26 Predictors of carer burden in impulse control disorders in parkinson’s disease

Leigh Townsend, Daniel Johnson, A. David, S. Askey‐Jones, Richard J. Brown, D. Okai
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Abstract

Aims/Objectives Impulse control behaviors (ICBs) affect 15%–35% of Parkinson’s Disease patients. There is evidence of increased carer strain due to these behaviours; however, little is known about clinical variables mediating this effect. This study aims to investigate the factors predictive of carer burden within a cohort of Parkinson’s Disease patients with ICBs. Identification of such factors may allow for targeted therapeutic intervention. Method Data was collected from 45 patients with clinically significant ICBs and their carers including levodopa equivalent daily dosage, assessments of motor and neuropsychiatric symptoms, cognitive function and ICBs. Carer burden was assessed using the Zarit Burden Interview (ZBI). Univariate analyses were performed using Spearman’s Rank Correlation Coefficient. A backward model was used to remove variables to create a final multivariate model using ZBI score as the dependent variable. Results Univariate analysis identified significant correlations between ZBI and total NPI (rs=0.50, p Conclusions This is the largest study to date, looking at associations between carer burden and ICBs. Our findings indicate low mood, poor motivation, social disinhibition and neuropsychiatric symptom burden to be significant factors in carer burden. We also observe that carers reporting poorer health had increased carer strain. Further work should explore methods of physical and psychosocial support and coping strategies for carers.
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帕金森病患者冲动控制障碍中护理人员负担的预测因素
冲动控制行为(ICBs)影响了15%-35%的帕金森病患者。有证据表明,这些行为增加了照顾者的压力;然而,很少知道临床变量介导这种影响。本研究旨在探讨帕金森病合并ICBs患者护理人员负担的预测因素。识别这些因素可能允许有针对性的治疗干预。方法收集45例具有临床意义的ICBs患者及其护理人员左旋多巴当量日剂量、运动和神经精神症状评估、认知功能和ICBs。采用Zarit burden Interview (ZBI)评估照顾者负担。采用Spearman秩相关系数进行单因素分析。使用反向模型去除变量,以ZBI评分为因变量创建最终的多变量模型。结果单变量分析发现ZBI和总NPI之间存在显著相关性(rs=0.50, p)。结论这是迄今为止规模最大的研究,研究了护理人员负担和ICBs之间的关系。本研究结果提示情绪低落、动机不良、社交去抑制和神经精神症状负担是照顾者负担的重要因素。我们还观察到,报告健康状况较差的护理人员增加了护理压力。进一步的工作应该探索身体和心理支持的方法以及照顾者的应对策略。
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