目的比较阿尔茨海默病(Alzheimer’Sdisease,AD)、轻度认知障碍(mild cognitive impairment,MCI)以及主观认知障碍(subjective cognitive impairment,SCI)的照料者负担,探索影响照料负担的相关因素。方法研究对象取自中国AD临床路径多中心登记研究的基线调查部分,共628例就诊患者(AD组445例,MCI组148例,SCI组35例)的照料者完成照料者负担问卷(caregiverburdeninventory,CBI)调查。结果CBI总分及5个维度评分均为AD组〉MCI组〉SCI组(P〈0.001),其中3组CBI总分依次为25.43±18.41、7.86±11.76和5.97±10.36,时间依赖负担评分依次为9.40±6.12、2.94±4.10和1.83±2.90,发展受限负担评分依次为7.72±6.01、2.15±4.11和1.49±2.90,身体负担评分依次为3.90±4.16、1.15±2.44和0.97±1.90,社交负担评分依次为1.66±2.64、0.60±1.46和0.89±2.07,情感负担评分依次为2.76±3.61、1.03±2.02和0.80±2.33。CBI总分与患者的认知功能障碍程度、照料者所感受的照料困难程度以及患者所患慢性疾病种类有关(P〈0.05)。结论照料负担随着认知功能水平的下降而加重,临床实践中医生应及早关注照料者负担。
Objectives To compare the caregiver burden of Alzheimer's disease (AD), mild cognitive impairment (MCI) and subjective cognitive impairment (SCI), and to explore the potential factors associated with caregiver burden. Methods The sample was derived from the baseline survey of China Pathway of Alzheimer's Disease (CPAD) study, a national multi-center observational regiswy study. Subjects were 628 caregivers (AD group: n=448; MCI group: n=148; SCI group: n=35) who completed the Caregiver Burden Inventory (CBI). Results There were significant differences in the total score and factor scores of CBI among the three groups, in the order of AD〉 MCI〉 SCI (P〈 0.001). And in this order, total scores of these 3 groups were 25.43±18.41, 7.86±11.76, and 5.97±10.36, Time Dependence Burden scores were 9.40± 6.12, 2.94±4.10, and 1.83±2.90, Developmental Burden sores were 7.72±6.01, 2.15±4.11, 1.49±2.90, Physical Burden scores were 3.90±4.16, 1.15±2.44, 0.97±1.90, Social Burden scores were 1.66±2.64, 0.60± 1.46, 0.89-±2.07, Emotional Burden scores were 2.76±3.61, 1.03±2.02, 0.80±2.33. Caregiver burden was associated with the diagnostic staging, the perceived caring difficulty, and multi-morbidities with physical conditions (P〈0.05). Conclusions Caregiver burden increases with the progression of cognitive impairment. The findings indicate that caregiver intervention and support should be provided as early as possible when early cognitive impairment is recognized.