School Medicine University of Zagreb, Zagreb, Croatia.
Health Care Center Zagreb-West, Zagreb, Croatia.
Cogn Neuropsychiatry. 2023 Sep;28(5):327-332. doi: 10.1080/13546805.2023.2255338. Epub 2023 Sep 5.
We aimed to evaluate how the presence of individual neuropsychiatric symptoms in non-institutionalised patients with dementia is associated with caregiver burden of their informal caregivers, family members.
We performed a cross-sectional study on a total of 131 pairs of one informal caregiver family member and non-institutionalised patient with dementia in a family medicine practices in a city of Zagreb, Croatia. Caregiver measures included Zarit Burden Interview (ZBI) whereas patient measures included Mini mental state examination (MMSE), Barthel index and Neuropsychiatric Inventory Questionnaire (NPI-Q).
Total NPI-Q score explained 21% of overall burden. In order of strength of the association, after adjustments for age, sex, MMSE and Barthel index, overall burden was significantly associated with higher NPI-Q scores for agitation/aggression, apathy/indifference, irritability/lability, disinhibition, motor disturbance, appetite/eating, depression/dysphoria, anxiety, elation/euphoria and nighttime behaviours. When evaluating mutually independent contribution of unique NPI-Q symptoms to caregiver burden, agitation/aggression and apathy/indifference remained only two mutually independently associated symptoms, each explaining 5% of overall burden in this context.
Informal caregivers who provide for family members with dementia suffering from agitation/aggression or apathy/indifference should be recognised as under special risk for the development of caregiver burden and considered as candidates for early targeted interventions.
我们旨在评估非住院痴呆患者个体神经精神症状的存在与他们的非正式照料者(家庭成员)的照料者负担之间的关系。
我们在克罗地亚萨格勒布市的一家家庭医学诊所共对 131 对非住院痴呆患者及其非正式照料者的家庭成员进行了横断面研究。照料者的评估包括 Zarit 负担量表(ZBI),而患者的评估则包括简易精神状态检查(MMSE)、巴氏量表和神经精神问卷(NPI-Q)。
总的 NPI-Q 评分解释了总负担的 21%。经过对年龄、性别、MMSE 和巴氏量表的调整后,按关联强度排列,总的负担与更高的 NPI-Q 评分的激越/攻击、淡漠/冷漠、易怒/不稳定、抑制障碍、运动障碍、食欲/进食、抑郁/情绪低落、焦虑、兴高采烈/欣快和夜间行为显著相关。在评估独特的 NPI-Q 症状对照料者负担的独立贡献时,激越/攻击和淡漠/冷漠仍然是仅有的两个相互独立的相关症状,在这种情况下,每个症状分别解释了总负担的 5%。
为患有激越/攻击或淡漠/冷漠的痴呆症家庭成员提供照料的非正式照料者应被视为处于照料者负担发展的特殊风险之中,并被视为早期有针对性干预的候选者。