visuospatial abilities, Planning, Organization and Divided Attention). Risk of progression to MCI or dementia by baseline ECog scores (and demographic data) was evaluated using Cox proportional hazard models. Results: Both selfand informant-reported functional limitations on the ECog (Total score) were associated with a significant increase in risk of diagnostic progression to MCI (HR1⁄42.3, CI 1⁄4 1.4-3.6 and HR1⁄42.0, CI 1⁄4 1.3-3.2, respectively). When examining risk of progression from MCI to dementia, again both selfand informant-reported baseline Total ECog (HR 1⁄41.8, 1.2-2.8 and HR1⁄44.2, 3.0-5.8, respectively) were significant predictors although informant-report was much more strongly associated with conversion. Even when controlling for baseline cognitive abilities, results both for predicting MCI and dementia remained similar. Conclusions: Findings indicate that early cognitively-based functional limitations have prognostic value and help identify older adults at risk for developing MCI or dementia. Both selfand informant-reported everyday function are useful in predicting the development of MCI, whereas later in the disease (the transition from MCI to dementia) informant-reported everyday function is most strongly predictive.