Prevalence and Predictors of Burden in Caregivers of People with Dementia
Prevalence and Predictors of Burden in Caregivers of People with Dementia
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DOI：
10.1016/j.jagp.2013.05.004
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发表时间：
2014-08-01
影响因子：
7.2
通讯作者：
Balshaw, Robert
中科院分区：
文献类型：
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作者：
Brodaty, Henry;Woodward, Michael;Balshaw, Robert
目的：探讨痴呆患者记忆门诊照顾者负担的患病率和预测因素。研究方法：这项前瞻性队列研究在澳大利亚的9家记忆诊所进行，在基线和3、6、12、24和36个月时对732名门诊患者及其主要照顾者进行了评估。评定基于以下内容：根据精神障碍诊断和统计手册第四版、简易精神状态检查、阿尔茨海默病评估量表-认知、功能自主测量系统、神经精神量表、精神和抗抑郁药物的使用、患者和护理人员资源使用以及Zarit护理人员负担访谈（ZBI）进行的痴呆诊断。结果如下：一半的照顾者有明显的高负担水平，在12个月时上升到57.7%;中度至重度负担率，从基线时的14.7%上升到12个月时的22.8%;平均ZBI水平从基线时的22.9上升到6个月时的25.5和12个月时的27.7。看护者预测6个月和12个月的负担是他们的神经质和基线ZBI评分。患者的预测因素是他们的行为症状水平，抗精神病药和抗抑郁药的使用，以及更快的功能下降。其他预测因子（女性照顾者、认知和功能水平、额颞叶痴呆的诊断）在回归分析中不显著。结论：痴呆症患者的照顾者有高的和持续的负担率。确定12个月时可能有高负担的照顾者，可以更准确地确定干预措施的目标。
Objective: To examine prevalence and predictors of burden in caregivers of people with dementia attending memory clinics. Methods: This Prospective cohort study conducted at nine memory clinics in Australia rated 732 outpatient attendees and their primary caregivers at baseline and at 3, 6, 12, 24, and 36 months. Ratings were based on the following: dementia diagnosis according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Mini-Mental State Exam, Alzheimer's Disease Assessment Scalee-Cognitive, Functional Autonomy Measurement System, Neuropsychiatric Inventory, use of psychotropic and antidepressant medications, patient and caregiver resource use, and the Zarit Caregiver Burden Interview (ZBI). Results: Half the caregivers had significantly high levels of burden, rising to 57.7% at 12 months; with moderate to severe burden rates, rising from 14.7% at baseline to 22.8% at 12 months; and mean ZBI levels rising from 22.9 at baseline to 25.5 at 6 months and 27.7 at 12 months. Caregiver predictors of 6- and 12-month burden were their neuroticism and baseline ZBI score. Patient predictors were their level of behavioral symptoms, use of antipsychotics and antidepressants, and more rapid functional decline. Other predictors (female caregiver, level of cognition and function, diagnosis of frontotemporal dementia) were not significant in regression analyses. Conclusion: Caregivers of people with dementia have high and persistent rates of burden. Identification of caregivers likely to have high levels of burden at 12 months may allow more accurate targeting of interventions.