Factors Associated With the Variability in Caregiver Assessments of the Capacities of Patients With Alzheimer Disease

• Published in: Journal of geriatric psychiatry and neurology 2013-06, Vol.26 (2), p.86-94
• Main Authors: Conde-Sala, Josep L., Reñé-Ramírez, Ramón, Turró-Garriga, Oriol, Gascón-Bayarri, Jordi, Juncadella-Puig, Montserrat, Moreno-Cordón, Laura, Viñas-Diez, Vanesa, Vilalta-Franch, Joan, Garre-Olmo, Josep
• Format: Article
• Language: English
• Subjects: Activities of Daily Living; Aged; Alzheimer Disease - diagnosis; Caregivers - psychology; Caregivers - statistics & numerical data; Cost of Illness; Depression - psychology; Disability Evaluation; Female; Geriatric Assessment; Humans; Male; Middle Aged; Neuropsychological Tests; Observer Variation; Quality of Life; Regression Analysis; Severity of Illness Index; Surveys and Questionnaires
• ISSN: 0891-9887; 1552-5708
• DOI: 10.1177/0891988713481266

Background:Several studies have identified certain caregiver factors that can produce variability in their assessments of the capacities of patients with Alzheimer disease (AD). Objectives:To identify the caregiver variables associated with variability in their ratings of patients’ capacities. Methods:Consecutive sample of 221 outpatients with AD and their family caregivers. The capacities evaluated by caregivers were the degree of functional disability, using the Disability Assessment for Dementia (DAD); psychological and behavioral symptoms, via the Neuropsychiatric Inventory (NPI); anosognosia, with the Anosognosia Questionnaire-Dementia (AQ-D); and quality of life, using the Quality of Life in AD (QOL-AD). The relationship between these measures and caregiver’s gender, burden, depression, and health was analyzed by means of a bivariate analysis, calculating the effect size (Cohen d) and subsequently by a regression analysis, calculating the contribution coefficient (CC). Results:The greatest variability in caregiver assessments was observed in relation to patients with early-stage dementia, where caregiver’s burden was the main factor associated with a more negative evaluation (d = 1.02-1.25). Depression in the caregiver was associated with less variability and only in the assessments of patients with moderate dementia (d = 0.38-0.69). In the regression analysis, caregiver factors were associated with greater variance in scores on the NPI (CC = 37.4%) and QOL-AD (CC = 27.2%), and lower variance in AQ-D (CC = 21.6%) and DAD (CC = 10.3%) scores. Conclusions:Caregiver’s burden and depression were associated with more negative assessments of patients’ psychological and behavioral symptoms and quality of life.