Faculty of Psychology, University of Barcelona, Barcelona, Spain.
J Geriatr Psychiatry Neurol. 2013 Jun;26(2):86-94. doi: 10.1177/0891988713481266. Epub 2013 Mar 20.
Several studies have identified certain caregiver factors that can produce variability in their assessments of the capacities of patients with Alzheimer disease (AD).
To identify the caregiver variables associated with variability in their ratings of patients' capacities.
Consecutive sample of 221 outpatients with AD and their family caregivers. The capacities evaluated by caregivers were the degree of functional disability, using the Disability Assessment for Dementia (DAD); psychological and behavioral symptoms, via the Neuropsychiatric Inventory (NPI); anosognosia, with the Anosognosia Questionnaire-Dementia (AQ-D); and quality of life, using the Quality of Life in AD (QOL-AD). The relationship between these measures and caregiver's gender, burden, depression, and health was analyzed by means of a bivariate analysis, calculating the effect size (Cohen d) and subsequently by a regression analysis, calculating the contribution coefficient (CC).
The greatest variability in caregiver assessments was observed in relation to patients with early-stage dementia, where caregiver's burden was the main factor associated with a more negative evaluation (d = 1.02-1.25). Depression in the caregiver was associated with less variability and only in the assessments of patients with moderate dementia (d = 0.38-0.69). In the regression analysis, caregiver factors were associated with greater variance in scores on the NPI (CC = 37.4%) and QOL-AD (CC = 27.2%), and lower variance in AQ-D (CC = 21.6%) and DAD (CC = 10.3%) scores.
Caregiver's burden and depression were associated with more negative assessments of patients' psychological and behavioral symptoms and quality of life.
多项研究已经确定了一些可以导致阿尔茨海默病（AD）患者能力评估出现差异的照料者因素。
确定与照料者对患者能力评估的变异性相关的照料者变量。
连续样本 221 例 AD 门诊患者及其家庭照料者。照料者评估的能力包括使用痴呆残疾评估量表（DAD）评估的功能障碍程度；通过神经精神问卷（NPI）评估的心理和行为症状；通过认知失认症问卷 - 痴呆（AQ-D）评估的认知失认症；通过阿尔茨海默病生活质量量表（QOL-AD）评估的生活质量。通过双变量分析，计算效应大小（Cohen d），然后通过回归分析，计算贡献系数（CC），分析这些措施与照料者性别、负担、抑郁和健康之间的关系。
在评估早期痴呆患者时，照料者评估的变异性最大，其中照料者负担是与更负面评估相关的主要因素（d = 1.02-1.25）。照料者的抑郁与变异性较小有关，仅在中度痴呆患者的评估中（d = 0.38-0.69）。在回归分析中，照料者因素与 NPI（CC = 37.4%）和 QOL-AD（CC = 27.2%）得分的变异较大相关，与 AQ-D（CC = 21.6%）和 DAD（CC = 10.3%）得分的变异较小相关。
照料者的负担和抑郁与患者心理和行为症状以及生活质量的更负面评估相关。
