A path analysis of patient dependence and caregiver burden in Alzheimer's disease
A path analysis of patient dependence and caregiver burden in Alzheimer's disease
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DOI：
10.1017/s1041610216000223
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发表时间：
2016-07-01
影响因子：
7
通讯作者：
Lopez-Pousa, S.
中科院分区：
文献类型：
--
作者：
Garre-Olmo, J.;Vilalta-Franch, J.;Lopez-Pousa, S.
背景：依赖性的概念已被提出作为一个综合的措施，以评估阿尔茨海默病（AD）的进展。本研究的目的是调查关联的患者的依赖水平与照顾者的负担在一个一般的理论模型，包括其他完善的determinators.Methods：观察和横断面多中心研究。样本包括AD患者招募门诊咨询办公室方便抽样程序分层痴呆的严重程度。认知和功能状态，行为障碍，依赖水平，医疗合并症，和照顾者的负担进行了评估，使用标准化的工具。路径分析被用来测试的假设之间的关系的照顾者的负担和它的决定因素，包括依赖的水平。结果：样本包括306例（33.3%轻度，35.9%中度，30.7%严重），平均年龄为78.5岁（SD = 7.8），和66.2%是女性。模型拟合是可以接受的，并解释了29%的照顾者负担的方差。主要压力源是依赖程度和与行为障碍有关的痛苦。照顾者的年龄、性别、与病患同住是影响照顾者负担的相关因素。照顾者的工作状态是一个显着的次要压力源，功能障碍是间接相关的照顾者的负担通过依赖，和行为障碍的频率是间接相关的照顾者的负担通过distress.Conclusions：依赖是，除了行为障碍，最重要的主要压力源直接相关的照顾者的负担，无论疾病的严重程度。
Background: The concept of dependence has been proposed as an integrative measure to assess the progression of Alzheimer's disease (AD). This study aimed to investigate the association of patient's dependence level with the caregiver burden within a general theoretical model that includes other well-established determinants.Methods: Observational and cross-sectional multicenter study. The sample consisted of patients with AD recruited in outpatient consultation offices by a convenience sampling procedure stratified by dementia severity. Cognitive and functional status, behavioral disturbances, dependence level, medical comorbidities, and caregiver burden were assessed by using standardized instruments. A path analysis was used to test the hypothesized relationships between the caregiver burden and its determinants, including the level of dependence.Results: The sample consisted of 306 patients (33.3% mild, 35.9% moderate, 30.7% severe), the mean age was 78.5 years (SD = 7.8), and 66.2% were women. The model fit was acceptable and explained 29% of the caregiver burden variance. Primary stressors were the level of dependence and the distress related to behavioral disturbances. Caregiver's age, gender, and co-residence with the patient were the contextual factors related to caregiver burden. The job status of the caregiver was a significant secondary stressor, functional disability was indirectly associated with caregiver burden via dependence, and frequency of behavioral disturbances was indirectly associated with the caregiver burden via distress.Conclusions: Dependence was, apart from behavioral disturbances, the most important primary stressor directly related to caregiver burden irrespective of the disease severity.