Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA.
J Am Geriatr Soc. 2011 Mar;59(3):488-94. doi: 10.1111/j.1532-5415.2010.03304.x.
To compare the characteristics and outcomes of caregivers of adults with dementia with those of caregivers of adults with cognitive impairment, not dementia (CIND).
Cross-sectional.
In-home assessment for cognitive impairment and self-administered caregiving questionnaire.
One hundred sixty-nine primary family caregivers of participants in the Aging, Demographics, and Memory Study (ADAMS). ADAMS participants were aged 71 and older drawn from the nationally representative Health and Retirement Study.
Neuropsychological testing, neurological examination, clinical assessment, and medical history were used to assign a diagnosis of normal cognition, CIND, or dementia. Caregiving measures included caregiving time, functional limitations, depressive symptoms, physical and emotional strain, caregiving rewards, caregiver health, and demographic characteristics.
Dementia caregivers spent approximately 9 hours per day providing care, compared with 4 hours per day for CIND caregivers (P=.001). Forty-four percent of dementia caregivers exhibited depressive symptoms, compared with 26.5% of CIND caregivers (P=.03). Physical and emotional strains were similar in both groups of caregivers. Regardless of the strains, nearly all caregivers reported some benefits from providing care. Behavioral problems (P=.01) and difficulty with instrumental activities of daily living (P=.01) in persons with CIND partially explained emotional strain experienced by CIND caregivers. For those with dementia, behavioral problems predicted caregiver emotional strain (P<.001) and depressive symptoms (P=.01).
Although support services are available to dementia caregivers, CIND caregivers also expend considerable time and experience strains. The real caregiver burden of cognitive impairment in the U.S. population may therefore be greatly underestimated if people who have reached the diagnostic threshold for dementia are focused on exclusively.
比较痴呆症成年患者照料者与认知障碍但非痴呆症（CIND）成年患者照料者的特征和结局。
横断面研究。
对认知障碍进行家庭评估和自我管理的照料者问卷调查。
169 名参加老龄化、人口统计学和记忆研究（ADAMS）的主要家庭照料者。ADAMS 参与者年龄均在 71 岁以上，均来自具有全国代表性的健康与退休研究。
神经心理学测试、神经系统检查、临床评估和病史用于诊断正常认知、CIND 或痴呆症。照料者测量包括照料时间、功能限制、抑郁症状、身体和情绪压力、照料者奖励、照料者健康和人口统计学特征。
痴呆症照料者每天提供约 9 小时的护理，而 CIND 照料者每天提供 4 小时（P<.001）。44%的痴呆症照料者表现出抑郁症状，而 CIND 照料者为 26.5%（P=.03）。两组照料者的身体和情绪压力相似。无论压力如何，几乎所有的照料者都报告了一些提供护理的好处。CIND 患者的行为问题（P=.01）和日常生活活动的工具性困难（P=.01）部分解释了 CIND 照料者所经历的情绪压力。对于那些患有痴呆症的人来说，行为问题预测了照料者的情绪压力（P<.001）和抑郁症状（P=.01）。
尽管为痴呆症照料者提供了支持服务，但 CIND 照料者也花费了大量时间并经历了压力。如果只关注已经达到痴呆症诊断标准的人群，那么美国人口认知障碍的实际照料者负担可能被大大低估。
