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Article type: Research Article
Authors: Perales, Jaimea; * | Turró-Garriga, Oriolb | Gascón-Bayarri, Jordic | Reñé-Ramírez, Ramónc | Conde-Sala, Josep Lluísd
Affiliations: [a] University of Kansas Medical Center, Department of Preventive Medicine and Public Health, Kansas, USA | [b] Research Unit, Santa Caterina Hospital, Institut d’Assistència Sanitària, Salt, Spain | [c] Dementia Unit, Department of Neurology, Bellvitge University Hospital, Hospitalet de Llobregat, Spain | [d] Faculty of Psychology, University of Barcelona, Spain
Correspondence: [*] Correspondence to: Jaime Perales, University of Kansas Medical Center, Department of Preventive Medicine and Public Health, 4125 Rainbow Blvd. MS 1056, Kansas City, KS 66103, USA. Tel.: +1 913 945 7869; E-mail: [email protected].
Abstract: Background: According to cross-sectional studies, there is an association between anosognosia in people with dementia and caregiver’s burden and depression. Anosognosia in patients may be a cause of caregiver burden and depression. However, variability in caregiver anosognosia ratings may exist as caregivers with burden and depression may have a more pessimistic view of the patients’ health. Objective: To assess the variability of caregiver anosognosia ratings of patients with dementia using a widely used anosognosia scale and its longitudinal relationship with caregiver burden and depression. Methods: A convenience cohort of 221 consecutive dementia outpatient and caregiver dyads was followed up at 12 and 24 months. The main instruments used were the Anosognosia Questionnaire-Dementia (AQ-D), Caregiver Burden Interview, and Geriatric Depression Scale. Linear mixed models were used including time as a factor in every model. Multivariate analyses controlled for caregiver’s socio-demographic and possible confounding factors. Results: Attrition at 12 and 24 months was 24.9% and 42.5% respectively. Patients at baseline were on average 77.8 years of age, 63.3% were women, and 63.3% had < 5 years of education. In the bivariate analyses, caregiver burden, depression, and gender were associated with caregiver ratings of total, cognitive, and personality AQ-D of the patient at different time points. Multivariate analyses revealed burden as the caregiver variable most consistently associated with total, cognitive, and personality caregiver AQ-D ratings of the patient. Conclusion: Some caregiver characteristics, especially burden, are associated with caregiver ratings of AQ-D with regard to the patient.
Keywords: Anosognosia, bias, burden of illness, caregivers, dementia, depression, longitudinal studies
DOI: 10.3233/JAD-160065
Journal: Journal of Alzheimer's Disease, vol. 53, no. 3, pp. 1133-1143, 2016
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