Does cognitive impairment influence burden in caregivers of patients with Alzheimer's disease?
Alzheimer's disease (AD) is characterized by a progressive deterioration of various cognitive and behavioral abilities, and it also has a health impact on the patients' caregiver. Our aim was to determine the patient (and to a lesser extent the caregiver) characteristics that contribute most to the caregiver burden. We used the baseline data from the ICTUS study, a European longitudinal cohort of patients with mild to moderate AD. Data from 1091 patients and their caregivers was used for analysis. Three principal components analyses were performed on variables from the domains of cognition, neuropsychiatric symptoms, and daily function using the MMSE plus the ADAS-Cog, NPI, and IADL subscores, respectively. These were followed by a stepwise logistic regression to identify patient characteristics which best predict caregiver burden. The regression model (R2 = 0.35, p < 0.001) shows that the best explanatory variables are: 1) neuropsychiatric symptoms (NPI); 2) difficulties in the IADL; 3) time taken by caregiving; 4) demographic variables such as caregiver's age and patient sex; and 5) severity of cognitive impairment. In conclusion, our results demonstrate that although the strongest determinant of the caregiver burden is behavioral disturbance, the impact of the degree of cognitive impairment on burden is also significant.
Germain
Sophie
S
Unité de Neuropsychologie, Département des Sciences cognitives, Université de Liège, Liège, Belgium.
Adam
Stéphane
S
Olivier
Catherine
C
Cash
Helen
H
Ousset
Pierre Jean
PJ
Andrieu
Sandrine
S
Vellas
Bruno
B
Meulemans
Thierry
T
Reynish
Emma
E
Salmon
Eric
E
D000203:Activities of Daily Living; D000544:Alzheimer Disease / Q000150:complications* / Q000451:nursing / Q000523:psychology; D017028:Caregivers / Q000523:psychology*; D003072:Cognition Disorders / Q000209:etiology / Q000451:nursing / Q000523:psychology; D017281:Cost of Illness; D006801:Humans; D007407:Interviews as Topic; D009483:Neuropsychological Tests; D025341:Principal Component Analysis; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D012189:Retrospective Studies