title: Are Amyotrophic Lateral Sclerosis Caregivers at Higher Risk for Health Problems?
abstract: BACKGROUND
  Amyotrophic lateral sclerosis is a rare neurodegenerative disease affecting motor neurons. Patients present with progressive physical impairment, respiratory failure being the main cause of death. A significant portion of patients presents neurobehavioral problems as well. As severe impairment occurs, patients become highly dependent and in general, their families assume the role of primary caregivers, exposing them to stress and other potential causes of disease like insomnia, physical strain from patients' mobilization and changes on eating habits. The aim of this work is to understand if taking care of patients with amyotrophic lateral sclerosis increases disease and health problems on caregivers.
  
  
  METHODS
  Comprehensive review of the literature published on the electronic databases PubMed and Scopus between 2010 and 2014.
  
  
  RESULTS
  Eighteen studies met the inclusion criteria. We found that amyotrophic lateral sclerosis caregivers have higher levels of burden, depression and anxiety with lower quality of life. This is associated to age and gender of caregivers, time spent caring, patients' disability and neurobehavioral changes. Higher sense of support and spirituality on family seem to promote wellbeing.
  
  
  CONCLUSIONS
  On our work, we were able to understand that several factors have influenced caregivers' quality of life and affect their health. Besides, we could understand that the outcomes studied are related between themselves and, as seen in some of the studies, related to patients' quality of life itself. Consequently, it has become essential to adopt a holistic approach of these patients and their families, fighting the deteriorating risk factors and investing on health promoters.
  
  
  CONCLUSIONS
  Despite the large body of research on family caregiving for amyotrophic lateral sclerosis patients, little has changed and the outcomes measured remain almost the same before and after 2010. The work indicates that caregivers have lower levels of health than the general population. Still additional research is required, in order to better understand and characterized the changes on caregivers' health. It is nevertheless clear that health care professionals cannot ignore these health changes and need an approach focused not only on patients but also on caregivers.
authors.affiliation: Faculdade de Medicina. Universidade do Porto. Porto. Portugal.
authors.forename: Ana Catarina
authors.initials: AC
authors.lastname: Pinho
authors.affiliation: Faculdade de Medicina. Universidade do Porto. Porto. Portugal. Serviço de Cuidados Paliativos. Centro Hospitalar São João. Porto. Portugal.
authors.forename: Edna
authors.initials: E
authors.lastname: Gonçalves
mesh_terms: D000690:Amyotrophic Lateral Sclerosis / Q000150:complications*; D001007:Anxiety / Q000150:complications*; D017028:Caregivers; D003863:Depression / Q000150:complications*; D006801:Humans; D011788:Quality of Life; D011795:Surveys and Questionnaires