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亨廷顿病的进展和照护者负担。

Huntington's Disease Progression and Caregiver Burden.

机构信息

Indywidualna Praktyka Lekarska Daniel Zielonka, Poznan, Poland.

Faculty of Mathematics and Computer Science, Adam Mickiewicz University, Poznan, Poland.

出版信息

Eur Neurol. 2022;85(5):398-403. doi: 10.1159/000524146. Epub 2022 Apr 28.

Abstract

Huntington's disease (HD) is a neurodegenerative, progressive disorder conditioned by a mutation in the HTT gene. Its progression is dependent on the causative mutation extension. Caregivers of individuals affected by HD, most often patients' relatives, are burdened with the care. This study aims to assess the caregivers' burden cross-sectionally and longitudinally and look for biological and clinical patients-related burdening factors. In total, 144 caregiver-patient pairs observed annually for up to 8 years were included in the study. In all of the patients, demographic data were collected, Unified Huntington's Disease Rating Scale (UHDRS) assessments were conducted, and disease burden (DB) was calculated when caregivers were assessed in Caregiver Burden Inventory (CBI). Caregivers' burden measured in CBI at the first visit reached 18.7 ± 18.4 scores. Longitudinal observation showed no evidence for any discrepancy between clinical progression measured in UHDRS, nor biological progression measured in DB and the caregivers' burden progression measured in CBI. Caregivers were burdened mostly by patients' dependence and a discrepancy between reality and life expectations. This study indicates factors to be addressed to reduce caregivers' burden. Strict relation between caregivers' burden and biological and clinical progression denies conception of overloaded with care tasks or adaptation to the burden.

摘要

亨廷顿病(HD)是一种由 HTT 基因突变引起的神经退行性、进行性疾病。其进展取决于致病突变的延伸。HD 患者的照顾者(通常是患者的亲属)承受着照顾的负担。本研究旨在横向和纵向评估照顾者的负担,并寻找与患者相关的生物学和临床负担因素。共有 144 对照顾者-患者对,每年观察最多 8 年,纳入本研究。对所有患者收集人口统计学数据,进行统一亨廷顿病评定量表(UHDRS)评估,并在照顾者负担量表(CBI)评估时计算疾病负担(DB)。首次就诊时 CBI 测量的照顾者负担达到 18.7±18.4 分。纵向观察表明,UHDRS 测量的临床进展、DB 测量的生物学进展与 CBI 测量的照顾者负担进展之间没有差异。照顾者主要因患者的依赖和现实与生活期望之间的差距而感到负担沉重。本研究提示了一些需要解决的因素,以减轻照顾者的负担。照顾者负担与生物学和临床进展之间的严格关系否认了因照顾任务过重或对负担的适应而导致的概念。

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