Koyama Asuka, Matsushita Masateru, Hashimoto Mamoru, Fujise Noboru, Ishikawa Tomohisa, Tanaka Hibiki, Hatada Yutaka, Miyagawa Yusuke, Hotta Maki, Ikeda Manabu
Department of Neuropsychiatry, Kumamoto University, Kumamoto, Japan.
Psychogeriatrics. 2017 Mar;17(2):108-114. doi: 10.1111/psyg.12200. Epub 2016 Mar 10.
Caregiver burden in dementia is an important issue, but few studies have examined the mental health of younger and older family caregivers by comparing them with age- and gender-matched community residents. We aimed to compare the mental health of dementia caregivers with that of community residents and to clarify factors related to mental health problems in younger and older caregivers.
We studied 104 dementia caregivers; 46 were younger (<65 years) and 58 were older (≥65 years). A total of 104 community residents who were matched for age and gender were selected. We compared depression (Center for Epidemiologic Studies Depression Scale for younger participants; Geriatric Depression Scale for older participants), health-related quality of life (QOL) short-form health survey (SF-8), sleep problems, and suicidal ideation between the caregivers and community residents by age. Behavioural and psychological symptoms of dementia, activities of daily living (ADL), and instrumental ADL were assessed among patients with dementia using the Neuropsychiatric Inventory, Physical Self-Maintenance Scale, and Lawton Instrumental ADL Scale, respectively.
According to SF-8 results, both younger and older caregivers had significantly worse mental QOL than community residents (younger caregivers: 46.3 vs community residents: 49.7, P = 0.017; older caregivers: 48.2 vs community residents: 51.1, P = 0.024) but were not more depressive. Sleep problems were significantly more frequent in younger caregivers (39.1%) than in community residents (17.0%) (P = 0.017). Multiple regression analysis revealed that caregivers' deteriorated mental QOL was associated with patients' behavioural and psychological symptoms of dementia in younger caregivers and with dementia patients' instrumental ADL and female gender in older caregivers.
Dementia caregivers had a lower mental QOL than community residents. To maintain caregivers' mental QOL, it is necessary to provide younger caregivers with skills or professional interventions for dealing with behavioural and psychological symptoms of dementia, and older caregivers must be offered adequate care support.
痴呆症患者照料者的负担是一个重要问题，但很少有研究通过将年轻和年长的家庭照料者与年龄和性别匹配的社区居民进行比较来考察他们的心理健康状况。我们旨在比较痴呆症照料者与社区居民的心理健康状况，并阐明年轻和年长照料者心理健康问题的相关因素。
我们研究了104名痴呆症照料者；46名较年轻（<65岁），58名较年长（≥65岁）。总共选取了104名年龄和性别匹配的社区居民。我们按年龄比较了照料者和社区居民之间的抑郁情况（较年轻参与者使用流行病学研究中心抑郁量表；较年长参与者使用老年抑郁量表）、健康相关生活质量（QOL）简式健康调查（SF - 8）、睡眠问题和自杀意念。分别使用神经精神科问卷、身体自我维持量表和洛顿工具性日常生活活动量表对痴呆症患者的痴呆行为和心理症状、日常生活活动（ADL）以及工具性ADL进行评估。
根据SF - 8结果，年轻和年长照料者的心理生活质量均显著低于社区居民（年轻照料者：46.3对社区居民：49.7，P = 0.017；年长照料者：48.2对社区居民：51.1，P = 0.024），但抑郁程度并不更高。年轻照料者的睡眠问题（39.1%）明显比社区居民（17.0%）更频繁（P = 0.017）。多元回归分析显示，年轻照料者心理生活质量下降与患者的痴呆行为和心理症状相关，而年长照料者心理生活质量下降与痴呆患者的工具性ADL及女性性别相关。
痴呆症照料者的心理生活质量低于社区居民。为维持照料者的心理生活质量，有必要为年轻照料者提供应对痴呆行为和心理症状的技能或专业干预，并且必须为年长照料者提供充足的护理支持。
