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

Abstract

BackgroundThere 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.MethodsTo 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).ResultsMean 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.ConclusionsThe 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.Electronic supplementary materialThe online version of this article (doi:10.1186/s40035-017-0085-5) contains supplementary material, which is available to authorized users.

Progression of Neuropsychiatric Symptoms over Time in an Incident Parkinson’s Disease Cohort (ICICLE-PD)

“…Similar to previous prevalent cohort studies [28][29][30][31][32][33], we found that NPS were a significant contributor to poorer quality of life in PD participants. The significance of our work is that this is evident even in newly diagnosed participants.…”

Validating the Parkinson’s disease caregiver burden questionnaire (PDCB) in German caregivers of advanced Parkinson’s disease patients

“…An adequate understanding of caregiver burden necessitates that this construct can be accurately assessed. Multiple measures of caregiver burden have been developed, the most widespread and accepted is the caregiver burden inventory (CBI) (Grün et al, 2016;Hagell et al, 2017;Jones et al, 2017;Martinez-Martin et al, 2008, 2015Mosley et al, 2017;Schmotz et al, 2017;Trapp et al, 2018;Zarit et al, 1980). However, the CBI is not specific to PD; that is, many issues that might particularly affect caregivers of patients with PD are not reflected by the items of the inventory.…”

Mindfulness and Psychological Flexibility are Inversely Associated with Caregiver Burden in Parkinson’s Disease

“…PwP suffer from a large variety of motor and non-motor symptoms [4,40,41]. These symptoms clearly have an impact on the HR-QoL of the patients and further on caregiver burden [2,[42][43][44][45][46][47][48]. Cognitive symptoms of PwP are correlated with a worse extent of caregiver burden [49,50].…”