Ruokostenpohja Nora, Välimäki Tarja, Martikainen Janne, Hallikainen Merja, Vehviläinen-Julkunen Katri, Koivisto Anne
Department of Nursing Science, University of Eastern Finland, Yliopistonranta 1B, 70210, Kuopio, Finland.
Neurology of Neuro Center, Kuopio University Hospital, Kuopio, Finland.
Eur Geriatr Med. 2018 Aug;9(4):477-483. doi: 10.1007/s41999-018-0060-4. Epub 2018 May 15.
Several countries support family caregivers (FCs) by means of an informal carer's allowance (CA). In this study, we aimed to examine CA entitlement in association with clinical factors related to persons with Alzheimer's disease (AD) and their FCs, provided psychosocial rehabilitation, and the Morbidity index designed to measure regional variations in morbidity and burden.
A total of 236 FCs and 236 care recipients (CRs) with AD participated in this prospective longitudinal 5-year follow-up study (ALSOVA). We used generalized estimating equation models to investigate the associations between granting CA and repeated measurements of socioeconomic and clinical characteristics.
Over 5 years of caregiving, CAs were granted to only 18% of the FCs. CA receipt was significantly associated with the CR having decreased activities of daily living (lower ADCS-ADL, p ≤ 0.001, OR 0.93, 95% CI 0.92-0.94) and increased disease severity (lower Clinical Dementia Rating-Sum of Boxes, p ≤ 0.001, OR 1.40, 95% CI 1.30-1.50). In addition, CAs were more commonly granted in municipalities with higher morbidity rates (p = 0.010, OR 1.03, 95% CI 1.01-1.05), and a 1-year increase in FC age was associated with a 4% increase in the odds of CA receipt (OR 1.04, 95% CI 1.01-1.07).
CA receipt was influenced by increased dependency (measured by ADCS-ADL) and disease severity of persons with AD. FCs more commonly received CAs in municipalities with older and less-healthy populations. These findings verified that informal care is supported in accordance with international recommendations.
多个国家通过非正式护理人员津贴（CA）来支持家庭护理人员（FC）。在本研究中，我们旨在探讨与阿尔茨海默病（AD）患者及其FC相关的临床因素、提供的心理社会康复以及用于衡量发病率和负担的区域差异的发病率指数与CA资格的关系。
共有236名FC和236名患有AD的护理接受者（CR）参与了这项为期5年的前瞻性纵向随访研究（ALSOVA）。我们使用广义估计方程模型来研究给予CA与社会经济和临床特征的重复测量之间的关联。
在5年的护理期间，只有18%的FC获得了CA。获得CA与CR的日常生活活动能力下降（较低的ADCS-ADL，p≤0.001，OR 0.93，95%CI 0.92-0.94）和疾病严重程度增加（较低的临床痴呆评定量表-方框总和，p≤0.001，OR 1.40，95%CI 1.30-1.50）显著相关。此外，在发病率较高的城市更常给予CA（p = 0.010，OR 1.03，95%CI 1.01-1.05），FC年龄每增加1岁，获得CA的几率增加4%（OR 1.04，95%CI 1.01-1.07）。
获得CA受到AD患者依赖性增加（通过ADCS-ADL衡量）和疾病严重程度的影响。在人口老龄化和健康状况较差的城市，FC更常获得CA。这些发现证实了非正式护理是按照国际建议得到支持的。
