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Title: | Factors associated with long-term impact on informal caregivers during Alzheimer's disease dementia progression: 36-month results from GERAS |
Author: | Reed, Catherine Belger, Mark Scott Andrews, J. Scott Tockhorn Heidenreich, Antje Jones, Roy W. Wimo, Anders Dodel, Richard Haro Abad, Josep Maria |
Keywords: | Malaltia d'Alzheimer Cuidadors Investigació mèdica Alzheimer's disease Caregivers Medicine research |
Issue Date: | 28-May-2019 |
Publisher: | Cambridge University Press |
Abstract: | OBJECTIVE: To identify, in caregivers of patients with Alzheimer's disease (AD) dementia, factors associated with subjective (personal, physical, emotional, and social) and objective (informal caregiver time and costs) caregiver burden. DESIGN: Prospective longitudinal European observational study: post-hoc analysis. SETTING: Clinic. PARTICIPANTS: Community-dwelling patients in France and Germany aged ≥ 55 years (n = 969) with probable AD and their informal caregivers. MEASUREMENTS: Mini-Mental State Examination (MMSE), Alzheimer's Disease Cooperative Study-Activities of Daily Living (ADCS-ADL), 12-item Neuropsychiatric Inventory (NPI-12), Zarit Burden Interview (ZBI), informal caregiver basic and instrumental ADL hours (Resource Utilization in Dementia instrument), and informal caregiver costs. Mixed-effect models of repeated measures (MMRM) were run, including baseline and time-dependent covariates (change from baseline [CFB] to 18 months in MMSE, ADCS-ADL, and NPI-12 scores) associated with CFB in ZBI score/informal caregiver time over 36 months (analyzed using linear regression models) and informal caregiver costs over 36 months (analyzed using generalized linear models). RESULTS: Greater decline in patient function (ADCS-ADL) over 18 months was associated with increased subjective caregiver burden (ZBI), hours, and costs over 36 months. Increased behavioral problems (NPI-12) over 18 months also negatively impacted ZBI. Cognitive decline (MMSE) over 18 months did not affect change in caregiver burden. CONCLUSIONS: Long-term informal caregiver burden was driven by worsening functional abilities and behavioral symptoms but not cognitive decline, over 18 months in community-dwelling patients with AD dementia. Identifying the drivers of caregiver burden could highlight areas in which interventions may benefit both caregivers and patients. |
Note: | Reproducció del document publicat a: https://doi.org/10.1017/S1041610219000425 |
It is part of: | International Psychogeriatrics, 2019, vol. 32, num. 2, p. 267-277 |
URI: | http://hdl.handle.net/2445/174779 |
Related resource: | https://doi.org/10.1017/S1041610219000425 |
ISSN: | 1041-6102 |
Appears in Collections: | Articles publicats en revistes (Medicina) |
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