Caregiver burden is increased in Parkinson's disease with mild cognitive impairment (PD-MCI)

Type of content
Journal Article
Thesis discipline
Degree name
Publisher
Journal Title
Journal ISSN
Volume Title
Language
English
Date
2017
Authors
Jones AJ
Kuijer RG
Livingston L
Myall D
Horne K
MacAskill M
Pitcher T
Barrett PT
Anderson TJ
Dalrymple-Alford JC
Abstract

There is limited evidence on caregiver outcomes associated with mild cognitive impairment in patients with Parkinson's disease (PD-MCI) and the coping strategies used by these caregivers.To investigate this relationship, we examined levels of burden, depression, anxiety, coping strategies and positive aspects of caregiving in the informal caregivers of 96 PD patients. The PD patients were classified using MDS-Task Force Level II criteria as showing either normal cognition (PD-N; n = 51), PD-MCI (n = 30) or with dementia (PDD; n = 15).Mean Zarit Burden Interview (ZBI) score increased significantly between carers of PD-N (M = 13.39, SD = 12.22) compared to those of PD-MCI patients (M = 22.00, SD = 10.8), and between carers of PD-MCI and PDD patients (M = 29.33, SD = 9.59). Moreover, the proportion of carers showing clinically significant levels of burden (ZBI score ≥ 21) also increased as the patients' cognitive status declined (18% for PD-N; 60% for PD-MCI; and 80% for PDD) and was mirrored by an increasing amount of time spent providing care by the caregivers. Caregiver ZBI score was independent of patient neuropsychiatric symptoms, motor function, disease duration and time that caregivers spent caregiving. Caregiver use of different coping strategies increased with worsening cognition. However, we found only equivocal evidence that the use of problem-focused, emotion-focused and dysfunctional coping mediated the association between patient cognitive status and caregiver burden, because the inverse models that used caregiver burden as the mediator were also significant.The study highlights the impact of Parkinson's disease on those providing care when the patient's cognition is poor, including those with MCI. Caregiver well-being has important implications for caregiver support, nursing home placement and disease course.

Description
Citation
Jones AJ, Kuijer RG, Livingston L, Myall D, Horne K, MacAskill M, Pitcher T, Barrett PT, Anderson TJ, Dalrymple-Alford JC (2017). Caregiver burden is increased in Parkinson's disease with mild cognitive impairment (PD-MCI). Translational Neurodegeneration. 6(1). 17-.
Keywords
Parkinson's disease, Mild cognitive impairment, Zarit caregiver burden interview, Coping, Depression, Anxiety, Positive aspects of caregiving
Ngā upoko tukutuku/Māori subject headings
ANZSRC fields of research
Field of Research::11 - Medical and Health Sciences::1117 - Public Health and Health Services::111707 - Family Care
Field of Research::17 - Psychology and Cognitive Sciences::1701 - Psychology::170106 - Health, Clinical and Counselling Psychology
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Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.