Abstract
BACKGROUND: The prevalence of Alzheimer's disease (AD) and vascular dementia (VD) is expected to rise substantially in the coming decades. As well, the impact of these conditions on caregiver burden and quality of life (QOL) is also expected to increase. OBJECTIVES: To (1) determine how the characteristics of patients and their caregivers affects caregiver's QOL, and (2) identify subsets of caregivers disproportionately affected by their patient's disease. METHODS: Data were collected cross-sectionally at baseline on 912 pairs of AD/VD patients and their primary caregivers as part of a multinational prospective longitudinal clinical trial. Patient and caregiver demographics, patient CDR and DAD scores were collected, as were caregiver EuroQol (EQ-5D) scores and time spent on caregiving activities. Univariate and multivariate analyses were conducted to determine patient and caregiver characteristics that were particularly associated with low caregiver QOL. RESULTS: Patient severity as measured by CDR score was moderately related to caregiver EuroQol score (p < .05). Specifically, caregiver EuroQol scores were .84, .78, .76, and .74 for questionable, mild, moderate, and severe dementia (on the CDR), respectively. In a main-effects only regression model, a 4-point and a 7-point reduction in caregiver's EuroQol score was associated with the caregiver being a women and being a spouse/partner of the patient, respectively. When an interaction term between these two variables was introduced into the regression, the main effects of caregiver gender and being a spouse/partner of the patient became insignificant. However, the interaction term, being a woman spouse caring for a patient, was associated with a significant 12-point reduction in EuroQol score. CONCLUSIONS: Worse caregiver QOL is associated with more severe patient disease stage and with being a woman caring for a demented spouse. Interventions should thus be planned with special consideration given this potentially more vulnerable set of caregivers.
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