Department of Internal Medicine, Geriatric Medicine Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy.
Aging Ment Health. 2010 May;14(4):481-8. doi: 10.1080/13607860903586128.
To determine if caregiver burden (CB) can be an independent predictive factor of weight loss at three months in older outpatients suffering from mild to moderate Alzheimer's disease (AD) and living at home.
Prospective cohort study involving 105 subjects aged 70 years or more, affected by mild to moderate AD and living at home with the assistance of at least one informal caregiver, who consecutively underwent a multidimensional geriatric assessment. Body weight was re-evaluated at a three month follow-up, from December 2008 to April 2009. Those who experienced a weight loss greater than 3% of the baseline weight constituted the 'weight loss' group.
Out of the 97 older participants attending follow-up, 22 (23%) had experienced a weight loss > 3%. At a multivariate logistic regression analysis, a greater CB at baseline, defined by a score of the caregiver burden inventory scale in the highest tertile (i.e. 36+ out of 96), turned out to predict weight loss at three months (odds ratio (OR) 13.93, 95% confidence interval (CI) 1.91-101.33, p = 0.009), independently of other factors associated with the 'weight loss' group such as age, functional dependence and the risk of malnutrition estimated by means of the Mini Nutritional Assessment Short Form (MNA-SF).
For older outpatients affected by mild to moderate AD and living at home, CB constitutes a risk factor for weight loss even in the short-term, independently of other factors such as the risk of malnutrition assessed by means of the MNA-SF.
确定照料者负担(CB)是否可以成为在家中接受轻度至中度阿尔茨海默病(AD)治疗的老年门诊患者三个月体重减轻的独立预测因素。
前瞻性队列研究涉及 105 名年龄在 70 岁或以上、受轻度至中度 AD 影响且至少有一名非正式照料者协助生活的患者,他们连续接受了多维老年评估。从 2008 年 12 月至 2009 年 4 月,对患者进行了为期三个月的随访,重新评估体重。体重减轻超过基线体重 3%的患者构成“体重减轻”组。
在参加随访的 97 名老年人中,有 22 名(23%)经历了体重减轻>3%。在多变量逻辑回归分析中,基线时 CB 较大,定义为照料者负担量表的评分处于最高三分位(即 36+分),三个月后体重减轻的可能性更高(比值比(OR)13.93,95%置信区间(CI)1.91-101.33,p=0.009),独立于其他与“体重减轻”组相关的因素,如年龄、功能依赖和通过 Mini Nutritional Assessment Short Form(MNA-SF)评估的营养不良风险。
对于在家中接受轻度至中度 AD 治疗的老年门诊患者,即使在短期,CB 也是体重减轻的危险因素,独立于通过 MNA-SF 评估的营养不良风险等其他因素。