Caregiver burden in atypical dementias: comparing frontotemporal dementia, Creutzfeldt-Jakob disease, and Alzheimer's disease
Caregiver burden in atypical dementias: comparing frontotemporal dementia, Creutzfeldt-Jakob disease, and Alzheimer's disease
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DOI：
10.1017/s1041610215001647
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发表时间：
2016-02-01
影响因子：
7
通讯作者：
Appleby, Brian S.
中科院分区：
文献类型：
--
作者：
Uflacker, Alice;Edmondson, Mary C.;Appleby, Brian S.
背景：护理人员负担是痴呆症治疗中的一个重要问题，也是导致痴呆症患者入院的已知原因。已发表的数据显示，与阿尔茨海默病 (AD) 相比，行为变异型额颞叶痴呆 (bvFTD) 的护理人员负担增加。另一种被认为照顾者负担较高的非典型痴呆症是散发性克雅氏病 (sCJD)，但尚未有正式研究评估这种看法。本研究的目的是比较不同非典型痴呆病因的护理人员负担。方法：在为期五年的时间里，对 76 名患有非典型痴呆（年轻发病 AD [YOAD]、bvFTD、语言变异 FTD [lvFTD] 和 sCJD）的成年人进行了简短版本的 Zarit 负担访谈 (ZBI)、神经精神量表 (NPI-Q) 和其他评估工具。约翰·霍普金斯医院 (JHH)。 Cox 回归模型检查了影响平均 ZBI 评分的疾病类别之间的差异。结果：痴呆病因之间的平均 ZBI 评分显着不同，其中 bvFTD 和 sCJD 的护理负担最高 (p = 0.026)。 bvFTD 和 sCJD 的平均 NPI-Q 照顾者痛苦评分最高 (p = 0.002)，其中 sCJD 和 bvFTD 认可的症状领域数量也最多 (p = 0.012)。在回归分析中，结合最终诊断类别和 NPI-Q 总严重程度评分的交互变量显示 sCJD 和 bvFTD 的平均 ZBI 评分存在统计学显着性差异。结论：本研究表明，bvFTD 和 sCJD 增加了护理人员负担、NPI-Q 护理人员痛苦、总严重程度评分和认可症状领域的数量。这些结果表明，bvFTD 和 sCJD 中较高的护理负担是疾病特异性的，并且可能与神经精神症状有关。
Background: Caregiver burden is a significant issue in the treatment of dementia and a known contributor to institutionalization of patients with dementia. Published data have documented increased caregiver burden in behavioral variant frontotemporal dementia (bvFTD) compared to Alzheimer's disease (AD). Another atypical dementia with high-perceived caregiver burden is sporadic Creutzfeldt-Jakob disease (sCJD), but no formal studies have assessed this perception. The aim of this study was to compare caregiver burden across atypical dementia etiologies.Methods: 76 adults with atypical dementia (young-onset AD [YOAD], bvFTD, language variant FTD [lvFTD], and sCJD) were administered an abbreviated version of the Zarit Burden Interview (ZBI), Neuropsychiatric Inventory (NPI-Q), and other assessment instruments during a five-year time period at Johns Hopkins Hospital (JHH). A Cox regression model examined differences between disease categories that impact mean ZBI scores.Results: Mean ZBI scores were significantly different between dementia etiologies, with bvFTD and sCJD having the highest caregiver burden (p = 0.026). Mean NPI-Q caregiver distress scores were highest in bvFTD and sCJD (p = 0.002), with sCJD and bvFTD also having the highest number of endorsed symptom domains (p = 0.012). On regression analyses, an interactive variable combining final diagnosis category and NPI-Q total severity score demonstrated statistically significant differences in mean ZBI scores for sCJD and bvFTD.Conclusions: This study demonstrates that bvFTD and sCJD have increased levels of caregiver burden, NPI-Q caregiver distress, total severity scores, and number of endorsed symptom domains. These results suggest that higher caregiver burden in bvFTD and sCJD are disease specific and possibly related to neuropsychiatric symptoms.