Premium
Factors associated with increased caregivers' burden in several cognitive stages of A lzheimer's disease
Author(s) -
Kamiya Masaki,
Sakurai Takashi,
Ogama Noriko,
Maki Yohko,
Toba Kenji
Publication year - 2014
Publication title -
geriatrics and gerontology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.823
H-Index - 57
eISSN - 1447-0594
pISSN - 1444-1586
DOI - 10.1111/ggi.12260
Subject(s) - dementia , medicine , activities of daily living , comorbidity , cognition , caregiver burden , montreal cognitive assessment , disease , gerontology , alzheimer's disease , psychiatry , physical therapy
Aim To investigate factors associated with caregiver burden ( CB ) in persons caring for older adults with various cognitive stages of A lzheimer'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 M ini‐ M ental S tate E xamination ( MMSE ) score: AD 29–24 ( n = 117), AD 23–18 ( n = 423), AD 17–12 ( n = 254) and AD 11–0 ( n = 87). Participants and their caregivers underwent comprehensive geriatric assessment batteries including Z arit B urden I nterview ( ZBI ) B arthel Index, L awton Index, D ementia B ehavior D isturbance S cale ( DBD ) to evaluate CB , I nstrumental and B asic A ctivity of D aily L iving ( IADL / BADL ), and B ehavioral and P sychological S ymptoms of D ementia ( 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 AD 29–24, AD 23–18 and AD 17–12, and geriatric syndrome including falls and motor disturbance, sleep problems, urinary incontinence, and fatigue was related to CB in AD 23–18 and AD 17–12. 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.