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Neuropsychiatric symptoms in Parkinson’s disease: association with caregiver distress and disease severity

Published online by Cambridge University Press:  24 October 2019

Wan-Chen Tsai ,
Hui-Chen Lin ,
Chiung-Chih Chang ,
Wen-Neng Chang ,
Chih-Cheng Huang ,
Kuei-Yueh Cheng ,
Hung-Chen Wang ,
Wei-Che Lin ,
Sheng-Yuan Hsiao  and
Yun-Ru Lai
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Wan-Chen Tsai
Affiliation:
Departments of Neurology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
Hui-Chen Lin
Affiliation:
Departments of Neurology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
Chiung-Chih Chang
Affiliation:
Departments of Neurology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
Wen-Neng Chang
Affiliation:
Departments of Neurology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
Chih-Cheng Huang
Affiliation:
Departments of Neurology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
Kuei-Yueh Cheng
Affiliation:
Departments of Nursing, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
Hung-Chen Wang
Affiliation:
Departments of Neurosurgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
Wei-Che Lin
Affiliation:
Departments of Radiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
Sheng-Yuan Hsiao
Affiliation:
Departments of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan Department of Biological Science, National Sun Yat-Sen University, Kaohsiung, Taiwan
Yun-Ru Lai
Affiliation:
Departments of Neurology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan Department of Biological Science, National Sun Yat-Sen University, Kaohsiung, Taiwan
Cheng-Hsien Lu
Affiliation:
Departments of Neurology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan Department of Biological Science, National Sun Yat-Sen University, Kaohsiung, Taiwan
Nai-Wen Tsai*
Affiliation:
Departments of Neurology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
*
Correspondence should be addressed to: Nai-Wen Tsai, Department of Neurology, Chang Gung Memorial Hospital, 123 123, Ta Pei Road, Niao Sung District, Kaohsiung, Taiwan, Phone: + 886 7 7317123 ext 2283. Fax: + 886 7 7317123 ext 2292. Email: tsainw@yahoo.com.tw.
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Abstract

Objectives:

The condition of caregivers is important to the quality of care received by people with Parkinson’s disease (PD), especially at the late disease stages. This study addresses the distress placed on caregivers by participants’ neuropsychiatric symptoms at different stages of PD in Taiwan

Methods:

This prospective study enrolled 108 people with PD. All participants were examined with the Unified Parkinson’s Disease Rating Scale (UPDRS), Neuropsychiatric Inventory (NPI), Mini-Mental State Examination (MMSE), Cognitive Abilities Screening Instrument (CASI), and Clinical Dementia Rating (CDR) scale. Caregiver distress was measured using the Neuropsychiatric Inventory Caregiver Distress Scale (NPI-D). Statistical analysis was used to explore the PD-related factors that contribute to caregiver distress.

Results:

The mean follow-up interval in the 108 PD participants were 24.0 ± 10.2 months with no participant lost to follow-up due to death. NPI-distress (the sum of NPI caregiver distress scale across the 12 domains of the NPI) was positively correlated with NPI-sum (the total score across the 12 domains of the NPI) (r = 0.787, p < 0.001), CDR (r = 0.403, p < 0.001), UPRDS (r = 0.276, p = 0.004), and disease duration (r = 0.246, p = 0.002), but negatively correlated with CASI (r = −0.237, p = 0.043) and MMSE (r = −0.281, p < 0.001). Multiple linear regression analysis showed that only NPI-sum and disease duration were independently correlated with NPI-distress.

Conclusion:

The disease duration and NPI-sum are independent predictors of caregiver distress in Taiwanese populations with PD. Early detection and reduction of neuropsychiatric symptoms in people with PD can help decrease caregiver distress.

Keywords

Parkinson’s diseasedistressneuropsychiatric inventorydementia
Type
Original Research Article
Information
International Psychogeriatrics , Volume 32 , Issue 6: Issue Theme: Interaction of Depression and Cognition in Older Age , June 2020 , pp. 733 - 739
Copyright
© International Psychogeriatric Association 2019

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