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Impact of diabetes on caregiver stress in patients with Alzheimer's disease: data from the ICTUS study

Published online by Cambridge University Press:  30 January 2018

Jun Li ,
Matteo Cesari ,
Natalia Del Campo ,
Sandrine Andrieu ,
Birong Dong ,
Wee Shiong Lim  and
Bruno Vellas
Jun Li*
Affiliation:
The Center of Gerontology and Geriatrics, West China Medical School/West China Hospital, Sichuan University, Chengdu, Sichuan, China Institut du Vieillissement, Gérontopôle, Université Toulouse III – Paul Sabatier, Toulouse, France
Matteo Cesari
Affiliation:
The Center of Gerontology and Geriatrics, West China Medical School/West China Hospital, Sichuan University, Chengdu, Sichuan, China
Natalia Del Campo
Affiliation:
The Center of Gerontology and Geriatrics, West China Medical School/West China Hospital, Sichuan University, Chengdu, Sichuan, China
Sandrine Andrieu
Affiliation:
UMR1027 Inserm, Université Toulouse III – Paul Sabatier, Toulouse, France
Birong Dong
Affiliation:
Institut du Vieillissement, Gérontopôle, Université Toulouse III – Paul Sabatier, Toulouse, France
Wee Shiong Lim
Affiliation:
Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore, Singapore
Bruno Vellas
Affiliation:
The Center of Gerontology and Geriatrics, West China Medical School/West China Hospital, Sichuan University, Chengdu, Sichuan, China
*
Correspondence should be addressed to: Jun Li, The Center of Gerontology and Geriatrics, West China Medical School/West China Hospital, Sichuan University, Chengdu, Sichuan, China. Phone: +86-18980602112. Email: jundream2013@163.com.
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Abstract

Background:

To estimate the impact of comorbid diabetes on caregiver stress in Alzheimer's disease (AD) patients from the Impact of Cholinergic Treatment Use (ICTUS) study.

Methods:

Using the Data from the ICTUS study, diabetes mellitus (DM) was recorded at baseline and caregiver burden was assessed twice per year using the Zarit Burden Interview (ZBI) scale. The three-factorial model of ZBI (the effect on the social and personal life of caregivers, the psychological burden and the feelings of guilt) was adopted. Linear mixed models were used to examine the relation between DM and the scores of ZBI.

Results:

The present analyses were conducted on 1,264 AD subjects. A total of 156 patients (12.3%) had DM with taking antidiabetic medication and/or self-report of a history. At baseline, the caregivers of patients with or without DM had similar ZBI global scores and similar scores of three different factors of ZBI. Unadjusted and adjusted models both indicated that ZBI global score increased over a 24-month follow-up without significant effect of DM. Similarly, unadjusted model showed that DM was not determining any significant difference in the score of any factor. However, adjusted model indicated that in diabetic patients, the scores of the social and personal life of caregivers and the psychological burden increased more slowly than those in non-diabetic patients (p = 0.04 and 0.01, respectively).

Conclusions:

DM may affect the caregivers’ daily social and personal life and psychological burden in AD patients. It is necessary for further research.

Keywords

Alzheimer's disease (AD)caregiverdiabetes mellitus (DM)stress
Type
Original Research Article
Information
International Psychogeriatrics , Volume 30 , Issue 8: Issue Theme: Caregiver Stress , August 2018 , pp. 1109 - 1117
Copyright
Copyright © International Psychogeriatric Association 2018 

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References

Akomolafe, A. et al. (2006). Diabetes mellitus and risk of developing Alzheimer disease: results from the Framingham study. Archneurol-Chicago, 63, 1551–1555.Google Scholar
Anaforoglu, I., Ramazanogullari, I., Algun, E. and Kutanis, R. (2012). Depression, anxiety and quality of life of family caregivers of patients with type 2 diabetes. Medical Principles and Practice, 21, 360–365.Google Scholar
Ankri, J., Andrieu, S., Beaufils, B., Grand, A. and Henrard, J. C. (2005). Beyond the global score of the zarit burden interview: useful dimensions for clinicians. International Journal of Geriatric Psychiatry, 20, 254–260.Google Scholar
Ascher-Svanum, H. et al. (2015). Cognitive and functional decline in patients with mild Alzheimer dementia with or without comorbid diabetes. Clinical Therapeutics, 37, 1195–1205.Google Scholar
Bedard, M., Molloy, D. W., Pedlar, D., Lever, J. A. and Stones, M. J. (1997). 1997 IPA/Bayer research awards in psychogeriatrics. Associations between dysfunctional behaviors, gender, and burden in spousal caregivers of cognitively impaired older adults. International Psychogeriatrics, 9, 277–290.Google Scholar
Bedard, M., Pedlar, D., Martin, N. J., Malott, O. and Stones, M. J. (2000). Burden in caregivers of cognitively impaired older adults living in the community: methodological issues and determinants. International Psychogeriatrics, 12, 307–332.Google Scholar
Beeri, M. S. et al. (2005). Type 2 diabetes is negatively associated with Alzheimer's disease neuropathology. The Journals of Gerontology Series A, Biological Sciences and Medical Sciences, 60, 471–475.Google Scholar
Cheah, W. K., Han, H. C., Chong, M. S., Anthony, P. V. and Lim, W. S. (2012). Multidimensionality of the Zarit Burden interview across the severity spectrum of cognitive impairment: an Asian perspective. International Psychogeriatrics, 24, 1846–1854.Google Scholar
Corte, F. et al. (2008). Prognosis of Alzheimer's disease today: a two-year prospective study in 686 patients from the REAL-FR Study. Alzheimers & Dementia, 4, 22–29.Google Scholar
Dominguez, R. O., Marschoff, E. R., Gonzalez, S. E., Repetto, M. G. and Serra, J. A. (2012). Type 2 diabetes and/or its treatment leads to less cognitive impairment in Alzheimer's disease patients. Diabetes Research and Clinical Practice, 98, 68–74.Google Scholar
D'Onofrio, G. et al. (2015). Caregiver burden characterization in patients with Alzheimer's disease or vascular dementia. International Journal of Geriatric Psychiatry, 30, 891–899.Google Scholar
Dubois, B. et al. (2014). Advancing research diagnostic criteria for Alzheimer's disease: the IWG-2 criteria. Lancet Neurology, 13, 614–629.Google Scholar
Dunkin, J. J. and Anderson-Hanley, C. (1998). Dementia caregiver burden: a review of the literature and guidelines for assessment and intervention. Neurology, 51, S53–S60. discussion S65–S57.Google Scholar
Feil, D. G., Lukman, R., Simon, B., Walston, A. and Vickrey, B. (2011). Impact of dementia on caring for patients' diabetes. Aging & Mental Health, 15, 894–903.Google Scholar
Gillette-Guyonnet, S. et al. (2000). Weight loss in Alzheimer disease. The American Journal of Clinical Nutrition, 71, 637S–642S.Google Scholar
Hayden, K. M. et al. (2006). Vascular risk factors for incident Alzheimer disease and vascular dementia: the cache county study. Alzheimer Disease & Association Disorders, 20, 93–100.Google Scholar
Hirakawa, Y., Kuzuya, M., Masuda, Y., Enoki, H. and Iguchi, A. (2008). Influence of diabetes mellitus on caregiver burden in home care: a report based on the Nagoya Longitudinal Study of the Frail Elderly (NLS-FE). Geriatrics & Gerontology International, 8, 41–47.Google Scholar
Irie, F. et al. (2008). Enhanced risk for Alzheimer disease in persons with type 2 diabetes and APOE epsilon4: the cardiovascular health study cognition study. Archneurol-Chicago, 65, 89–93.Google Scholar
Knight, B. G., Silverstein, M., McCallum, T. J. and Fox, L. S. (2000). A sociocultural stress and coping model for mental health outcomes among African American caregivers in Southern California. Journals of Gerontology Series B-Psychological Sciences and Social Sciences, 55, P142–P150.Google Scholar
Laks, J., Goren, A., Duenas, H., Novick, D. and Kahle-Wrobleski, K. (2016). Caregiving for patients with Alzheimer's disease or dementia and its association with psychiatric and clinical comorbidities and other health outcomes in Brazil. International Journal of Geriatric Psychiatry, 31, 176–185.Google Scholar
Langa, K. M. et al. (2002). Informal caregiving for diabetes and diabetic complications among elderly americans. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 57, S177–S186.Google Scholar
Lau, S., Chong, M. S., Ali, N., Chan, M., Chua, K. C. and Lim, W. S. (2015). Caregiver Burden: looking beyond the unidimensional total score. Alzheimer Disease and Associated Disorders, 29, 338–346.Google Scholar
Li, J., Shao, Y. H., Gong, Y. P., Lu, Y. H., Liu, Y. and Li, C. L. (2014). Diabetes mellitus and dementia- a systematic review and meta-analysis. Europen Review Medicine and Pharmacological Science, 18, 1778–1789.Google Scholar
Lim, W. S. et al. (2014). Worry about performance: a unique dimension of caregiver burden. International Psychogeriatrics, 26, 677–686.Google Scholar
Majerovitz, S. D. (1995). Role of family adaptability in the psychological adjustment of spouse caregivers to patients with dementia. Psychology and Aging, 10, 447–457.Google Scholar
Mohamed, S., Rosenheck, R., Lyketsos, C. G. and Schneider, L. S. (2010). Caregiver burden in Alzheimer disease: cross-sectional and longitudinal patient correlates. The American Journal of Geriatric Psychiatry, 18, 917–927.Google Scholar
Ott, A., Stolk, R. P., Hofman, A., van Harskamp, F., Grobbee, D. E. and Breteler, M. M. (1996). Association of diabetes mellitus and dementia: the Rotterdam study. Diabetologia, 39, 1392–1397.Google Scholar
Prince, M., Bryce, R., Albanese, E., Wimo, A., Ribeiro, W. and Ferri, C. P. (2013). The global prevalence of dementia: a systematic review and metaanalysis. Alzheimer's & Dementia, 9, 63–75 e2.Google Scholar
Reynish, E. et al. (2007). The ICTUS study: a prospective longitudinal observational study of 1,380 AD patients in Europe. Study design and baseline characteristics of the cohort. Neuroepidemiology, 29, 29–38.Google Scholar
Robinson, B. C. (1983). Validation of a caregiver strain index. Journal of Gerontology, 38, 344–348.Google Scholar
Sanz, C., Andrieu, S., Sinclair, A., Hanaire, H., Vellas, B. and REALFR Study Group. (2009). Diabetes is associated with a slower rate of cognitive decline in Alzheimer disease. Neurology, 73, 1359–1366.Google Scholar
Test, M. A. and Stein, L. I. (1980). Alternative to mental hospital treatment. III. Social cost. Archives of General Psychiatry, 37, 409–412.Google Scholar
Van Durme, T., Macq, J., Jeanmart, C. and Gobert, M. (2012). Tools for measuring the impact of informal caregiving of the elderly: a literature review. International Journal of Nursing Studies, 49, 490–504.Google Scholar
Vitaliano, P. P., Young, H. M., Russo, J., Romano, J. and Magana-Amato, A. (1993). Does expressed emotion in spouses predict subsequent problems among care recipients with Alzheimer's disease? Journal of Gerontology, 48, P202–P209.Google Scholar
Zarit, S. H., Anthony, C. R. and Boutselis, M. (1987). Interventions with care givers of dementia patients: comparison of two approaches. Psychology and Aging, 2, 225–232.Google Scholar
Zarit, S. H., Reever, K. E., and Bach-Peterson, J. (1980). Relatives of the impaired elderly: correlates of feelings of burden. Gerontologist, 20, 649–655.Google Scholar