Department of Neurology, University of Pittsburgh School of Medicine, University of Pittsburgh, 3471 Fifth Avenue, Kaufmann Medical Building, Suite 811, Pittsburgh, PA, 15213, USA.
Center for Clinical Trials and Data Coordination, Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
J Neurol. 2021 Aug;268(8):2961-2972. doi: 10.1007/s00415-021-10443-7. Epub 2021 Feb 25.
Caregiver burden is high among caregivers of PD patients (CPD). Neuropsychiatric symptoms are leading contributors to CPD burden, but whether different symptoms differentially impact domains of caregiver burden is not known. Our objective was to examine which neuropsychiatric symptoms and demographic factors contribute to different domains of caregiver burden in PD.
This was a cross-sectional online survey study. Participants were recruited from the Fox Insight (FI) study and were eligible if they identified themselves as a CPD. The primary outcome was the Caregiver Burden Inventory (CBI) total score and its 5 sub-domain scores. The Neuropsychiatric Inventory Questionnaire (NPI-Q) assessed caregiver-reported neuropsychiatric symptoms in the care recipient. Multivariable linear regression models were used to characterize the associations between NPI-Q symptom severity scores and CBI scores. Covariates were caregiver age, sex, education, and caregiving duration.
The sample consisted of 450 CPD, mean age 65.87 (SD 10.39) years, 74% females. After adjusting for covariates, CBI total score was predicted by NPI-Q total score (β = 1.96, p < 0.001); model adjusted R = 39.2%. Anxiety severity had the largest effect size [standardized β (sβ) = 0.224] on the time-dependency domain, which was also associated with female sex (sβ = - 0.133) and age (sβ = 0.088). Severity of disinhibition (sβ = 0.218), agitation (sβ = 0.199), and female sex (sβ = 0.104) were associated with greater emotional burden.
Our findings indicate that demographic characteristics and specific neuropsychiatric symptoms contribute differentially to domains of caregiver burden. Tailored interventions to support CPD are needed.
帕金森病（PD）患者的照料者负担较高（CPD）。神经精神症状是导致 CPD 负担的主要原因，但不同的症状是否会对照料者负担的不同领域产生不同的影响尚不清楚。我们的目的是研究神经精神症状和人口统计学因素如何导致 PD 患者不同的照料者负担领域。
这是一项横断面在线调查研究。参与者从 Fox Insight（FI）研究中招募，如果他们自认为是 CPD，则符合条件。主要结果是照料者负担量表（CBI）总分及其 5 个子量表得分。神经精神疾病问卷（NPI-Q）评估了照料者报告的照顾对象的神经精神症状。多变量线性回归模型用于描述 NPI-Q 症状严重程度评分与 CBI 评分之间的关系。协变量为照料者年龄、性别、教育程度和照料时间。
样本由 450 名 CPD 组成，平均年龄 65.87（10.39）岁，74%为女性。调整协变量后，CBI 总分由 NPI-Q 总分预测（β=1.96，p<0.001）；模型调整 R=39.2%。焦虑严重程度对时间依赖性领域的影响最大[标准化β（sβ）=0.224]，且与女性性别（sβ=-0.133）和年龄（sβ=0.088）相关。脱抑制严重程度（sβ=0.218）、激越（sβ=0.199）和女性性别（sβ=0.104）与更大的情绪负担相关。
我们的研究结果表明，人口统计学特征和特定的神经精神症状对照料者负担的不同领域有不同的影响。需要针对 CPD 的定制干预措施。
