title: Cognitive impairment in Parkinson's disease: impact on quality of life of carers.
abstract: The quality of life (QoL) of informal caregivers of people with Parkinson's disease (PD) (PwP) can be affected by the caring role. Because of cognitive symptoms and diminished activities of daily living, in addition to the management of motor symptoms, carers of PwP and cognitive impairment may experience increased levels of burden and poorer QoL compared with carers of PwP without cognitive impairment. This study aimed to investigate the impact of cognitive impairment in PD upon QoL of carers.
  
  
  
  Approximately 36 months after diagnosis, 66 dyadic couples of PwP and carers completed assessments. PwP completed a schedule of neuropsychological assessments and QoL measures; carers of PwP completed demographic questionnaires and assessments of QoL. Factor scores of attention, memory/executive function and global cognition, as derived by principal component analysis, were used to evaluate cognitive domains.
  
  
  
  Hierarchical regression analysis found lower Montreal Cognitive Assessment was a significant independent predictor of poorer carer QoL, in addition to number of hours spent caregiving, carer depression and PD motor severity. Attentional deficits accounted for the largest proportion of variance of carer QoL. Carers of PwP and dementia (n = 9) had significantly poorer QoL scores compared with PwP and mild cognitive impairment (n = 18) or normal cognition (n = 39) carers (p < 0.01).
  
  
  
  Attentional deficits were the strongest predictor of carer QoL compared with other cognitive predictors. Carers for those with PD dementia reported the poorest QoL. Interventions such as respite or cognitive behavioural therapy to improve mood and self-efficacy in carers may improve carer QoL. © 2016 The Authors. International Journal of Geriatric Psychiatry published by John Wiley & Sons, Ltd.
authors.affiliation: Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: R A
authors.initials: RA
authors.lastname: Lawson
authors.affiliation: Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: A J
authors.initials: AJ
authors.lastname: Yarnall
authors.affiliation: Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: F
authors.initials: F
authors.lastname: Johnston
authors.affiliation: Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK.|Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.
authors.forename: G W
authors.initials: GW
authors.lastname: Duncan
authors.affiliation: School of Medicine and Menzies Health Institute Queensland, Griffith University, Queensland, Australia.
authors.forename: T K
authors.initials: TK
authors.lastname: Khoo
authors.affiliation: Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: D
authors.initials: D
authors.lastname: Collerton
authors.affiliation: Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: J P
authors.initials: JP
authors.lastname: Taylor
authors.affiliation: Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: D J
authors.initials: DJ
authors.lastname: Burn
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology; D012044:Regression Analysis; D011795:Surveys and Questionnaires
keywords: Cognitive impairment; Parkinson's disease; carer; quality of life