Rebolo Margarida, Maroco João, de Mendonça Alexandre, Melo Graça
Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.
Universidade Lusófona, Lisbon, Portugal.
Psychogeriatrics. 2025 May;25(3):e70033. doi: 10.1111/psyg.70033.
Caregivers of people with mild forms of cognitive decline, namely mild cognitive impairment (MCI), are subjected to caregiver burden. In recent years, a major breakthrough was the possibility of diagnosing Alzheimer's disease (AD) reliably in patients that present with MCI, as required for the use of the recently approved anti-amyloid therapies. We aimed to examine the caregiver burden in caregivers of patients with MCI due to AD, describe how caregiver burden evolves with time, and determine caregiver baseline factors that might predict the progression of burden.
Twenty-five dyads of community-dwelling patients and caregivers were consecutively recruited from a memory outpatient clinic, after receiving the diagnosis of MCI due to AD. Caregiver burden was measured with the Zarit Burden Inventory (ZBI), life satisfaction with Satisfaction With Life Scale, depressive symptoms with the Centre for Epidemiological Studies-Depression Scale (CES-D), anxiety symptoms with the State Anxiety Subscale of the State-Trait Anxiety Inventory (STAI) and patient neuropsychiatric symptoms with the Neuropsychiatric Inventory (NPI).
At baseline, the mean ZBI score was 24.5 ± 15.2 and correlated positively with caregiver CES-D and STAI scores and with patient neuropsychiatric symptoms (NPI-frequency × severity) and distress felt by the caregiver (NPI-distress). At follow-up (17.7 ± 9.4 months) the mean ZBI score increased to 31.4 ± 16.3 (P < 0.001); however, no baseline caregiver or patient characteristics were identified associated with the evolution of caregiver burden.
Caregivers of patients who received a diagnosis of MCI due to AD report substantial burden, that increased with time. Future studies should investigate caregiver characteristics that may predict burden progression and help delineate strategies to minimise it.
轻度认知功能减退患者(即轻度认知障碍,MCI)的照料者承受着照料负担。近年来,一项重大突破是能够按照使用最近获批的抗淀粉样蛋白疗法的要求,在患有MCI的患者中可靠地诊断出阿尔茨海默病(AD)。我们旨在研究AD所致MCI患者的照料者负担,描述照料负担如何随时间演变,并确定可能预测负担进展的照料者基线因素。
从记忆门诊连续招募了25对社区居住的患者及其照料者,这些患者已被诊断为AD所致MCI。使用 Zarit 照料负担量表(ZBI)测量照料者负担,使用生活满意度量表测量生活满意度,使用流行病学研究中心抑郁量表(CES-D)测量抑郁症状,使用状态-特质焦虑问卷的状态焦虑分量表(STAI)测量焦虑症状,使用神经精神科问卷(NPI)测量患者的神经精神症状。
在基线时,ZBI平均得分为24.5±15.2,与照料者的CES-D和STAI得分、患者的神经精神症状(NPI-频率×严重程度)以及照料者感受到的痛苦(NPI-痛苦)呈正相关。在随访时(17.7±9.4个月),ZBI平均得分增至31.4±16.3(P<0.001);然而,未发现与照料者负担演变相关的基线照料者或患者特征。
AD所致MCI患者的照料者报告负担较重,且负担随时间增加。未来的研究应调查可能预测负担进展的照料者特征,并有助于制定将负担降至最低的策略。