Impact of Caregiving for Patients with Alzheimer's Disease and Dementia on Psychiatric and Clinical Comorbidities in Brazil.

Abstract

PND67 ImPact of caregIvINg for PatIeNts wIth alzheImer’s DIsease aND DemeNtIa oN PsychIatrIc aND clINIcal comorbIDItIes IN brazIl Goren A.1, Novick D.2, Barros B.R.3, Laks J.4, Duenas H.5, Kahle-Wrobleski K.6 1Kantar Health, New York, NY, USA, 2Eli Lilly and Company, Windlesham, UK, 3Eli Lilly do Brasil Ltda, Sao Paulo, Brazil, 4Federal University of Rio de Janeiro, Rio de Janeiro, Brazil, 5Eli Lilly de Mexico, Mexico City, Mexico, 6Eli Lilly and Company, Indianapolis, IN, USA Objectives: Patients with dementia due to Alzheimer’s disease (AD) are often cared for by family members who experience physical, psychological, social, and financial burdens associated with provision of care. This study quantifies the impact of caregiving in Brazil and helps identify characteristics associated with caregiving. MethOds: Data were analyzed from the 2012 National Health and Wellness Survey (NHWS) in Brazil (n = 12,000), an Internet-based survey of adults (aged 18+), using stratified random sampling (by sex and age) to ensure demographic representation of the Brazil adult population. Caregivers were compared with non-caregivers on select comorbidities considered potential outcomes of caregiving, plus sociodemographic characteristics, health characteristics and behaviors, and Charlson comorbidity index (CCI) scores. Binary logistic regression models assessed comorbidities associated with caregiving, adjusting for potential confounds (CCI, age, gender, education, income, insurance, and marital status). Results: Among 10,853 respondents (caregivers [n= 209]; non-caregivers [n= 10,644]), caregivers were on average 42.1 years old, and 53% were female, 52% married/living with a partner, 87% insured, and 42% living with 1+ children in the household. Caregivers vs. non-caregivers were more frequently obese, smokers, insured, employed, and with college education or above, and they had higher CCI scores and higher income, all p < .05. Adjusting for covariates, caregiving was associated with significantly increased risk of depressive symptoms (odds ratio [OR] = 2.008), major depressive disorder (OR= 1.483), anxiety (OR= 1.714), insomnia (OR= 1.644), hypertension (OR= 1.584), pain (OR= 1.704), and diabetes (OR= 2.103), all p< .015. cOnclusiOns: This is the first study on caregivers for persons with dementia in Brazil using a large dataset (NHWS). Being a caregiver (compared with noncaregiver) is a predictor of overall psychiatric and clinical disorders in this sample. The online survey format provides certain sampling advantages but may under-represent caregivers without access/comfort with online technology. Direct treatment and policies to help caregivers are needed in Brazil.