Taub Institute for Research on Alzheimer's Disease and the Aging Brain and Gertrude H. Sergievsky Center, Department of Neurology, Columbia University Irving Medical Center, New York, New York, USA.
Department of Neurology, Case Western Reserve University, Cleveland, Ohio, USA.
Alzheimers Dement. 2022 Sep;18(9):1635-1649. doi: 10.1002/alz.12494. Epub 2021 Dec 2.
Caregivers of patients with frontotemporal lobar degeneration (FTLD) spectrum disorders experience tremendous burden, which has been associated with the neuropsychiatric and behavioral features of the disorders.
In a sample of 558 participants with FTLD spectrum disorders, we performed multiple-variable regressions to identify the behavioral features that were most strongly associated with caregiver burden, as measured by the Zarit Burden Interview, at each stage of disease.
Apathy and disinhibition, as rated by both clinicians and caregivers, as well as clinician-rated psychosis, showed the strongest associations with caregiver burden, a pattern that was consistent when participants were separated cross-sectionally by disease stage. In addition, behavioral features appeared to contribute most to caregiver burden in patients with early dementia.
Caregivers should be provided with early education on the management of the behavioral features of FTLD spectrum disorders. Interventions targeting apathy, disinhibition, and psychosis may be most useful to reduce caregiver burden.
额颞叶变性(FTLD)谱系障碍患者的照顾者承受着巨大的负担,这与疾病的神经精神和行为特征有关。
在 558 名 FTLD 谱系障碍患者的样本中,我们进行了多变量回归分析,以确定在疾病的每个阶段,通过 Zarit 负担访谈测量的与照顾者负担最密切相关的行为特征。
临床医生和照顾者评定的淡漠和去抑制,以及临床医生评定的精神病,与照顾者负担的关联最强,当参与者按疾病阶段进行横断面分离时,这种模式仍然一致。此外,在早期痴呆的患者中,行为特征似乎对照顾者的负担影响最大。
应向 FTLD 谱系障碍患者的照顾者提供有关管理疾病行为特征的早期教育。针对淡漠、去抑制和精神病的干预措施可能最有助于减轻照顾者的负担。