Department of Neurology, Korea University Guro Hospital, Seoul 08308, Republic of Korea.
Int J Environ Res Public Health. 2022 Dec 5;19(23):16252. doi: 10.3390/ijerph192316252.
Despite the growing awareness of poor health-related quality of life (HRQoL) in family caregivers of people with dementia (PWD), their relationship has rarely been explored with population-based samples. The current cross-sectional study aimed to determine the detrimental impact of informal dementia caregiving on HRQoL by using nationally representative population-based samples from the Korean Community Health Survey. Demographics, socioeconomic, and physical and mental health-related characteristics as well as HRQoL measured by the Korean version of the European Quality of Life Questionnaire Five Dimension (EQ-5D) were compared between 9563 family caregivers of PWD and 186,165 noncaregivers. Caregivers had lower index scores and higher frequency of some/extreme problems in all five dimensions of the EQ-5D compared with noncaregivers. Logistic regression adjusting for potential confounding factors found that caregivers had a higher frequency of poor HRQoL (lowest quartile of EQ-5D index) than noncaregivers (adjusted odds ratio [95% confidence interval] = 1.46 [1.39-1.53]). Compared to noncaregivers, caregivers had a higher frequency of some/extreme problems in each dimension of the EQ-5D: mobility (1.30 [1.21-1.40]), self-care (1.62 [1.46-1.80]), usual activity (1.39 [1.29-1.51]), pain/discomfort (1.37 [1.31-1.45]), and anxiety/depression (1.51 [1.42-1.61]). A one-to-one propensity score matching analysis confirmed that poor HRQoL was more frequently found in caregivers compared to noncaregivers (1.38 [1.29-1.48]). Our results indicated that family caregivers of PWD are significantly associated with overall poor HRQoL, underscoring the detrimental impact of informal dementia caregiving on HRQoL. Given the high frequency of poor HRQoL in dementia caregivers and the important recognition of its serious consequences on physical and mental health, clinicians should take into consideration efficient interventions to improve health and HRQoL for family caregivers of PWD.
尽管人们越来越意识到痴呆症患者（PWD）家庭成员的健康相关生活质量（HRQoL）较差，但很少有研究基于人群样本探讨其相关性。本横断面研究旨在通过使用韩国社区健康调查的全国代表性人群样本，确定非正规痴呆症护理对 HRQoL 的不利影响。比较了 9563 名 PWD 家庭成员照顾者和 186165 名非照顾者的人口统计学、社会经济、身体和心理健康相关特征以及使用韩国版欧洲生活质量问卷五维（EQ-5D）测量的 HRQoL。与非照顾者相比，照顾者在 EQ-5D 的所有五个维度中得分较低，且某些/极度问题的发生率较高。调整潜在混杂因素的逻辑回归发现，与非照顾者相比，照顾者的 HRQoL 较差（EQ-5D 指数最低四分位数）的发生率较高（调整后的优势比[95%置信区间] = 1.46[1.39-1.53]）。与非照顾者相比，照顾者在 EQ-5D 的每个维度中都更有可能出现某些/极度问题：行动能力（1.30[1.21-1.40]）、自理能力（1.62[1.46-1.80]）、日常活动（1.39[1.29-1.51]）、疼痛/不适（1.37[1.31-1.45]）和焦虑/抑郁（1.51[1.42-1.61]）。一对一倾向评分匹配分析证实，与非照顾者相比，照顾者的 HRQoL 较差的比例更高（1.38[1.29-1.48]）。我们的研究结果表明，PWD 的家庭成员照顾者与整体较差的 HRQoL 显著相关，突显出非正规痴呆症护理对 HRQoL 的不利影响。鉴于痴呆症照顾者中较差的 HRQoL 发生率较高，以及对其对身心健康产生严重后果的重要认识，临床医生应考虑采取有效的干预措施，以改善 PWD 家庭成员照顾者的健康和 HRQoL。
