Conde-Sala Josep L, Turró-Garriga Oriol, Calvó-Perxas Laia, Vilalta-Franch Joan, Lopez-Pousa Secundino, Garre-Olmo Josep
Department of Developmental Psychology, University of Barcelona, Barcelona, Spain.
Research Unit, Institut d'Assistència Sanitária, Salt, Spain.
J Alzheimers Dis. 2014;42(2):623-33. doi: 10.3233/JAD-140360.
Although numerous studies have examined caregiver burden in the context of Alzheimer's disease, discrepancies remain regarding the influence of certain factors. This study aimed to identify trajectories of caregiver burden in the context of Alzheimer's disease, as well as the factors associated with them. A cohort of patients and caregivers (n = 330) was followed up over three years. Growth mixture models were fitted to identify trajectories of caregiver burden according to scores on the Zarit Burden Interview (ZBI). A multilevel multinomial regression analysis was then conducted with the resulting groups and the patient and caregiver factors. In the sample as a whole, burden increased during follow-up (F = 4.4, p = 0.004). Three groups were identified: G1 (initially high but decreasing burden), G2 (moderate but increasing burden), and G3 (low burden that increased slightly). Patients in G1 and G2 presented more neuropsychiatric symptoms and poorer functional status than did those in G3. Caregivers in G1 and G2 had poorer mental health. Spouses and, especially, adult children who lived with their parent (the patient) were more likely to belong to G2 (odds ratio [OR] 6.24; 95% CI 2.89-13.47), as were sole caregivers (OR 3.51; 95% CI 1.98-6.21). The patient factors associated with increased burden are neuropsychiatric symptoms and functional status, while among caregivers, being the sole carer, poor mental health, and living with the patient are of relevance.
尽管众多研究已在阿尔茨海默病背景下考察了照料者负担，但某些因素的影响仍存在差异。本研究旨在确定阿尔茨海默病背景下照料者负担的轨迹，以及与之相关的因素。对一组患者及其照料者（n = 330）进行了为期三年的随访。采用增长混合模型，根据 Zarit 负担访谈（ZBI）得分确定照料者负担的轨迹。然后对所得分组以及患者和照料者因素进行多水平多项回归分析。在整个样本中，随访期间负担增加（F = 4.4，p = 0.004）。确定了三组：G1（初始负担高但逐渐减轻）、G2（负担中等但逐渐增加）和 G3（负担低且略有增加）。与 G3 组患者相比，G1 组和 G2 组患者表现出更多的神经精神症状和更差的功能状态。G1 组和 G2 组的照料者心理健康状况较差。配偶，尤其是与父母（患者）同住的成年子女更有可能属于 G2 组（优势比[OR] 6.24；95%置信区间 2.89 - 13.47），单独照料者也是如此（OR 3.51；95%置信区间 1.98 - 6.21）。与负担增加相关的患者因素是神经精神症状和功能状态，而在照料者中，作为唯一照料者、心理健康状况差以及与患者同住具有相关性。
