Frontal Function, Disability and Caregiver Burden in Elderly Patients With Major Depressive Disorder

Abstract

Caregivers of patients with late-life major depressive disorder experience a significant level of general caregiver burden. Disability in patients is possibly one of the origins of caregiver burden. Frontal lobe dysfunction might be the source of disability. This study investigated if frontal lobe dysfunction (body level) of patients with late-life major depressive disorder was associated with their disability (individual level), and if it led to a high level of caregiver burden (societal level). Thirty-four unselected pairs of caregivers and their family members with late-life major depressive disorder were recruited. Frontal Assessment Battery and Timed Instrumental Activities of Daily Living (TIADL) were used to assess patients' frontal function and disability, and Caregiver Burden Inventory was used to measure caregiver burden. Frontal Assessment Battery correlated with TIADL (r= -0.47; p<0.006). TIADL score was also associated with two subscales of the Caregiver Burden Inventory: social (r = 0.38, p=0.026) and time-dependent (r= 0.37, p= 0.033). This study supported the hypothesis that frontal lobe dysfunction in elderly patients with depression is associated with their disability in instrumental activities of daily living. Disability is related to social and time-dependent aspects of caregiver burden. Further studies to examine proposed cognitive interventions are suggested to reduce patient disability and caregiver burden.

Frontal lobe function in elderly patients with Alzheimer's disease and caregiver burden

“…Finally, a more sophisticated frontal function measure, in addition to the FAB, is recommended in future studies. Neuroimaging technology is one such alternative method for defining frontal lobe function . The findings of our pilot study need confirmation with further studies using a prospective design, larger sample size, and a more precise measure of frontal function to address these issues.…”

“…The limitation of specific functions, such as the instrumental activities of daily living, increases the burden on caregivers of patients with dementia . Across all cognitive domains, frontal system behavioural functioning has a larger influence on daily functioning than memory dysfunction . Previous studies have indicated that frontal system behavioural problems of demented patients are predictive of caregiver burden after controlling for dementia severity and caregiver depression …”

The Multi-Dimensional Burden of Cirrhosis and Hepatic Encephalopathy on Patients and Caregivers

“…This is probably because LTT time and ICT lures evaluate frontal lobe function and visuo-spatial ability, which are required to perform daily instrumental activities (4). Interestingly, impairment in similar tests has been associated with caregiver stress in other diseases (35,36). Even with the categorical approach using previous HE instead of cognitive tests, previous HE was still a significant contributor to caregiver burden.…”

Research on the Development of Theme Trends and Changes of Knowledge Structures of Drug Therapy Studies on Major Depressive Disorder Since the 21st Century: A Bibliometric Analysis

“…Epidemiological investigations reported the life-time prevalence of MDD in different countries, such as the United States, 16.2% ( 2 ), Canada, 11.3% ( 3 ), and China, 3.4% ( 4 ), with considerable regional variation. As a chronic mental disorder, MDD exerts a substantial burden on patients (e.g., cognitive impairment, premature mortality, and even suicide) ( 5 , 6 ), their families (e.g., physical and economic burden) ( 7 ), and society (e.g., the economic burden of MDD in US is estimated to exceed $210 billion) ( 8 ). Moreover, it is reported that psychiatric disorders account for 22.8% of the global burden of disease, among which MDD is the main cause of disability, and this proportion will increase along with population growth and ageing ( 9 ).…”