title: Stress affects carers before patient's first visit to a memory clinic.
abstract: OBJECTIVE
  To measure and compare the burden on spousal carers of patients with and without dementia who were consulting a memory clinic for the first time.
  
  
  METHODS
  We included 413 dyads of patients and their spousal carers consulting a memory clinic for the first time. Of them 276 had a diagnosis of Cognitive Impairment No Dementia (CIND) and 137 had a dementia diagnosis. The burden of care was measured with the Relative Stress Scale (RSS). The gender of patients and their spouses was recorded and measures of cognition, depression and functional capacity of the patients were included in the analysis.
  
  
  RESULTS
  Of all carers, 27.6% had a score on the RSS of above 23, indicating a moderate to severe burden. The corresponding score for carers of patients with CIND was 20.3%, compared to 42.2% for those with dementia. However, in a linear regression analysis with RSS as the dependent variable, the dementia diagnosis variable was not significant. Three variables were significant (p < 0.05) and has explained 34% of the variance of the score on the RSS, impaired function in activities of daily living (ADL) was the most important variable (beta 0.56), followed by female gender of carers (beta 0.19) and the extent of the symptoms of depression observed in the patients (beta 0.10).
  
  
  CONCLUSIONS
  Carers of both CIND and dementia patients when attending a memory clinic for initial diagnostic assessment experience high levels of stress. Impaired function in ADL in patients is the strongest predictor of this stress.
authors.affiliation: Norwegian Centre for Dementia Research, Department of Geriatric Medicine, Ullevaal University Hospital, Oslo, Norway. tor.rosness@aldringoghelse.no
authors.forename: Tor Atle
authors.initials: TA
authors.lastname: Rosness
authors.forename: Ingun
authors.initials: I
authors.lastname: Ulstein
authors.forename: Knut
authors.initials: K
authors.lastname: Engedal
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000554:Ambulatory Care Facilities; D000704:Analysis of Variance; D017028:Caregivers / Q000523:psychology*; D003072:Cognition Disorders / Q000451:nursing* / Q000523:psychology; D017281:Cost of Illness; D003704:Dementia / Q000451:nursing* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D012737:Sex Factors; D018454:Spouses / Q000523:psychology*; D013315:Stress, Psychological / Q000523:psychology*