Center for Clinical Research, Samsung Biomedical Research Institute, Seoul, Republic of Korea.
Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Psychiatry Investig. 2014 Apr;11(2):152-9. doi: 10.4306/pi.2014.11.2.152. Epub 2014 Apr 11.
Caregivers for patients with Alzheimer's disease (AD) suffer from psychological and financial burdens. However, the results of the relationship between burden and cognitive function, performance of activities of daily living, and depressive symptoms have remained inconsistent. Therefore, the aim of this study was to examine which factors are more significant predictors of heightened burden, cognitive impairment or functional decline, besides neuropsychiatric symptoms.
A cross-sectional study was conducted in a sample comprised of 1,164 pairs of patients with AD and caregivers from the Clinical Research of Dementia of South Korea study cohorts. The cognitive function of each sub-domain, functional impairments, depressive symptoms, and caregiver burden were assessed using the dementia version of Seoul Neuropsychological Screening Battery (SNSB-D), Barthel Index for Daily Living Activities (ADL), Seoul-Instrumental Activities of Daily Living (S-IADL), the Clinical Dementia Rating Sum of Box (CDR-SB), the Global Deterioration Scale (GDS), the Korean version of the Neuropsychiatric Inventory (K-NPI), and the 15-item Geriatric Depression Scale.
We found that higher severity (higher CDR-SB and GDS scores) and more functional impairment (lower ADL and higher S-IADL scores) were significantly associated with higher caregiver burden. In addition, depressive symptoms of patients (higher Geriatric Depression Scale scores) were associated with higher caregiver burden.
Therefore, interventions to help maintain activities of daily living in patients with AD may alleviate caregiver burden and improve caregiver well-being.
阿尔茨海默病（AD）患者的照料者承受着心理和经济负担。然而，负担与认知功能、日常生活活动表现和抑郁症状之间的关系结果一直不一致。因此，本研究旨在检验哪些因素是导致负担增加、认知障碍或功能下降的更重要预测因素，除了神经精神症状之外。
本研究为横断面研究，来自韩国痴呆临床研究的 AD 患者及其照料者的样本共 1164 对。使用痴呆版首尔神经心理筛查量表（SNSB-D）、日常生活活动量表（ADL）、首尔工具性日常生活活动量表（S-IADL）、临床痴呆评定量表总和评分（CDR-SB）、总体衰退量表（GDS）、神经精神问卷韩国版（K-NPI）和 15 项老年抑郁量表评估认知功能的各个子领域、功能障碍、抑郁症状和照料者负担。
我们发现，严重程度较高（CDR-SB 和 GDS 评分较高）和功能障碍更严重（ADL 评分较低，S-IADL 评分较高）与照料者负担较高显著相关。此外，患者的抑郁症状（较高的老年抑郁量表评分）与照料者负担较高有关。
因此，干预措施有助于维持 AD 患者的日常生活活动，可能会减轻照料者的负担并改善照料者的幸福感。
