title: Alzheimer's Disease: Differences of Transdermal versus Oral Treatment on Caregiving Time.
abstract: BACKGROUND
  Data on indirect effects of dementia treatment on caregiver burden obtained from naturalistic studies are still lacking. We explored differences between patients with oral and transdermal application of acetylcholine esterase inhibitors regarding caregiver's time burden and psychopathology.
  
  
  METHODS
  A cross-sectional naturalistic cohort study of 403 patients in outpatient care with three treatment groups (none, oral, and transdermal) was conducted. Assessments included a standardized clinical burden questionnaire and a standardized caregiver interview.
  
  
  RESULTS
  Any treatment was associated with lower burden in most measures. Transdermal treatment was superior regarding (1) administration time (p < 0.001); (2) rates of administration problems (p = 0.031); (3) burden in activities of daily living (p = 0.008), and (4) caregiver anxiety (OR 0.25; 95% CI 0.05-0.99). Caregivers did not report better quality of life regarding mental/physical health. Physicians' and caregivers' ratings of patients' improvements were not associated (κ = 0.01-0.06).
  
  
  CONCLUSIONS
  Benefits associated with transdermal treatment do not translate into a better 'generic quality of life' of the caregiver. The substantially different perceptions of patients' improvements need to be considered in future studies.
authors.affiliation: Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Germany.
authors.forename: O
authors.initials: O
authors.lastname: Riedel
authors.forename: A
authors.initials: A
authors.lastname: Emmrich
authors.forename: J
authors.initials: J
authors.lastname: Klotsche
authors.forename: R
authors.initials: R
authors.lastname: Dodel
authors.forename: H
authors.initials: H
authors.lastname: Förstl
authors.forename: W
authors.initials: W
authors.lastname: Maier
authors.forename: H
authors.initials: H
authors.lastname: Reichmann
authors.forename: H-U
authors.initials: HU
authors.lastname: Wittchen
keywords: Burden; Care; Caregiver; Dementia; Patch; Rivastigmine