D'Onofrio Grazia, Sancarlo Daniele, Addante Filomena, Ciccone Filomena, Cascavilla Leandro, Paris Francesco, Picoco Michele, Nuzzaci Claudia, Elia Anna Chiara, Greco Antonio, Chiarini Ramona, Panza Francesco, Pilotto Alberto
Geriatric Unit and Laboratory of Gerontology and Geriatrics, Department of Medical Sciences, IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Foggia, Italy.
Geriatrics Unit, Azienda ULSS 16, Padova, Italy.
Int J Geriatr Psychiatry. 2015 Sep;30(9):891-9. doi: 10.1002/gps.4232. Epub 2014 Dec 4.
To characterize the differences of caregiver burden in patients with Alzheimer's disease (AD) and vascular dementia (VaD) in order to improve the care counselling and management plan.
We included 506 patients consecutively attending the Alzheimer's Evaluation Unit of a Geriatric Unit, evaluated with Mini Mental State Examination (MMSE), Clinical Dementia Rating (CDR), Hamilton Rating Scale for Depression, and Neuropsychiatric Inventory. To all caregivers were administered the Caregiver Burden Inventory (CBI), a 24-item multidimensional questionnaire in which 5 subscales explore 5 dimensions of caregiver burden: (1) CBI-Objective; (2) CBI-Developmental; (3) CBI-Physical; (4) CBI-Social; and (5) CBI-Emotional.
The present study included, respectively, 253 AD patients and 253 VaD patients. AD patients at baseline showed a significantly higher instruction level (p < .0001), higher grade of cognitive impairment (MMSE, p < .0001), and increased severity stage of dementia (CDR, p < .0001) than VaD patients. AD caregivers, mainly females (p = 0.010), devoted significantly more length of time care (in months, p = 0.010) and time of daily care (in hours, p = 0.011) and showed a significantly higher burden level in CBI-Objective (p = 0.047), CBI-Physical (p < .0001), CBI-Social (p = 0.003), CBI-Emotional (p < .0001), and CBI-total score (p < .0001), than VaD caregivers. In both caregiver groups, a higher presence of spouses and sons (p < .0001) compared to other relatives was observed. AD caregiver burden showed a significant association with sex of caregivers and length of time care in months.
AD caregivers showed a higher burden level than VaD caregivers, and this appeared to be associated with sex and length of time care.
描述阿尔茨海默病(AD)患者和血管性痴呆(VaD)患者照料者负担的差异,以改善护理咨询和管理计划。
我们纳入了连续就诊于老年科阿尔茨海默病评估单元的506例患者,采用简易精神状态检查表(MMSE)、临床痴呆评定量表(CDR)、汉密尔顿抑郁评定量表和神经精神科问卷进行评估。对所有照料者均采用照料者负担量表(CBI)进行评估,这是一份包含24个条目的多维问卷,其中5个分量表探讨照料者负担的5个维度:(1)CBI-客观负担;(2)CBI-发展性负担;(3)CBI-身体负担;(4)CBI-社会负担;(5)CBI-情感负担。
本研究分别纳入了253例AD患者和253例VaD患者。与VaD患者相比,AD患者在基线时表现出显著更高的教育水平(p<0.0001)、更高程度的认知障碍(MMSE,p<0.0001)以及更高的痴呆严重程度阶段(CDR,p<0.0001)。AD患者的照料者主要为女性(p = 0.010),花费在照料上的时间长度(以月计,p = 0.010)和每日照料时间(以小时计,p = 0.011)显著更多,并且在CBI-客观负担(p = 0.047)、CBI-身体负担(p<0.0001)、CBI-社会负担(p = 0.003)、CBI-情感负担(p<0.0001)以及CBI总分(p<0.0001)方面表现出显著更高的负担水平。在两个照料者组中,与其他亲属相比,配偶和儿子的比例更高(p<0.0001)。AD照料者负担与照料者性别以及照料时间长度(以月计)显著相关。
AD患者的照料者负担水平高于VaD患者的照料者,且这似乎与性别和照料时间长度有关。