Department of Neurology, National Neuroscience Institute, Singapore.
Duke-NUS, Graduate Medical School, Singapore.
J Alzheimers Dis. 2018;61(2):537-543. doi: 10.3233/JAD-170409.
There is an increase in prevalence of young onset dementia (YOD). The specific problems among YOD patients and levels of caregiver burden (CB) in this group warrants further evaluation.
To evaluate and compare level of CB in YOD and late onset dementia (LOD). Also, we sought to understand the specific factors, such as neuropsychiatric symptoms, that may affect the levels of caregiver burden in the YOD group.
Patient-caregiver dyads with YOD and LOD were recruited from a tertiary neurology center. Levels of CB between YOD and LOD were compared among 183 patient-caregiver dyads. CB was quantified using the Zarit Burden Inventory (ZBI). Neuropsychological evaluations as well as the Neuropsychiatric Inventory were performed. Factors that influenced level of CB in YOD group was investigated with regression analyses.
There were 57 YOD and 126 LOD dyads. Caregivers of YOD subjects reported significantly higher levels of burden compared to caregivers of LOD subjects (ZBI: 17.3 versus 13.94; p = 0.015). 52.6% of YOD caregivers reported a high caregiver burden. When compared to caregivers of LOD, the odds of a caregiver of YOD reporting high caregiver burden was 2.34 (95% CI: 1.22-4.49: p = 0.010). YOD dyads with a high caregiver burden had significantly higher neuropsychiatric inventory scores. Risk factors for high caregiver burden in YOD included family history of dementia and behavioral symptoms including disinhibited behavior, delusions, and apathy.
Targeted support for caregivers of patients with YOD is needed to address the higher CB in this group.
早发性痴呆（YOD）的患病率正在增加。 YOD 患者的具体问题以及该人群的 caregiver 负担（CB）水平需要进一步评估。
评估和比较 YOD 和晚发性痴呆（LOD）患者的 CB 水平。此外，我们还试图了解可能影响 YOD 组 caregiver负担水平的特定因素，例如神经精神症状。
从一家三级神经病学中心招募了 YOD 和 LOD 的患者-照护者对子。在 183 对患者-照护者对中比较了 YOD 和 LOD 之间的 CB 水平。使用 Zarit 负担量表（ZBI）量化 CB。进行神经心理学评估和神经精神病学检查。使用回归分析调查了影响 YOD 组 CB 水平的因素。
有 57 对 YOD 和 126 对 LOD 对子。 YOD 受试者的照护者报告的负担明显高于 LOD 受试者的照护者（ZBI：17.3 与 13.94；p = 0.015）。 52.6％的 YOD 照护者报告了高照护负担。与 LOD 的照护者相比，YOD 的照护者报告高照护负担的几率为 2.34（95％CI：1.22-4.49：p = 0.010）。 YOD 对子中，有高 CB 的患者的神经精神病学检查评分明显更高。 YOD 中高 CB 的危险因素包括痴呆的家族史以及行为症状，包括抑制障碍，妄想和冷漠。
需要为 YOD 患者的照护者提供有针对性的支持，以解决该人群中较高的 CB 问题。
