A Comparison of Caregiver Burden for Different Types of Dementia: An 18-Month Retrospective Cohort Study

BackgroundThis study aimed to elucidate the influence of dementia etiologies on the degree of caregiver burden and determine which factors predict a high caregiving burden.MethodsThis 18-month retrospective cohort study enrolled 630 patients and their caregivers from the Dementia Center of Changhua Christian Hospital. The care team performed face-to-face interviews every 6 months, for 18 months from when a diagnosis of dementia was made. The primary outcome was the change in Zarit Burden Interview (ZBI) scores. Generalized estimating equations were used for the longitudinal data analysis.ResultsParticipants with Lewy body disease (LBD) had a significantly higher caregiving burden compared with those with Alzheimer's disease (AD) (β = 3.83 ± 1.47, Wald = 6.79, p = 0.009) after adjusting for patient and caregiver features. Caregivers of mixed-type dementia and frontotemporal dementia (FTD) experienced a greater burden than caregivers of AD, at 6- and 18-month follow-up. Patients with more severe dementia, neuropsychiatric symptoms, being cared for by more than two caregivers, or utilizing social resources were associated with higher ZBI scores; the depressive mood of caregiver also predicted higher ZBI scores.ConclusionThis longitudinal study demonstrated that caregiver burden was influenced by the underlying dementia etiology of patients. The dementia care team should provide personalized education and transfer patients and caregivers to appropriate resources, especially for high-risk populations.

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Effectiveness of palliative home-care services in reducing hospital admissions and determinants of hospitalization for terminally ill patients followed up by a palliative home-care team: A retrospective cohort study

Palliative Medicine ◽

10.1177/0269216313517283 ◽

2013 ◽

Vol 28 (5) ◽

pp. 403-411 ◽

Cited By ~ 31

Author(s):

Mirko Riolfi ◽

Alessandra Buja ◽

Chiara Zanardo ◽

Chiara Francesca Marangon ◽

Pietro Manno ◽

...

Keyword(s):

Cohort Study ◽

Home Care ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Hospital Admissions ◽

Terminally Ill ◽

Home Care Services ◽

Care Team ◽

Palliative Home Care ◽

Care Services

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Predictors of New Dementia Diagnoses in Elderly Individuals: A Retrospective Cohort Study Based on Prefecture-Wide Claims Data in Japan

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18020629 ◽

2021 ◽

Vol 18 (2) ◽

pp. 629

Author(s):

Yuriko Nakaoku ◽

Yoshimitsu Takahashi ◽

Shinjiro Tominari ◽

Takeo Nakayama

Keyword(s):

Cohort Study ◽

Cerebrovascular Disease ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Claims Data ◽

Neuropsychiatric Symptoms ◽

Administrative Claims ◽

Medical Care System ◽

Elderly Individuals ◽

Diagnosis Of Dementia

Preventing dementia in elderly individuals is an important public health challenge. While early identification and modification of predictors are crucial, predictors of dementia based on routinely collected healthcare data are not fully understood. We aimed to examine potential predictors of dementia diagnosis using routinely collected claims data. In this retrospective cohort study, claims data from fiscal years 2012 (baseline) and 2016 (follow-up), recorded in an administrative claims database of the medical care system for the elderly (75 years or older) in Niigata prefecture, Japan, were used. Data on baseline characteristics including age, sex, diagnosis, and prescriptions were collected, and the relationship between subsequent new diagnoses of dementia and potential predictors was examined using multivariable logistic regression models. A total of 226,738 people without a diagnosis of dementia at baseline were followed. Of these, 26,092 incident dementia cases were detected during the study period. After adjusting for confounding factors, cerebrovascular disease (odds ratio, 1.15; 95% confidence interval, 1.11–1.18), depression (1.38; 1.31–1.44), antipsychotic use (1.40; 1.31–1.49), and hypnotic use (1.17; 1.11–1.24) were significantly associated with subsequent diagnosis of dementia. Analyses of routinely collected claims data revealed neuropsychiatric symptoms including depression, antipsychotic use, hypnotic use, and cerebrovascular disease to be predictors of new dementia diagnoses.

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Impact of autoimmune cytopenias on severity of childhood-onset systemic lupus erythematosus: A single-center retrospective cohort study

Lupus ◽

10.1177/0961203320969806 ◽

2020 ◽

Vol 30 (1) ◽

pp. 109-117

Author(s):

Ekemini A Ogbu ◽

Shanmuganathan Chandrakasan ◽

Kelly Rouster-Stevens ◽

Larry A Greenbaum ◽

Ignacio Sanz ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

Cohort Study ◽

Lupus Erythematosus ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Neuropsychiatric Symptoms ◽

Immune Therapy ◽

Class Iii ◽

Systemic Lupus ◽

Autoimmune Cytopenias

Objective To assess whether children with autoimmune cytopenias prior to or at diagnosis of systemic lupus erythematosus (cSLE), differ phenotypically from other cSLE patients; and have a lower risk and severity of lupus nephritis (LN) as observed in prior adult studies. To assess the effect of prior immune therapy for autoimmune cytopenias on 2-year risk of LN. Methods This was a retrospective cohort study of incident cSLE cases. We included patients aged less than 17 years at diagnosis. We excluded patients with LN at cSLE diagnosis. Our follow-up period was 2 years. We defined autoimmune cytopenias as either autoimmune hemolytic anemia, immune thrombocytopenia or Evan’s syndrome. Results Forty-three (33%) of the 130 patients had autoimmune cytopenias before or at cSLE diagnosis. Those with autoimmune cytopenias had significantly more neuropsychiatric symptoms and higher mean ESR but less arthritis, malar rash and myositis versus those without autoimmune cytopenias. They had lower 2-year incidence proportion of LN compared to other cSLE patients (7% vs 15%). Of the 16 patients who developed LN, those with autoimmune cytopenias had mostly class V (2 of 3 patients) versus mostly class III and IV in those without autoimmune cytopenias (6 of 12 patients). None of the 13 patients pre-treated for autoimmune cytopenias developed LN. Conclusion Patients with autoimmune cytopenias before or at cSLE diagnosis have intriguing differences from other cSLE patients. They may represent a unique sub-type of cSLE patients and should be further explored.

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