title: Burden and health-related quality of life among caregivers of Brazilian Parkinson's disease patients.
abstract: OBJECTIVE
  To analyze the main determinants of burden and health-related quality-of-life (HRQoL) in caregivers of Brazilian Parkinson's disease (PD) patients.
  
  
  METHODS
  Caregivers answered Hospital Anxiety and Depression Scale (HADS), Zarit caregiver burden interview (ZCBI) and EQ-5D, a generic measure of HRQoL. Patients were assessed with Hoehn and Yahr (H&Y) staging; Scales for Outcomes in Parkinson's disease (SCOPA) Motor, Cognition, Psychosocial and Sleep scales; Non-Motor Symptoms Scale; HADS; Clinical Impression of Severity Index; EQ-5D and Parkinson's Psychosis Rating Scale.
  
  
  RESULTS
  50 Caregiver-patient dyads were assessed. Caregivers were significantly younger (55.7 vs. 65.4 years), p < 0.0001. Eighty-eight per cent of caregivers were females, and 78% were spouses. The proportion of caregivers who scored ≥11 points in the HADS-anxiety or HADS-depression subscales was 12% and 14% respectively. ZCBI mean score was 20.2 (SD 12.8), and significantly worsened as severity of disease, based on H&Y, increased (H&Y 1-2: 16.4, H&Y 3-5: 24.6; p = 0.02). Caregiver's EQ-5D Index and visual analog scale mean scores were 0.7 (SD: 0.26) and 76.3 (SD: 16.2) respectively. Weak to moderate association (r = -0.27 to -0.39) between EQ-5D Index and ZBCI mean scores was observed in caregivers. Patient outcomes (sleep disorders and behavioral-psychotic symptoms) and caregiver outcomes (mood, time of caregiving) were independent predictors of caregiver burden (adjusted R(2) = 0.55; p < 0.0001) in the multivariate regression analysis. Caregiver's mood status was a significant determinant of caregiver's HRQoL, as measured by the EQ-5D Index (adjusted R(2) = 0.28; p = 0.006).
  
  
  CONCLUSIONS
  Patients' psychiatric and sleep disorders and caregiver's mood significantly influenced burden and HRQoL in Brazilian PD caregivers.
authors.affiliation: Medicine and Health Sciences Faculty, Universitat Internacional de Catalunya (UIC), Barcelona, Spain. Electronic address: fjcarod-artal@hotmail.com.
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: Carod-Artal
authors.forename: Hudson Mourão
authors.initials: HM
authors.lastname: Mesquita
authors.forename: Sofia
authors.initials: S
authors.lastname: Ziomkowski
authors.forename: Pablo
authors.initials: P
authors.lastname: Martinez-Martin
mesh_terms: D000328:Adult; D000368:Aged; D001938:Brazil / Q000208:ethnology; D017028:Caregivers / Q000523:psychology*; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000208:ethnology / Q000523:psychology* / Q000628:therapy*; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*
keywords: Burden; Caregivers; Depression; Health status; Parkinson's disease; Quality of life