title: Relationship Between Comorbidities in Patients With Cognitive Complaint and Caregiver Burden: A Cross-Sectional Study.
abstract: OBJECTIVE
  Informal caregivers of patients with a cognitive impairment may face exhaustion while taking care of their relatives, and are themselves at higher risk of disease. The objective was to assess the relationship between patients' comorbidities evaluated with the Charlson index, and the caregiver burden, independently of health disorders related to cognitive impairment.
  
  
  METHODS
  Cross-sectional observational study.
  
  
  METHODS
  Memory clinic at the University Hospital of Lyon.
  
  
  METHODS
  Outpatients with cognitive complaint and consulting a Clinical and Research Memory Centre of Lyon (n = 1300).
  
  
  METHODS
  Comorbidity was measured using the Charlson Comorbidity Index related to age (CCI). The caregiver burden was measured with the short version of the Zarit Burden Interview (ZBI). The relationship was assessed between the CCI and the mini-Zarit and other patients' characteristics: behavior, cognition, autonomy as assessed respectively by the Neuropsychiatric Inventory (NPI), Mini Mental State Examination (MMSE), Instrumental Activities of Daily Living (IADL), etiology, and stage of the cognitive impairment.
  
  
  RESULTS
  The study included 1300 outpatients: mean age: 80.8 ± 7 years. The mean CCI was 4.8 ± 1.7. The mini-Zarit score: 3.1 ± 2.0. The caregiver burden increased by 0.22 per unit of CCI (95% confidence interval 0.15-0.28, P < .001) in unadjusted analysis. The caregiver burden remained significantly associated with CCI, after adjustment for the MMSE, IADL, and NPI.
  
  
  CONCLUSIONS
  The caregiver burden is higher when patients' comorbidities increase, independently of behavioral and psychological symptoms, level of functional autonomy, and the stage of the cognitive disease. However, dementia may be the comorbidity that contributes the most to caregiver burden.
authors.affiliation: Clinical and Research Memory Centre of Lyon (CMRR), Geriatrics Unit, Charpennes Hospital, University Hospital of Lyon, Villeurbanne, France; University Lyon 1, F-6900, Lyon, France. Electronic address: virginie.dauphinot@chu-lyon.fr.
authors.forename: Virginie
authors.initials: V
authors.lastname: Dauphinot
authors.affiliation: Clinical and Research Memory Centre of Lyon (CMRR), Geriatrics Unit, Charpennes Hospital, University Hospital of Lyon, Villeurbanne, France; University Lyon 1, F-6900, Lyon, France.
authors.forename: Alix
authors.initials: A
authors.lastname: Ravier
authors.affiliation: Clinical and Research Memory Centre of Lyon (CMRR), Geriatrics Unit, Charpennes Hospital, University Hospital of Lyon, Villeurbanne, France.
authors.forename: Teddy
authors.initials: T
authors.lastname: Novais
authors.affiliation: Clinical and Research Memory Centre of Lyon (CMRR), Geriatrics Unit, Charpennes Hospital, University Hospital of Lyon, Villeurbanne, France.
authors.forename: Floriane
authors.initials: F
authors.lastname: Delphin-Combe
authors.affiliation: Clinical Research Centre (CRC) - VCF (Aging - Brain - Frailty), Charpennes Hospital, University Hospital of Lyon, Villeurbanne, France.
authors.forename: Claire
authors.initials: C
authors.lastname: Moutet
authors.affiliation: Clinical and Research Memory Centre of Lyon (CMRR), Geriatrics Unit, Charpennes Hospital, University Hospital of Lyon, Villeurbanne, France; Clinical Research Centre (CRC) - VCF (Aging - Brain - Frailty), Charpennes Hospital, University Hospital of Lyon, Villeurbanne, France.
authors.forename: Jing
authors.initials: J
authors.lastname: Xie
authors.affiliation: University Lyon 1, F-6900, Lyon, France; Clinical Research Centre (CRC) - VCF (Aging - Brain - Frailty), Charpennes Hospital, University Hospital of Lyon, Villeurbanne, France; University Hospital of Lyon, Geriatrics Hospital Group, Pharmaceutical Unit, Lyon, France; University Lyon 1, INSERM, U1028, UMR CNRS 5292, Research Centre of Neurosciences of Lyon, Lyon, France.
authors.forename: Christelle
authors.initials: C
authors.lastname: Mouchoux
authors.affiliation: Clinical and Research Memory Centre of Lyon (CMRR), Geriatrics Unit, Charpennes Hospital, University Hospital of Lyon, Villeurbanne, France; University Lyon 1, F-6900, Lyon, France; Clinical Research Centre (CRC) - VCF (Aging - Brain - Frailty), Charpennes Hospital, University Hospital of Lyon, Villeurbanne, France; University Lyon 1, INSERM, U1028, UMR CNRS 5292, Research Centre of Neurosciences of Lyon, Lyon, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Krolak-Salmon
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology*; D003072:Cognition Disorders; D015897:Comorbidity; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D005260:Female; D005602:France; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D011795:Surveys and Questionnaires
keywords: Aging; Alzheimer disease or related disorder; Caregiver burden; Charlson Comorbidity Index; comorbidity