Claudia Ledda1,2, Elisa Montanaro1,2, Leonardo Lopiano1,2, Alberto Romagnolo3,4, Gabriele Imbalzano1,2, Aristide Merola5, Ilaria Bruno1, Carlo Alberto Artusi1,2, Maurizio Zibetti1,2, Mario Giorgio Rizzone1,2, Marco Bozzali1,2, Gabriele Sobrero6, Fabrizio Vallelonga6, Simona Maule6. 1. Department of Neuroscience "Rita Levi Montalcini", University of Turin, Via Cherasco 15, 10126, Turin, Italy. 2. SC Neurologia 2U, AOU Città della Salute e della Scienza, Via Cherasco 15, 10126, Turin, Italy. 3. Department of Neuroscience "Rita Levi Montalcini", University of Turin, Via Cherasco 15, 10126, Turin, Italy. al.romagnolo@gmail.com. 4. SC Neurologia 2U, AOU Città della Salute e della Scienza, Via Cherasco 15, 10126, Turin, Italy. al.romagnolo@gmail.com. 5. Department of Neurology, Wexner Medical Center, Ohio State University, Columbus, OH, USA. 6. Department of Medical Sciences, Internal Medicine Division, Autonomic Unit and Hypertension Unit, University of Turin, Turin, Italy.
Abstract
PURPOSE: We sought to estimate the impact of cardiovascular autonomic neuropathy (cAN) on informal caregivers of patients with Parkinson's disease (PD), defined as individuals providing regular care to a friend, partner, or family member with PD, and to evaluate the mutual relationship between caregiver burden and patient health-related quality of life (HRQoL). METHODS: We enrolled 36 consecutive patients with PD and their informal caregivers. Patients underwent a detailed motor, autonomic, cognitive, and functional assessment. Caregivers were assessed using the Zarit Burden Interview (ZBI). Differences in caregiver burden, expressed by the ZBI score, and strength of association between caregiver burden, cAN, and HRQoL were assessed using analysis of covariance (ANCOVA), logistic regression, and linear regression analyses. Analyses were adjusted for patients' age, PD duration, and motor and cognitive disability, as well as caregivers' age. RESULTS: Moderate-severe caregiver burden was reported in 41.7% of PDcAN+ versus 8.7% of PDcAN- (p < 0.001). The ZBI score was increased in PDcAN+ versus PDcAN- (31.5 ± 3.4 versus 15.2 ± 2.3; p < 0.001), with tenfold higher odds (p = 0.012) of moderate-severe caregiver burden in PDcAN+, even after adjusting for potential confounders. The ZBI score correlated with cAN severity (p = 0.005), global autonomic impairment (p = 0.012), and HRQoL impairment (p < 0.001). CONCLUSION: These results highlight the significant impact of cAN on PD caregivers and the need for targeted interventions addressing this frequently overlooked and insufficiently treated source of nonmotor disability in PD.
PURPOSE: We sought to estimate the impact of cardiovascular autonomic neuropathy (cAN) on informal caregivers of patients with Parkinson's disease (PD), defined as individuals providing regular care to a friend, partner, or family member with PD, and to evaluate the mutual relationship between caregiver burden and patient health-related quality of life (HRQoL). METHODS: We enrolled 36 consecutive patients with PD and their informal caregivers. Patients underwent a detailed motor, autonomic, cognitive, and functional assessment. Caregivers were assessed using the Zarit Burden Interview (ZBI). Differences in caregiver burden, expressed by the ZBI score, and strength of association between caregiver burden, cAN, and HRQoL were assessed using analysis of covariance (ANCOVA), logistic regression, and linear regression analyses. Analyses were adjusted for patients' age, PD duration, and motor and cognitive disability, as well as caregivers' age. RESULTS: Moderate-severe caregiver burden was reported in 41.7% of PDcAN+ versus 8.7% of PDcAN- (p < 0.001). The ZBI score was increased in PDcAN+ versus PDcAN- (31.5 ± 3.4 versus 15.2 ± 2.3; p < 0.001), with tenfold higher odds (p = 0.012) of moderate-severe caregiver burden in PDcAN+, even after adjusting for potential confounders. The ZBI score correlated with cAN severity (p = 0.005), global autonomic impairment (p = 0.012), and HRQoL impairment (p < 0.001). CONCLUSION: These results highlight the significant impact of cAN on PD caregivers and the need for targeted interventions addressing this frequently overlooked and insufficiently treated source of nonmotor disability in PD.
Authors: Andrea Pilotto; Alberto Romagnolo; Jasmine A Tuazon; Joaquin A Vizcarra; Luca Marsili; Maurizio Zibetti; Michela Rosso; Federico Rodriguez-Porcel; Barbara Borroni; Maria Cristina Rizzetti; Carlo Rossi; Darwin Vizcarra-Escobar; Jennifer R Molano; Leonardo Lopiano; Roberto Ceravolo; Mario Masellis; Alberto J Espay; Alessandro Padovani; Aristide Merola Journal: J Neurol Neurosurg Psychiatry Date: 2019-05-29 Impact factor: 10.154
Authors: Aristide Merola; Russell P Sawyer; Carlo Alberto Artusi; Ritika Suri; Zoe Berndt; Jose' Ricardo Lopez-Castellanos; Jennifer Vaughan; Joaquin A Vizcarra; Alberto Romagnolo; Alberto J Espay Journal: Parkinsonism Relat Disord Date: 2017-11-28 Impact factor: 4.891
Authors: Andrea Pilotto; Alberto Romagnolo; Andrea Scalvini; Mario Masellis; Yasushi Shimo; Laura Bonanni; Richard Camicioli; Lily L Wang; Alok K Dwivedi; Katherine Longardner; Federico Rodriguez-Porcel; Mark DiFrancesco; Joaquin A Vizcarra; Elisa Montanaro; Simona Maule; Alessandro Lupini; Carmen Ojeda-López; Sandra E Black; Stefano Delli Pizzi; Myrlene Gee; Ryota Tanaka; Kazuo Yamashiro; Taku Hatano; Barbara Borroni; Roberto Gasparotti; Maria C Rizzetti; Nobutaka Hattori; Leonardo Lopiano; Irene Litvan; Alberto J Espay; Alessandro Padovani; Aristide Merola Journal: Neurology Date: 2021-06-07 Impact factor: 11.800