Hostname: page-component-76fb5796d-5g6vh Total loading time: 0 Render date: 2024-04-26T15:45:03.549Z Has data issue: false hasContentIssue false
  • English
  • Français

The relationship between specific cognitive defects and burden of care in Parkinson's disease

Published online by Cambridge University Press:  05 October 2015

Michael Zhong ,
Richard Peppard ,
Dennis Velakoulis  and
Andrew H. Evans
Michael Zhong*
Affiliation:
University of Melbourne, Melbourne, Victoria, Australia
Richard Peppard
Affiliation:
Department of Clinical Neurosciences, St Vincent's Hospital, Melbourne, Victoria, Australia
Dennis Velakoulis
Affiliation:
Melbourne Neuropsychiatry Centre, University of Melbourne, Melbourne, Victoria, Australia Department of Neuropsychiatry, Royal Melbourne Hospital, Melbourne, Victoria, Australia
Andrew H. Evans
Affiliation:
Department of Neurology, Royal Melbourne Hospital, Melbourne, Victoria, Australia Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
*
Correspondence should be addressed to: Dr. Michael Zhong, 163 Lennox St Richmond, Melbourne, Victoria 3192, Australia. Phone: +03-0422-737-611; Fax: +03-9428-7769. Email: mzhong23@gmail.com.
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

In spite of the recognized physical and psychosocial effects of caring for patients with Parkinson's disease (PD), caregiver burden (CB) in this setting is poorly understood. The objective of this research was to identify factors that were associated with CB in an Australian population of PD caregivers using a novel instrument – the Parkinson's Disease Caregiver Burden (PDCB) questionnaire.

Methods:

Fifty patient–caregiver couples were recruited from three movement disorders clinics in Melbourne, Australia. Burden on caregivers was rated using the PDCB questionnaire. Burden scores were correlated with patient factors, including motor symptom severity (Unified Parkinson's Disease Ratings Scale and Hoehn & Yahr (H&Y) scale), patient cognition (Neuropsychiatry Unit Cognitive Assessment Tool; NUCOG), presence of impulsive and compulsive behaviors (Questionnaire for Impulsive–Compulsive Disorders in Parkinson's disease), and patient olfaction. Caregiver and patient demographics, as well as results for depression and anxiety (Hospital Anxiety and Depression Scale; HADS), were also examined for their relationship with CB.

Results:

H&Y stage, depression or anxiety in either caregiver or patient, and decreased patient NUCOG score were significantly associated with higher PDCB score. Multiple linear regression analysis identified caregiver and patient depression score and patient score for the visuoconstructional subscale of NUCOG to predict burden score. In addition, disease duration, duration of caregiving, and increased hours per day spent in giving care were significantly associated with increased burden.

Conclusions:

We found psychiatric and cognitive factors to be the most relevant factors in the perception of burden in PD caregivers. On top of this, we found deficits in the domain of visuoconstruction predicted burden – a relationship not yet described in literature. Targeting depression and anxiety in this setting as well as identifying caregivers at high risk of burden may give clinicians the chance to optimize care of patients with PD through the caregiver.

Keywords

caregiverburdenquestionnairedepressionanxietycognition
Type
Research Article
Information
International Psychogeriatrics , Volume 28 , Issue 2 , February 2016 , pp. 275 - 281
Copyright
Copyright © International Psychogeriatric Association 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aarsland, D. (1999). Mental symptoms in Parkinson's disease are important contributors to caregiver distress. International Journal of Geriatric Psychiatry, 14, 866.3.0.CO;2-Z>CrossRefGoogle ScholarPubMed
Aarsland, D. and Kurz, M. W. (2010). The epidemiology of dementia associated with Parkinson's disease. Brain Pathology, 20, 633–639.Google Scholar
Baba, T. et al. (2012). Severe olfactory dysfunction is a prodromal symptom of dementia associated with Parkinson's disease: a 3-year longitudinal study. Brain, 135 (Pt. 1), 161–169.Google Scholar
Bohnen, N. I. (2010). Olfactory dysfunction, central cholinergic integrity and cognitive impairment in Parkinson's disease. Brain, 133, 1747–1754.CrossRefGoogle ScholarPubMed
Carter, J. H. (1997). Living with a person who has Parkinson's disease: the spouse's perspective by stage of disease. Neurology, 48, 3090–3090.Google Scholar
Caserta, M. S. (1996). Exploring the caregiver burden inventory (CBI): further evidence for a multidimensional view of burden. International Journal of Aging & Human Development, 43, 21–34.Google Scholar
Chang, H. (2010). Impact of mental health and caregiver burden on family caregivers’ physical health. Archives of Gerontology & Geriatrics, 50, 267–271.Google Scholar
Chou, K. R., Jiann-Chyun, L. and Chu, H. (2002). The reliability and validity of the Chinese version of the caregiver burden inventory. Nursing Research, 51, 324–331.CrossRefGoogle ScholarPubMed
D’Amelio, M. (2009). Predictors of caregiver burden in partners of patients with Parkinson's disease. Neurological Sciences, 30, 171–174.Google Scholar
Denno, M. S. et al. (2013). Anxiety and depression associated with caregiver burden in caregivers of stroke survivors with spasticity. Archives of Physical Medicine and Rehabilitation, 94, 1731–1736.Google Scholar
Evans, A. H. (2009). Impulsive and compulsive behaviors in Parkinson's disease. Movement Disorders, 24, 1561.Google Scholar
Fernandez, H. H. (2001). Predictors of depressive symptoms among spouse caregivers in Parkinson's disease. Movement Disorders, 16, 1123.Google Scholar
Goetz, C. G. et al. (2007). Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS): process, format, and clinimetric testing plan. Movement Disorders, 22, 41–47.Google Scholar
Happe, S. (2002). The association between caregiver burden and sleep disturbances in partners of patients with Parkinson's disease. Age and Ageing, 31, 349–354.Google Scholar
Hoehn, M. M. (2001). Parkinsonism: onset, progression, and mortality, 1967. Neurology, 57 (Suppl. 3), S11.Google ScholarPubMed
Hughes, A. J. (1992). Accuracy of clinical diagnosis of idiopathic Parkinson's disease: a clinico-pathological study of 100 cases. Journal of Neurology, Neurosurgery, and Psychiatry, 55, 181.Google Scholar
Johnson, D. K. and Galvin, J. E. (2011). Longitudinal changes in cognition in Parkinson's disease with and without dementia. Dementia and Geriatric Cognitive Disorders, 31, 98–108.CrossRefGoogle ScholarPubMed
Kim, J. W., Cheon, S. M., Park, M. J., Kim, S. Y. and Jo, H. Y. (2009). Cognitive impairment in Parkinson's disease without dementia: subtypes and influences of age. Journal of Clinical Neurology, 5, 133–138.CrossRefGoogle ScholarPubMed
Kobal, G. (1996). “Sniffin sticks”: screening of olfactory performance. Rhinology, 34, 222.Google Scholar
Leroi, I. (2012). Apathy and impulse control disorders in Parkinson's disease: a direct comparison. Parkinsonism & Related Disorders, 18, 198.Google Scholar
Liepelt-Scarfone, I. et al. (2012). Cognitive profiles in Parkinson's disease and their relation to dementia: a data-driven approach. International Journal of Alzheimers Disease, 2012, 910757.Google Scholar
Martinez-Martin, P. (2007). Caregiver burden in Parkinson's disease. Movement Disorders, 22, 924–931.CrossRefGoogle ScholarPubMed
Muslimovic, D., Schmand, B., Speelman, J. D. and de Haan, R. J. (2007). Course of cognitive decline in Parkinson's disease: a meta-analysis. Journal of International Neuropsychological Society, 13, 920–932.CrossRefGoogle ScholarPubMed
Oh, Y. S., Lee, J. E., Lee, P. H. and Kim, J. S. (2015). Neuropsychiatric symptoms in Parkinson's disease dementia are associated with increased caregiver burden. Journal of Movement Disorders, 8, 26–32.Google Scholar
Olanow, C. W., Stern, M. B. and Sethi, K. (2009). The scientific and clinical basis for the treatment of Parkinson's disease. Neurology, 72 (Suppl. 4), S1.Google Scholar
Qutub, K., Lacomis, D., Albert, S. M. and Feingold, E. (2014). Life factors affecting depression and burden in amyotrophic lateral sclerosis caregivers. Amyotrophic Lateral Sclerosis & Frontotemporal Degeneration, 15, 292–297.Google Scholar
Ramirez-Ruiz, B., Junque, C., Marti, M. J., Valldeoriola, F. and Tolosa, E. (2007). Cognitive changes in Parkinson's disease patients with visual hallucinations. Dementia and Geriatric Cognitive Disorders, 23, 281–288.Google Scholar
Rosas-Carrasco, O., Guerra-Silla Mde, G., Torres-Arreola Ldel, P., Garcia-Pena, C., Escamilla-Jimenez, C. I. and Gonzalez-Gonzalez, C. (2014). Caregiver burden of Mexican dementia patients: the role of dysexecutive syndrome, sleep disorders, schooling, and caregiver depression. Geriatric & Gerontology International, 14, 146–152.Google Scholar
Samii, A. (2004). Parkinson's disease. Lancet, 363, 1783.CrossRefGoogle ScholarPubMed
Schrag, A. (2006). Caregiver-burden in Parkinson's disease is closely associated with psychiatric symptoms, falls, and disability. Parkinsonism & Related Disorders, 12, 35–41.Google Scholar
Secker, D. L. (2005). Cognitive behavioural therapy (CBT) for caregivers of patients with Parkinson's disease: a preliminary randomised controlled trial. Journal of Neurology Neurosurgery and Psychiatry, 76, 491–497.Google Scholar
Snaith, R. P. and Zigmond, A. S. (1986). The hospital anxiety and depression scale. British Medical Journal (Clinical Research Ed.), 292, 344.Google Scholar
Thommessen, B. (2002). The psychosocial burden on spouses of the elderly with stroke, dementia and Parkinson's disease. International Journal of Geriatric Psychiatry, 17, 78.Google Scholar
Walterfang, M. (2006). The NUCOG: validity and reliability of a brief cognitive screening tool in neuropsychiatric patients. Australian and New Zealand Journal of Psychiatry, 40, 995–1002.Google Scholar
Weintraub, D. (2009). Validation of the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's disease. Movement Disorders, 24, 1461–1467.Google Scholar
Williamson, C., Simpson, J. and Murray, C. D. (2008). Caregivers’ experiences of caring for a husband with Parkinson's disease and psychotic symptoms. Social Science & Medicine, 67, 583–589.Google Scholar
Zarit, S. H., Todd, P. A. and Zarit, J. M. (1986). Subjective burden of husbands and wives as caregivers: a longitudinal study. Gerontologist, 26, 260–266.Google Scholar
Zhong, M. (2013). Validity and reliability of the PDCB: a tool for the assessment of caregiver burden in Parkinson's disease. International Psychogeriatrics, 25, 1437.Google Scholar
Supplementary material: PDF

Zhong supplementary material

Zhong supplementary material 1

Download Zhong supplementary material(PDF)
PDF 109.6 KB