Chia-Fen Tsai1, Wei-Shen Hwang1,2, Jun-Jun Lee3,4, Wen-Fu Wang5,6, Ling-Chun Huang7,8, Li-Kai Huang9,10,11, Wei-Ju Lee12,13, Pi-Shan Sung14, Yi-Chien Liu15,16, Chih-Cheng Hsu17, Jong-Ling Fuh18,19. 1. Department of Psychiatry, Division of Geriatric Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan. 2. Department of Psychiatry, Tungs' Taichung Metroharbor Hospital, Taichung, Taiwan. 3. Department of Neurology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, College of Medicine, Kaohsiung, Taiwan. 4. Department of Information Management, National Sun Yat-sen University, Kaohsiung, Taiwan. 5. Department of Neurology, Changhua Christian Hospital, Changhua, Taiwan. 6. Department of Holistic Wellness, Ming Dao University, Changhua, Taiwan. 7. Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan. 8. Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, 112, Taiwan. 9. Department of Neurology, Shuang Ho Hospital, Taipei, Taipei Medical University, New Taipei City, Taiwan. 10. Graduate Institute of Humanities in Medicine, Taipei Medical University, Taipei, Taiwan. 11. The PhD program for Neural Regenerative Medicine, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan. 12. Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan. 13. Faculty of Medicine, National Yang-Ming University Schools of Medicine, Taipei, Taiwan. 14. Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan. 15. Neurological Center of Cardinal Tien Hospital, Taipei, Taiwan. 16. Fu Jen University School of Medicine, Taipei, Taiwan. 17. Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan. 18. Faculty of Medicine, National Yang-Ming University Schools of Medicine, Taipei, Taiwan. stellafuh@gmail.com. 19. Division of General Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan. stellafuh@gmail.com.
Abstract
BACKGROUND: Dementia in the oldest-old is projected to increase exponentially as is the burden of their caregivers who may experience unique challenges and suffering. Thus, we aim to investigate which factors are associated with older caregivers' burden in caring demented outpatients in a multicenter cohort. METHODS: Patients and their caregivers, both aged ≧65 years, in the National Dementia Registry Study in Taiwan (T-NDRS) were included in this study. Caregiver burden was measured with the short version of the Zarit Burden Interview (ZBI). The correlations between the ZBI scores and characteristics of caregivers and patients, including severity of dementia, physical comorbidities, instrumental activities of daily living (IADL), neuropsychiatric symptoms assessed by the Neuropsychiatric Inventory (NPI), and family monthly income, were analyzed. RESULTS: We recruited 328 aged informal caregiver-patient dyads. The mean age of caregivers was 73.7 ± 7.0 years, with female predominance (66.8%), and the mean age of patients was 78.8 ± 6.9 years, with male predominance (61.0%). Multivariable linear regression showed that IADLs (β = 0.83, p < 0.001) and NPI subscores of apathy (β = 3.83, p < 0.001)and irritability (β = 4.25, p < 0.001) were positively associated with ZBI scores. The highest family monthly income (β = - 10.92, p = 0.001) and caregiver age (β = - 0.41, p = 0.001) were negatively correlated with ZBI scores. CONCLUSIONS: Older caregivers of older demented patients experience a higher care burden when patients had greater impaired functional autonomy and the presence of NPI symptoms of apathy and irritability. Our findings provide the direction to identify risky older caregivers, and we should pay more attention to and provide support for these exhausted caregivers.
BACKGROUND:Dementia in the oldest-old is projected to increase exponentially as is the burden of their caregivers who may experience unique challenges and suffering. Thus, we aim to investigate which factors are associated with older caregivers' burden in caring demented outpatients in a multicenter cohort. METHODS:Patients and their caregivers, both aged ≧65 years, in the National Dementia Registry Study in Taiwan (T-NDRS) were included in this study. Caregiver burden was measured with the short version of the Zarit Burden Interview (ZBI). The correlations between the ZBI scores and characteristics of caregivers and patients, including severity of dementia, physical comorbidities, instrumental activities of daily living (IADL), neuropsychiatric symptoms assessed by the Neuropsychiatric Inventory (NPI), and family monthly income, were analyzed. RESULTS: We recruited 328 aged informal caregiver-patient dyads. The mean age of caregivers was 73.7 ± 7.0 years, with female predominance (66.8%), and the mean age of patients was 78.8 ± 6.9 years, with male predominance (61.0%). Multivariable linear regression showed that IADLs (β = 0.83, p < 0.001) and NPI subscores of apathy (β = 3.83, p < 0.001)and irritability (β = 4.25, p < 0.001) were positively associated with ZBI scores. The highest family monthly income (β = - 10.92, p = 0.001) and caregiver age (β = - 0.41, p = 0.001) were negatively correlated with ZBI scores. CONCLUSIONS: Older caregivers of older demented patients experience a higher care burden when patients had greater impaired functional autonomy and the presence of NPI symptoms of apathy and irritability. Our findings provide the direction to identify risky older caregivers, and we should pay more attention to and provide support for these exhausted caregivers.
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