Internal Medicine and Critical Subacute Care Unit, Geriatric-Rehabilitation Department, Azienda Ospedaliero-Universitaria di Parma, 43126 Parma, Italy.
Geriatric Clinic Unit, Geriatric-Rehabilitation Department, Azienda Ospedaliero-Universitaria di Parma, 43126 Parma, Italy.
Nutrients. 2019 Jan 28;11(2):281. doi: 10.3390/nu11020281.
The assistance to older community-dwellers provided by family caregivers is crucial for the maintenance of an acceptable quality of life, especially when dementia is present. The caregiver burden may be extremely high, but few data are available on what patient domains mainly affect the caregiver. The aim of this cross-sectional study, performed in older outpatients, was to examine the impact of cognitive, physical and nutritional status of elderly community-dwellers on the caregiver burden, as evaluated by the Caregiver Burden Inventory (CBI). A group of 406 elderly outpatients (161 M, 245 F, mean age of 83.20 ± 6.40) was enrolled. A significant correlation was observed between Mini Nutritional Assessment Instrument-Short Form (MNA-SF) and CBI ( = -0.34; < 0.001), suggesting that a poor nutritional status is significantly associated with the caregiver burden. There was also a significant correlation between CBI and Short Physical Performance Battery score ( = -0.29; < 0.001), hand grip strength ( = -0.25; < 0.001), Mini-Mental State Examination score ( = -0.39; < 0.001), Geriatric Depression Scale ( = 0.23; < 0.001), Body Mass Index (BMI) ( = 0.01; = 0.03), Activities of Daily Living and Instrumental Activities of Daily Living (ADL/IADL) ( = -0.61 and -0.62, respectively; < 0.001), and with the 4-m walking speed ( = -0.42; < 0.001). In the multivariate analysis, only the relationships of the CBI (in particular the physical subcomponent) with ADL, IADL and MNA-SF remained statistically significant (β ± SE -0.89 ± 0.20, < 0.001; -0.58 ± 0.15, < 0.001 and -0.25 ± 0.11, = 0.02, respectively). The relationship between CBI and BMI remained statistically significant only for the physical subcomponent (β ± SE 0.14 ± 0.05; = 0.006). Thus, in this study, we confirmed that the impairment in the activities of daily living is associated with a significant impact on the caregiver burden, and we found also that a poor nutritional status of the older outpatient is independently more associated with the caregiver burden than cognitive and physical disability. The combined evaluation of both patients and caregivers can improve the knowledge and assistance to the elderly subjects.
家庭照顾者为社区居住的老年人提供的帮助对于维持可接受的生活质量至关重要，尤其是在存在痴呆症的情况下。照顾者的负担可能非常沉重，但关于哪些患者领域主要影响照顾者的信息很少。这项横断面研究在老年门诊患者中进行，旨在通过 caregiver Burden Inventory (CBI) 评估老年人的认知、身体和营养状况对照顾者负担的影响。招募了一组 406 名老年门诊患者（161 名男性，245 名女性，平均年龄 83.20 ± 6.40 岁）。MNA-SF 和 CBI 之间存在显著相关性（ = -0.34； < 0.001），表明营养状况不佳与照顾者负担显著相关。CBI 与短体能表现电池评分（ = -0.29； < 0.001）、握力（ = -0.25； < 0.001）、Mini-Mental State Examination 评分（ = -0.39； < 0.001）、老年抑郁量表（ = 0.23； < 0.001）、体重指数（BMI）（ = 0.01； = 0.03）、日常生活活动和工具性日常生活活动（ADL/IADL）（ = -0.61 和 -0.62，分别； < 0.001），以及 4 米步行速度（ = -0.42； < 0.001）之间存在显著相关性。在多变量分析中，只有 CBI（特别是身体子组件）与 ADL、IADL 和 MNA-SF 的关系在统计学上仍然显著（β ± SE -0.89 ± 0.20， < 0.001；-0.58 ± 0.15， < 0.001 和 -0.25 ± 0.11， = 0.02）。CBI 与 BMI 之间的关系仅在身体子组件方面在统计学上仍然显著（β ± SE 0.14 ± 0.05； = 0.006）。因此，在这项研究中，我们证实日常生活活动的障碍与照顾者负担的显著影响相关，我们还发现，与认知和身体残疾相比，老年门诊患者较差的营养状况与照顾者负担更相关。对患者和照顾者的综合评估可以提高对老年受试者的认识和帮助。
