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The impact of the nocturnal disabilities of Parkinson’s disease on caregivers’ burden: implications for interventions

  • Neurology and Preclinical Neurological Studies - Original Article
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Abstract

Parkinson’s disease (PD) imposes a burden on those who care for the person afflicted. The objective of this study was to assess and analyze the main determinants of caregivers’ burden, especially the nocturnal manifestations of PD. This multi-center, national, cross-sectional study included 89 patient–caregiver pairs. Caregiver self-assessments were performed with Hospital Anxiety and Depression Scale (HADS) and Zarit Caregiver Burden Interview (ZCBI). Patient self-assessments were performed with Modified Parkinson’s Disease Sleep Scale (MPDSS), Nocturnal Akinesia Dystonia and Cramp Score (NADCS), HADS and Parkinson’s Disease Quality of Life Questionnaire (PDQ-8). Most of the caregivers were employed women, and the majority had been permanently taking care of the patient for 6.8 ± 5.4 years. The study found that the ZCBI mean score of the caregivers significantly worsened as patients became more dependent (HY: 4–5, p = 0.036), and the mean ZCBI score of spousal caregivers (19.4; SD 15.5) was significantly higher than that of the offspring group (11.7; SD 7.9) (p = 0.008). Disease duration (r = 0.22), NADCS (r = 0.38), MPDSS (r = −0.36), PDQ-8 SI (r = 0.39) and HADS (total, anxiety and depression) scores (r = 0.46–0.49), and HADS (total, anxiety and depression scores (r = 0.37–0.52), had significant negative effect on caregivers’ burden. Moderate association was found on MPDSS item 14 (r = 0.38) and NADCS akinesia score (r = 0.37). Patients’ anxiety, nocturnal akinesia and the feeling of tiredness and sleepiness upon awakening in the morning were independent predictors of caregivers’ burden (adjusted R 2 = 0.46). Based on these findings, treatment of early mood symptoms of the patients and caregivers at risk may be helpful for the effective management of PD and it is also important to have well-designed psycho-educational and multicomponent interventions in the community for caregivers of persons with PD.

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Acknowledgments

The study was supported by the Rachadaphiseksomphot Endowment Fund Part of the “Strengthen CU’s Researcher’s Project” and the research unit (RU) Grant Number GRU 56-012-30-002 of Chulalongkorn Center of Excellence on Parkinson’s Disease and Related Disorders of Chulalongkorn University, Bangkok, Thailand. We would like to thank Kamolwan Boonpeng and Onnalin Jandaew for their assistance in patient recruitment and data assortment.

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Authors and Affiliations

  1. Chulalongkorn Center of Excellence on Parkinson’s Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, 1873 Rama 4 Road, Bangkok, 10330, Thailand

    Pramon Viwattanakulvanid, Lalita Kaewwilai, Onanong Jitkritsadakul, Neil R. Brenden, Nonglak Boonrod & Roongroj Bhidayasiri

  2. Faculty of Medicine, Songklanagarind Hospital, Prince of Songkla University, Songkhla, Thailand

    Suwanna Setthawatcharawanich

  3. Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, Thailand

    Pawut Mekawichai

  4. Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, 90095, USA

    Roongroj Bhidayasiri

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  1. Pramon Viwattanakulvanid
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  2. Lalita Kaewwilai
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  3. Onanong Jitkritsadakul
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  4. Neil R. Brenden
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  7. Pawut Mekawichai
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Correspondence to Roongroj Bhidayasiri.

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Viwattanakulvanid, P., Kaewwilai, L., Jitkritsadakul, O. et al. The impact of the nocturnal disabilities of Parkinson’s disease on caregivers’ burden: implications for interventions. J Neural Transm 121 (Suppl 1), 15–24 (2014). https://doi.org/10.1007/s00702-014-1200-8

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  • DOI: https://doi.org/10.1007/s00702-014-1200-8

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