Predicting caregiving status and caregivers' burden in multiple sclerosis. A short report.
OBJECTIVE
Predicting caregiving status (CS) in multiple sclerosis (MS) is of both clinical and health policy-making value. The aim of this cross-sectional study was to assess the clinical predictors of CS, along with factors related to caregivers' stress.


METHODS
A sample of 342 clinically definite MS patients (67.5% females, 67.8% relapsing MS, mean age 43.1 ± 11.4 year-old, mean disease duration 147 ± 105.4 months, median Expanded Disability Status Scale -EDSS-3.0) was screened for CS. The Multiple Sclerosis Quality of Life-54 and Zarit Burden Interview were used to measure quality of patients' life and the their caregivers' burden, respectively.


RESULTS
In total, 57.9% of patients reported at least one caregiver, 97% of which were relatives or friends. Higher EDSS was associated with higher chance of reporting a caregiver. Two EDSS cut-offs were recognized; 2.0 and 4.5, the former with increased sensitivity (78.8%) and the latter with increased specificity (82.3%) to predict CS. Patients in the mild disability group (EDSS: 0-1.5) needing a caregiver had higher subjective cognitive function, implying presumably a beneficial role of care in cognition. Age and education were showed to affect CS in the moderate disability group (EDSS: 2.0-4.5). Physical and mental disability was more pronounced in patients reporting at least one caregiver in the high disability group (EDSS above 4.5). Caregivers' stress was significantly positively correlated with age, EDSS, and duration of the disease and negatively with cognitive, physical, and mental health.


CONCLUSIONS
In conclusion, the clinical predictors of CS are known to serve well both the researchers and the clinicians.
a Immunogenetics Laboratory, 1st Department of Neurology , Medical School, National and Kapodistrian University of Athens, Aeginition Hospital , Athens , Greece (Hellas).
Serafeim
S
Katsavos
a Immunogenetics Laboratory, 1st Department of Neurology , Medical School, National and Kapodistrian University of Athens, Aeginition Hospital , Athens , Greece (Hellas).
Artemios K
AK
Artemiadis
b Demyelinating Diseases Clinic, 1st Department of Neurology , Medical School, National and Kapodistrian University of Athens, Aeginition Hospital , Athens , Greece (Hellas).
Markos
M
Zacharis
b Demyelinating Diseases Clinic, 1st Department of Neurology , Medical School, National and Kapodistrian University of Athens, Aeginition Hospital , Athens , Greece (Hellas).
Paraskevi
P
Argyrou
c 1st Department of Psychiatry , Medical School, National and Kapodistrian University of Athens, Aeginition Hospital , Athens , Greece (Hellas).
Ilia
I
Theotoka
b Demyelinating Diseases Clinic, 1st Department of Neurology , Medical School, National and Kapodistrian University of Athens, Aeginition Hospital , Athens , Greece (Hellas).
Chrysa
C
Chrysovitsanou
a Immunogenetics Laboratory, 1st Department of Neurology , Medical School, National and Kapodistrian University of Athens, Aeginition Hospital , Athens , Greece (Hellas).|b Demyelinating Diseases Clinic, 1st Department of Neurology , Medical School, National and Kapodistrian University of Athens, Aeginition Hospital , Athens , Greece (Hellas).
Maria
M
Anagnostouli
D000328:Adult; D017028:Caregivers / Q000523:psychology*; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000451:nursing* / Q000523:psychology*; D011237:Predictive Value of Tests; D012372:ROC Curve; D011795:Surveys and Questionnaires
Multiple sclerosis; burden; caregiver; caregiving; carer; disability; stress