P4-180: Burden of care in Alzheimer’s disease and its relationship to coping: An Indian experience

Abstract

Many studies have addressed the issue of caregiver burden in patients with major psychiatric illnesses. However, this aspect has been less studied in the case of dementia caregivers, especially in Indian context where family is the sole care–provider and institutional care is not prevalent. It aims to evaluate the burden of the caregivers of dementia patients and assess its relationship with various clinical and psychosocial variables as well as coping. It was a cross–sectional study design with sample of convenience. Total of 32 patients with dementia of Alzheimer's type (DSM–IV) and their caregivers visiting the dementia clinic, All India Institute of Medical Sciences, New Delhi between 1st Oct 2003 and 31st March 2004 were included. In addition to complete history including sociodemographic profile, the patients were assessed for level of cognitive functioning using Hindi Mental State Examination (HMSE; Tsolaki 2000) and for severity of dementia using Clinical Dementia Rating (CDR; Hughes 1982).The caregivers were assessed for burden using Burden Assessment Schedule (BAS; Thara, 1998) and coping using Coping checklist (Rao, 1989). Mean age of patients was 71.75 ±9.66 years, majority being males. Mean age of caregivers was 53.94±16.16 years, majority being females. Majority of caregivers comprised of spouses (50%) followed by children (46.9%). The mean total adjusted burden score was found to be 58.57± 11.52 with maximum possible score of 100, suggesting moderate degree of burden. Total burden didn't correlate with age or educational status. Females and those who were housewives were the major bearers in certain subgroups of burden as compared to males and working females respectively. HMSE score had significant negative correlation with total burden score. Total burden score was significantly more in severe dementia as compared to mild and moderate dementia. ‘Problem solving’ coping had significant negative correlation with total burden score. The present study suggests a considerable burden of care on caregivers, especially females. Problem–focused approach was found to be associated with lesser burden. The importance of designing appropriate caregiver interventions cannot be undermined.