Abstract
Background
Carers of Alzheimer's disease (AD) and Mild Cognitive Impairment (MCI) patients often experience burden associated with caregiving(Black et al., 2010). Whilst progression of AD is typically slow, some patients experience a more rapid decline (Alzheimer's Association, 2012). We aimed to compare levels of patient dependence, resource utilization, carer satisfaction, burden, and attitudes to ageing as reported by carers of patients with rapid decline (RD) to those with non-rapid decline (NRD).
Methods
Carers and patients were recruited from the Australian Imaging, Biomarkers and Lifestyle (AIBL) study, with 64 carers recruited to date (mean age 69.9 + 14.7 years, 65.7% female). Nearly three quarters of carers were a spouse of the patient (71.9%); most were retired from paid work (68.8%). Questionnaires measured level of patient dependence, resource utilization, carer satisfaction, burden, and attitudes to ageing. Two groups were formed based on whether the patient met criteria for RD, using the criterion of a 6 point decline on the Mini-Mental State Examination (MMSE) over 18 months as defined in our previous work (Sona et al., 2012).
Results
There were no significant differences between the two groups for age, gender, marital status, retirement status of the carer (all p>.05); however carers of RD were less likely to be married to the patient (p<.05). Chi-squared analysis showed that the number of AD patients in each of the groups was distributed proportionately (p>.05). Independent samples t-tests indicated that the groups differed significantly in their dependence levels (p<.01), with the RD group demonstrating higher levels of dependence. However, no differences were observed between groups for resource utilization, carer satisfaction, burden, or attitudes to ageing.
Conclusions
Carers of rapid decliners, despite being more depended upon, do not use additional resources to NRD carers, and this does not appear to affect their perceived burden, level of satisfaction or attitudes to ageing. Carer satisfaction, burden and attitudes may not be influenced by rate of decline or level of dependence, but other factors may play a more important role. Further research is required to clarify these relationships as it is likely that it is complex and multifaceted.