Department of Psychiatry, Division of Geriatric Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.
Department of Psychiatry, Tungs' Taichung Metroharbor Hospital, Taichung, Taiwan.
BMC Geriatr. 2021 Jan 14;21(1):59. doi: 10.1186/s12877-021-02007-1.
Dementia in the oldest-old is projected to increase exponentially as is the burden of their caregivers who may experience unique challenges and suffering. Thus, we aim to investigate which factors are associated with older caregivers' burden in caring demented outpatients in a multicenter cohort.
Patients and their caregivers, both aged ≧65 years, in the National Dementia Registry Study in Taiwan (T-NDRS) were included in this study. Caregiver burden was measured with the short version of the Zarit Burden Interview (ZBI). The correlations between the ZBI scores and characteristics of caregivers and patients, including severity of dementia, physical comorbidities, instrumental activities of daily living (IADL), neuropsychiatric symptoms assessed by the Neuropsychiatric Inventory (NPI), and family monthly income, were analyzed.
We recruited 328 aged informal caregiver-patient dyads. The mean age of caregivers was 73.7 ± 7.0 years, with female predominance (66.8%), and the mean age of patients was 78.8 ± 6.9 years, with male predominance (61.0%). Multivariable linear regression showed that IADLs (β = 0.83, p < 0.001) and NPI subscores of apathy (β = 3.83, p < 0.001)and irritability (β = 4.25, p < 0.001) were positively associated with ZBI scores. The highest family monthly income (β = - 10.92, p = 0.001) and caregiver age (β = - 0.41, p = 0.001) were negatively correlated with ZBI scores.
Older caregivers of older demented patients experience a higher care burden when patients had greater impaired functional autonomy and the presence of NPI symptoms of apathy and irritability. Our findings provide the direction to identify risky older caregivers, and we should pay more attention to and provide support for these exhausted caregivers.
随着最年长人群中痴呆症的呈指数级增长,以及他们的照顾者可能面临独特的挑战和痛苦,照顾者的负担也在增加。因此,我们旨在调查在多中心队列中,哪些因素与照顾痴呆门诊患者的老年照顾者的负担相关。
本研究纳入了来自台湾国家痴呆症登记研究(T-NDRS)的患者及其均年龄≥65 岁的照顾者。使用 Zarit 负担量表(ZBI)的简短版来衡量照顾者的负担。分析 ZBI 评分与照顾者和患者特征之间的相关性,包括痴呆严重程度、身体共病、日常生活活动能力(IADL)、由神经精神问卷(NPI)评估的神经精神症状以及家庭月收入。
我们招募了 328 对年龄较大的非正规照顾者-患者二人组。照顾者的平均年龄为 73.7±7.0 岁,女性居多(66.8%),患者的平均年龄为 78.8±6.9 岁,男性居多(61.0%)。多变量线性回归显示,IADL(β=0.83,p<0.001)和 NPI 冷漠(β=3.83,p<0.001)和易激惹(β=4.25,p<0.001)的亚评分与 ZBI 评分呈正相关。最高的家庭月收入(β=-10.92,p=0.001)和照顾者年龄(β=-0.41,p=0.001)与 ZBI 评分呈负相关。
当患者的功能自主能力受损更大,并且存在 NPI 冷漠和易激惹症状时,老年痴呆患者的老年照顾者会感到更高的照顾负担。我们的研究结果为确定有风险的老年照顾者提供了方向,我们应该更加关注并为这些疲惫不堪的照顾者提供支持。