Department of Geriatrics and Cognitive Disorders, Fujita Health University School of Medicine, Toyoake City, Japan.
Psychogeriatrics. 2023 Jan;23(1):157-163. doi: 10.1111/psyg.12921. Epub 2022 Nov 25.
Dementia is a disease that is frequently associated with significant caregiving burden. The present study was conducted on patients with dementia in order to investigate the causes of caregiver burden using the Dementia Assessment Sheet for Community-based Integrated Care System-21 items (DASC-21) and Zarit Caregiver Burden Interview (ZBI).
The study subjects consisted of 206 elderly patients (mean age: 80.9 ± 5.9 years) with dementia in an outpatient clinic. Current age, gender, type of dementia, Mini-Mental State Examination, Hasegawa Dementia Scale-Revised, Clinical Dementia Rating (CDR), Geriatric Depression Scale (GDS) and the DASC-21 were investigated. Caregiver burden was assessed by using the ZBI. Behavioural and Psychological Symptom of Dementia (BPSD) were evaluated by using the Neuropsychiatric Inventory (NPI). Simple regression analysis for the ZBI was performed with respective risk factors as independent variables. Thereafter, multiple regression analysis was performed.
The mean ZBI score was 28.0 ± 18.1, whereas mean DASC-21 score was 44.4 ± 13.2. Simple regression analysis for the ZBI was performed with respective risk factors as independent variables. The DASC-21 (P < 0.001), CDR (P < 0.001), NPI (P < 0.001), and GDS (P = 0.034) were significantly associated with the ZBI. For each item of the DASC-21, Memory (P < 0.001), Orientation (P < 0.001), Solving issues/Common sense (P < 0.001), Instrumental activities of daily living (IADL) outside the home (P < 0.001), IADL inside the home (P < 0.001), Physical ADL① (P < 0.001) and Physical ADL② (P = 0.014) were also significantly associated with the ZBI. To find the independent association of the ZBI, multiple regression analysis was performed. The results showed that DASC-21 (P < 0.001) and NPI (P < 0.001) had significant correlation. For each item of the DASC-21, Memory (P = 0.014) and Solving issues/Common sense (P < 0.001) were also shown to have significant correlation.
Both BPSD, cognition and IADL have affected caregiver burden. The DASC-21 is useful for determining the causes of caregiver burden of dementia patients.
痴呆是一种常伴有严重照料负担的疾病。本研究对痴呆患者进行了调查，以使用痴呆评估量表（DASC-21）和照料者负担访谈量表（ZBI）来研究照料者负担的原因。
研究对象为 206 名在门诊就诊的老年痴呆症患者（平均年龄：80.9±5.9 岁）。调查了当前年龄、性别、痴呆类型、简易精神状态检查、长谷川痴呆量表修订版、临床痴呆评定量表（CDR）、老年抑郁量表（GDS）和 DASC-21。使用 ZBI 评估照料者负担。使用神经精神问卷（NPI）评估痴呆患者的行为和心理症状（BPSD）。将 ZBI 的各自风险因素作为自变量进行简单回归分析。然后进行多元回归分析。
ZBI 的平均得分为 28.0±18.1，而 DASC-21 的平均得分为 44.4±13.2。将 ZBI 的各自风险因素作为自变量进行简单回归分析。DASC-21（P<0.001）、CDR（P<0.001）、NPI（P<0.001）和 GDS（P=0.034）与 ZBI 显著相关。对于 DASC-21 的每个项目，记忆（P<0.001）、定向（P<0.001）、解决问题/常识（P<0.001）、工具性日常生活活动（IADL）外出（P<0.001）、IADL 在家中（P<0.001）、身体自理能力①（P<0.001）和身体自理能力②（P=0.014）也与 ZBI 显著相关。为了找出 ZBI 的独立关联，进行了多元回归分析。结果表明，DASC-21（P<0.001）和 NPI（P<0.001）具有显著相关性。对于 DASC-21 的每个项目，记忆（P=0.014）和解决问题/常识（P<0.001）也具有显著相关性。
BPSD、认知和 IADL 均对照料者负担产生影响。DASC-21 可用于确定痴呆患者照料者负担的原因。
