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Erschienen in: Drugs & Aging 3/2002

01.03.2002 | Review Article

Assessment, Measures and Approaches to Easing Caregiver Burden in Alzheimer’s Disease

verfasst von: Karl Farcnik, Dr Michelle S. Persyko

Erschienen in: Drugs & Aging | Ausgabe 3/2002

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Abstract

The reduction of caregiver burden for those caring for patients with Alzheimer’s disease (AD) is especially important given the prevalence of AD as populations age. This paper reviews the complex nature of caregiver burden, how it is measured, and possible interventions that may affect caregiver burden. Caregiver characteristics as well as symptoms exhibited by patients contribute to burden. A number of specific quantitative measures which have been developed to better evaluate caregiver burden are discussed. Such measures are also useful in measuring the impact of interventions on caregiver burden. Pharmacological treatment of patients with AD through the use of acetylcholinesterase inhibitors has positively affected cognition, activities of daily living, and behavioural problems. These benefits significantly reduce caregiver burden. The same is true for psychosocial interventions for the caregiver. It has been suggested that combining both approaches should be utilised for optimal management. Our knowledge of caregiver burden has greatly increased over the past two decades with clear benefits for both patients and caregivers. However, many aspects still clearly require further research.
Given the significance of caregiver burden, various aspects have been extensively studied including contributing and protective factors, quantitative assessment, and pharmacological and psychosocial intervention. It is important for clinicians to be aware of this knowledge so that they can effectively incorporate it into their treatment plans for those affected by AD.
Literatur
1.
Zurück zum Zitat Canadian Study of Health and Aging. Patterns of caring for people with dementia in Canada. Can J Aging 1994; 14(4): 470–87 Canadian Study of Health and Aging. Patterns of caring for people with dementia in Canada. Can J Aging 1994; 14(4): 470–87
2.
Zurück zum Zitat Office of Technology Assessment. Losing a million minds: confronting the tragedy of Alzheimer’s disease and other dementias. Washington, DC: US Government Printing Office, 1987 Office of Technology Assessment. Losing a million minds: confronting the tragedy of Alzheimer’s disease and other dementias. Washington, DC: US Government Printing Office, 1987
3.
Zurück zum Zitat Zarit SH, Reever KE, Bach-Peterson J. Relatives of the impaired elderly: correlates of feelings of burden. Gerontology 1980; 20(6): 649–55CrossRef Zarit SH, Reever KE, Bach-Peterson J. Relatives of the impaired elderly: correlates of feelings of burden. Gerontology 1980; 20(6): 649–55CrossRef
4.
Zurück zum Zitat George LK, Gwyther LP. Caregiver well-being: a multidimensional examination of family caregivers of demented adults. Gerontology 1986; 26(3): 253–9CrossRef George LK, Gwyther LP. Caregiver well-being: a multidimensional examination of family caregivers of demented adults. Gerontology 1986; 26(3): 253–9CrossRef
5.
Zurück zum Zitat Taylor S, Puurunen T, Brownlee K. Support for caregivers of persons with Alzheimer’s disease: an evaluation of the effectiveness of the Diner’s Club program. Mature Med 1998 Nov/Dec:41–3 Taylor S, Puurunen T, Brownlee K. Support for caregivers of persons with Alzheimer’s disease: an evaluation of the effectiveness of the Diner’s Club program. Mature Med 1998 Nov/Dec:41–3
6.
Zurück zum Zitat Rice DP, Fox PJ, Max W, et al. The economic burden of Alzheimer’s disease care. Health Aff 1993; 12: 164–76CrossRef Rice DP, Fox PJ, Max W, et al. The economic burden of Alzheimer’s disease care. Health Aff 1993; 12: 164–76CrossRef
7.
Zurück zum Zitat Select Committee on Aging, House of Representatives. Exploding the myths: caregiving in America; publication no. 99–611. Washington, DC: US Government Printing Office, 1987 Select Committee on Aging, House of Representatives. Exploding the myths: caregiving in America; publication no. 99–611. Washington, DC: US Government Printing Office, 1987
8.
Zurück zum Zitat Wimo A, Ljunggren G, Winblad B. Costs of dementia and dementia care: a review. Int J Geriatr Psychiatry 1997; 12: 841–56PubMedCrossRef Wimo A, Ljunggren G, Winblad B. Costs of dementia and dementia care: a review. Int J Geriatr Psychiatry 1997; 12: 841–56PubMedCrossRef
9.
Zurück zum Zitat Maheu S, Cohen CA. Support of families. In: Gauthier S, editor. Clinical diagnosis and management of Alzheimer’s disease. London: Martin Dunitz, 1996: 293–304 Maheu S, Cohen CA. Support of families. In: Gauthier S, editor. Clinical diagnosis and management of Alzheimer’s disease. London: Martin Dunitz, 1996: 293–304
10.
Zurück zum Zitat Hux MJ, O’Brien BJ, Iskedjian M, et al. Relation between severity of Alzheimer’s disease and costs of caring. Can Med Assoc J 1998; 159(5): 457–65 Hux MJ, O’Brien BJ, Iskedjian M, et al. Relation between severity of Alzheimer’s disease and costs of caring. Can Med Assoc J 1998; 159(5): 457–65
11.
Zurück zum Zitat Schulz R, O’Brien AT, Bookwala J, et al. Psychiatric and physical morbidity effects of dementia caregiving: prevalence, correlates, and causes. Gerontology 1995; 35: 771–91CrossRef Schulz R, O’Brien AT, Bookwala J, et al. Psychiatric and physical morbidity effects of dementia caregiving: prevalence, correlates, and causes. Gerontology 1995; 35: 771–91CrossRef
12.
Zurück zum Zitat Kiecolt-Glaser JK, Dura JR, Speicher CE, et al. Spousal caregivers of dementia victims: longitudinal changes in immunity and health. Psychosom Med 1991; 53: 345–62PubMed Kiecolt-Glaser JK, Dura JR, Speicher CE, et al. Spousal caregivers of dementia victims: longitudinal changes in immunity and health. Psychosom Med 1991; 53: 345–62PubMed
13.
Zurück zum Zitat Gallant MP, Connell CM. Predictors of decreased self-care among spouse caregivers of older adults with dementing illnesses. J Aging Health 1997; 9: 373–95PubMedCrossRef Gallant MP, Connell CM. Predictors of decreased self-care among spouse caregivers of older adults with dementing illnesses. J Aging Health 1997; 9: 373–95PubMedCrossRef
14.
Zurück zum Zitat Clyburn LD, Stones MJ, Hadjistavropoulos T, et al. Predicting caregiver burden and depression in Alzheimer’s disease. J Gerontol B Psychol Sci Soc Sci 2000; 55(1): S2–13PubMedCrossRef Clyburn LD, Stones MJ, Hadjistavropoulos T, et al. Predicting caregiver burden and depression in Alzheimer’s disease. J Gerontol B Psychol Sci Soc Sci 2000; 55(1): S2–13PubMedCrossRef
15.
Zurück zum Zitat Cook JM, Pearson JL, Ahrens AH. General and specific events and depressive symptoms in Alzheimer’s disease caregivers. Am J Alzheimer Dis 1997; 12: 32–4CrossRef Cook JM, Pearson JL, Ahrens AH. General and specific events and depressive symptoms in Alzheimer’s disease caregivers. Am J Alzheimer Dis 1997; 12: 32–4CrossRef
16.
Zurück zum Zitat Coen RF, Swanwick GRJ, O’Boyle CA, et al. Behaviour disturbance and other predictors of caregiver burden in Alzheimer’s disease. Int J Geriatr Psychiatry 1997; 12: 331–6PubMedCrossRef Coen RF, Swanwick GRJ, O’Boyle CA, et al. Behaviour disturbance and other predictors of caregiver burden in Alzheimer’s disease. Int J Geriatr Psychiatry 1997; 12: 331–6PubMedCrossRef
17.
Zurück zum Zitat Cohen CA, Gold, DP, Shulman KI, et al. Factors determining the decision to institutionalize dementing individuals. Gerontologist 1993, 33(6): 714–20PubMedCrossRef Cohen CA, Gold, DP, Shulman KI, et al. Factors determining the decision to institutionalize dementing individuals. Gerontologist 1993, 33(6): 714–20PubMedCrossRef
18.
Zurück zum Zitat Chappell NL, Penning M. Behavioural problems and distress among caregivers of people with dementia. Aging Soc 1996; 16: 57–73CrossRef Chappell NL, Penning M. Behavioural problems and distress among caregivers of people with dementia. Aging Soc 1996; 16: 57–73CrossRef
19.
Zurück zum Zitat Williamson G, Schulz R. Coping with specific stressors in Alzheimer’s disease caregiving. Gerontology 1993; 33: 747–55CrossRef Williamson G, Schulz R. Coping with specific stressors in Alzheimer’s disease caregiving. Gerontology 1993; 33: 747–55CrossRef
20.
Zurück zum Zitat Schulz R, Williamson GM. The measurement of caregiver outcomes in Alzheimer disease research. Alzheimer Dis Assoc Disord 1997; 11(6): 117–24PubMed Schulz R, Williamson GM. The measurement of caregiver outcomes in Alzheimer disease research. Alzheimer Dis Assoc Disord 1997; 11(6): 117–24PubMed
21.
Zurück zum Zitat Dunkin JJ, Anderson-Hanley C. Dementia caregiver burden: a review of the literature and guidelines for assessment and intervention. Neurology 1998; 511 Suppl 1: S53–60PubMedCrossRef Dunkin JJ, Anderson-Hanley C. Dementia caregiver burden: a review of the literature and guidelines for assessment and intervention. Neurology 1998; 511 Suppl 1: S53–60PubMedCrossRef
22.
Zurück zum Zitat Pearlin LI, Mullan JT, Semple SJ. Caregiving and the stress process: an overview of concepts and their measures. Gerontology 1990; 30(5): 583–94CrossRef Pearlin LI, Mullan JT, Semple SJ. Caregiving and the stress process: an overview of concepts and their measures. Gerontology 1990; 30(5): 583–94CrossRef
23.
Zurück zum Zitat Kaufer DI, Cummings JL, Christine D, et al. Assessing the impact of neuropsychiatric symptoms in Alzheimer’s disease: the neuropsychiatric inventory caregiver distress scale. J Assoc Geriatr Soc 1998; 46: 210–5 Kaufer DI, Cummings JL, Christine D, et al. Assessing the impact of neuropsychiatric symptoms in Alzheimer’s disease: the neuropsychiatric inventory caregiver distress scale. J Assoc Geriatr Soc 1998; 46: 210–5
24.
Zurück zum Zitat Max W, Webber P, Fox P. Alzheimer’s disease: the unpaid burden of caring. J Aging Health 1995; 7: 179–99PubMedCrossRef Max W, Webber P, Fox P. Alzheimer’s disease: the unpaid burden of caring. J Aging Health 1995; 7: 179–99PubMedCrossRef
25.
Zurück zum Zitat Knight BG, Lutzky SM, Macofsky-Urban F. A meta-analytic review of interventions for caregiver distress: recommendations for future research. Gerontology 1993; 33: 240–8CrossRef Knight BG, Lutzky SM, Macofsky-Urban F. A meta-analytic review of interventions for caregiver distress: recommendations for future research. Gerontology 1993; 33: 240–8CrossRef
26.
Zurück zum Zitat Mittelman MS, Ferris SH, Shulman E, et al. A family intervention to delay nursing home placement of patients with Alzheimer disease: a randomized controlled trial. JAMA 1996; 276: 1725–31PubMedCrossRef Mittelman MS, Ferris SH, Shulman E, et al. A family intervention to delay nursing home placement of patients with Alzheimer disease: a randomized controlled trial. JAMA 1996; 276: 1725–31PubMedCrossRef
27.
Zurück zum Zitat Thompson E, Doll W. The burden of families coping with the mentally ill: an invisible crisis. Fam Relations 1982; 31: 379–88CrossRef Thompson E, Doll W. The burden of families coping with the mentally ill: an invisible crisis. Fam Relations 1982; 31: 379–88CrossRef
28.
Zurück zum Zitat Vitaliano PP, Young HM, Russo J. Burden: a review of measures used among caregivers of individuals with dementia. Geront Soc Am 1991; 31(1): 67–75 Vitaliano PP, Young HM, Russo J. Burden: a review of measures used among caregivers of individuals with dementia. Geront Soc Am 1991; 31(1): 67–75
29.
Zurück zum Zitat Cummings JL, Mega M, Gray K, et al. The neuropsychiatric inventory: comprehensive assessment of psychopathology in dementia. Neurology 1994; 44: 2308–14PubMedCrossRef Cummings JL, Mega M, Gray K, et al. The neuropsychiatric inventory: comprehensive assessment of psychopathology in dementia. Neurology 1994; 44: 2308–14PubMedCrossRef
30.
Zurück zum Zitat Vitaliano PP, Russo J, Young HM, et al. The screen for caregiver burden. Gerontology 1991; 31(1): 76–83CrossRef Vitaliano PP, Russo J, Young HM, et al. The screen for caregiver burden. Gerontology 1991; 31(1): 76–83CrossRef
31.
Zurück zum Zitat Kinney JM, Stephens MAP. Caregiving hassles scale: assessing the daily hassles of caring for a family member with dementia. Gerontology 1989; 29: 328–32CrossRef Kinney JM, Stephens MAP. Caregiving hassles scale: assessing the daily hassles of caring for a family member with dementia. Gerontology 1989; 29: 328–32CrossRef
32.
Zurück zum Zitat Novak M, Guest CI. Application of a multidimensional caregiver burden inventory. Gerontology 1989; 29: 798–803CrossRef Novak M, Guest CI. Application of a multidimensional caregiver burden inventory. Gerontology 1989; 29: 798–803CrossRef
33.
Zurück zum Zitat Davis KL, Marin DB, Kane R, et al. The caregiver activity survey (CAS): development and validation of a new measure for caregivers of persons with Alzheimer’s disease. Int J Geriatr Psychiatry 1997; 12: 978–88PubMedCrossRef Davis KL, Marin DB, Kane R, et al. The caregiver activity survey (CAS): development and validation of a new measure for caregivers of persons with Alzheimer’s disease. Int J Geriatr Psychiatry 1997; 12: 978–88PubMedCrossRef
34.
Zurück zum Zitat Zarit SH, Zarit JM. The memory and behavior problems checklist-1987R and the burden interview (technical report). University Park (PA): Pennsylvania State University, 1987 Zarit SH, Zarit JM. The memory and behavior problems checklist-1987R and the burden interview (technical report). University Park (PA): Pennsylvania State University, 1987
35.
Zurück zum Zitat Given CW, Given B, Stommel M, et al. The caregiver reaction assessment (CRA) for caregivers to persons with chronic physical and mental impairments. Res Nurs Health 1992; 15: 271–83PubMedCrossRef Given CW, Given B, Stommel M, et al. The caregiver reaction assessment (CRA) for caregivers to persons with chronic physical and mental impairments. Res Nurs Health 1992; 15: 271–83PubMedCrossRef
36.
Zurück zum Zitat Greene JG, Smith R, Gardiner M, et al. Measuring behavioral disturbance of elderly demented patients in the community and its effects on relatives: a factor analytic study. Age Ageing 1982; 11: 121–6PubMedCrossRef Greene JG, Smith R, Gardiner M, et al. Measuring behavioral disturbance of elderly demented patients in the community and its effects on relatives: a factor analytic study. Age Ageing 1982; 11: 121–6PubMedCrossRef
37.
Zurück zum Zitat Gilleard DJ. Living with dementia: community care of the elderly mental infirm. Beckenham: Croom Helm, 1984 Gilleard DJ. Living with dementia: community care of the elderly mental infirm. Beckenham: Croom Helm, 1984
38.
39.
Zurück zum Zitat Niederehe G. TRIMS behavioral problem checklist (BPC). Psychopharmacol Bull 1988; 24: 771–8PubMed Niederehe G. TRIMS behavioral problem checklist (BPC). Psychopharmacol Bull 1988; 24: 771–8PubMed
40.
41.
Zurück zum Zitat Poulshock SW, Deimling GT. Families caring for elders in residence: issues in the measurement of burden. J Gerontol 1984; 39: 230–9PubMedCrossRef Poulshock SW, Deimling GT. Families caring for elders in residence: issues in the measurement of burden. J Gerontol 1984; 39: 230–9PubMedCrossRef
42.
Zurück zum Zitat Montgomery RJV, Gonyea JG, Hooyman NR. Caregiving and the experience of subjective and objective burden. Fam Relations 1985; 34: 19–26CrossRef Montgomery RJV, Gonyea JG, Hooyman NR. Caregiving and the experience of subjective and objective burden. Fam Relations 1985; 34: 19–26CrossRef
43.
Zurück zum Zitat Vitaliano PP, Russo J, Carr JE, et al. Medical school pressures and their relationship to anxiety. J Nerv Ment Dis 1984; 172: 730–6PubMedCrossRef Vitaliano PP, Russo J, Carr JE, et al. Medical school pressures and their relationship to anxiety. J Nerv Ment Dis 1984; 172: 730–6PubMedCrossRef
44.
Zurück zum Zitat Marin DB, Dugue M, Schmeidler J, et al. The caregiver activity survey (CAS): longitudinal validation of an instrument that measures time spent caregiving for individuals with Alzheimer’s disease. Int J Geriatr Psychiatry 2000; 15: 680–6PubMedCrossRef Marin DB, Dugue M, Schmeidler J, et al. The caregiver activity survey (CAS): longitudinal validation of an instrument that measures time spent caregiving for individuals with Alzheimer’s disease. Int J Geriatr Psychiatry 2000; 15: 680–6PubMedCrossRef
45.
Zurück zum Zitat Teri L, Truax P, Logsdon R, et al. Assessment of behavioral problems indementia: the revised memory and behavior problems checklist. Psychol Aging 1992; 7: 622–31PubMedCrossRef Teri L, Truax P, Logsdon R, et al. Assessment of behavioral problems indementia: the revised memory and behavior problems checklist. Psychol Aging 1992; 7: 622–31PubMedCrossRef
46.
Zurück zum Zitat Rosen WG, Mohs RC, Davis KL. A new rating scale for Alzheimer’s disease. Am J Psychiatry 1984; 141: 1356–64PubMed Rosen WG, Mohs RC, Davis KL. A new rating scale for Alzheimer’s disease. Am J Psychiatry 1984; 141: 1356–64PubMed
47.
Zurück zum Zitat DeJong R, Osterlund OW, Roy GW. Measurement of quality-of-life changes in patients with Alzheimer’s disease. Clin Ther 1989; 11: 545–54PubMed DeJong R, Osterlund OW, Roy GW. Measurement of quality-of-life changes in patients with Alzheimer’s disease. Clin Ther 1989; 11: 545–54PubMed
48.
Zurück zum Zitat Sheikh K, Smith DS, Meade TW, et al. Repeatability and validity of a modified activities of daily living (ADL) index in studies of chronic disability. Int Rehabil Med 1979; 1: 51–8PubMed Sheikh K, Smith DS, Meade TW, et al. Repeatability and validity of a modified activities of daily living (ADL) index in studies of chronic disability. Int Rehabil Med 1979; 1: 51–8PubMed
49.
Zurück zum Zitat Schneider LS, Olin JT, Doody RS, et al. Validity and reliability of the Alzheimer’s disease co-operative study: clinical global impression of change. Alzheimer Dis Assoc Disord 1997; 11Suppl. 2: S22–32PubMedCrossRef Schneider LS, Olin JT, Doody RS, et al. Validity and reliability of the Alzheimer’s disease co-operative study: clinical global impression of change. Alzheimer Dis Assoc Disord 1997; 11Suppl. 2: S22–32PubMedCrossRef
50.
Zurück zum Zitat Beck AT, Ward CH, Mendelson M, et al. An inventory for measuring depression. Arch Gen Psychiatry 1961; 4: 53–63CrossRef Beck AT, Ward CH, Mendelson M, et al. An inventory for measuring depression. Arch Gen Psychiatry 1961; 4: 53–63CrossRef
51.
Zurück zum Zitat Spielberger CD. Manual for the state: trait anxiety inventory. Palo Alto (CA): Consulting Psychologists Press, 1983 Spielberger CD. Manual for the state: trait anxiety inventory. Palo Alto (CA): Consulting Psychologists Press, 1983
52.
Zurück zum Zitat Rogers SL, Farlow, MR, et al. A 24-week double-blind, placebo-controlled trial of donepezil in patients with Alzheimer’s disease. Neurology 1998; 50: 136–45PubMedCrossRef Rogers SL, Farlow, MR, et al. A 24-week double-blind, placebo-controlled trial of donepezil in patients with Alzheimer’s disease. Neurology 1998; 50: 136–45PubMedCrossRef
53.
Zurück zum Zitat Rogers SL, Freidhoff LT. The donepezil study group. The efficacy and safety of donepezil in patients with Alzheimers disease: results of a US multicentre, randomized, double-blind, placebo-controlled trial. Dementia 1996; 7: 293–303PubMed Rogers SL, Freidhoff LT. The donepezil study group. The efficacy and safety of donepezil in patients with Alzheimers disease: results of a US multicentre, randomized, double-blind, placebo-controlled trial. Dementia 1996; 7: 293–303PubMed
54.
Zurück zum Zitat Corey-Bloom J, Anand R, Veach J. A randomized trial evaluating the efficacy and safety of ENA-713 (rivastigmine tartrate), a new acetylcholinesterase inhibitor, in patients with mild to moderately severe Alzheimer’s disease. Int J Geriatr Psychopharm 1998; 1: 55–65 Corey-Bloom J, Anand R, Veach J. A randomized trial evaluating the efficacy and safety of ENA-713 (rivastigmine tartrate), a new acetylcholinesterase inhibitor, in patients with mild to moderately severe Alzheimer’s disease. Int J Geriatr Psychopharm 1998; 1: 55–65
55.
Zurück zum Zitat Rosler M, Anand R, Cicin-Sain A, et al. Efficacy and safety of rivastigmine in patients with Alzheimer’s disease: international randomized controlled trial. BMJ 1999; 318: 633–8PubMedCrossRef Rosler M, Anand R, Cicin-Sain A, et al. Efficacy and safety of rivastigmine in patients with Alzheimer’s disease: international randomized controlled trial. BMJ 1999; 318: 633–8PubMedCrossRef
56.
Zurück zum Zitat Tariot PN, Solomon PR, Morris JC, et al. A 5-month, randomized, placebo-controlled trial of galantamine in AD. Neurology 2000; 54(2): 2269–76PubMedCrossRef Tariot PN, Solomon PR, Morris JC, et al. A 5-month, randomized, placebo-controlled trial of galantamine in AD. Neurology 2000; 54(2): 2269–76PubMedCrossRef
57.
Zurück zum Zitat Blesa, R. Galantamine: therapeutic effects beyond cognition. Dement Geriatr Cogn Disord 2000; 11(1): 28–34PubMedCrossRef Blesa, R. Galantamine: therapeutic effects beyond cognition. Dement Geriatr Cogn Disord 2000; 11(1): 28–34PubMedCrossRef
58.
Zurück zum Zitat Kaufer DI, Cummings JL, Christine D. Effect of tacrine on behavioral symptoms in Alzheimer’s disease: an open-label study. J Geriatr Psychiatry Neurol 1996; 9: 1–6PubMed Kaufer DI, Cummings JL, Christine D. Effect of tacrine on behavioral symptoms in Alzheimer’s disease: an open-label study. J Geriatr Psychiatry Neurol 1996; 9: 1–6PubMed
59.
Zurück zum Zitat Knopman, D, Schneider L, et al. Long-term tacrine (Cognex) treatment: effects on nursing home placement and mortality. Neurology 1996; 47: 166–77PubMedCrossRef Knopman, D, Schneider L, et al. Long-term tacrine (Cognex) treatment: effects on nursing home placement and mortality. Neurology 1996; 47: 166–77PubMedCrossRef
60.
Zurück zum Zitat Gelinas I, Gauthier S, Cyrus PA. Metrifonate enhances the ability of Alzheimer’s disease patients to initiate, organize, and execute instrumental and basic activities of daily living. J Geriatr Psychiatry Neurol 2000; 13: 9–16PubMedCrossRef Gelinas I, Gauthier S, Cyrus PA. Metrifonate enhances the ability of Alzheimer’s disease patients to initiate, organize, and execute instrumental and basic activities of daily living. J Geriatr Psychiatry Neurol 2000; 13: 9–16PubMedCrossRef
61.
Zurück zum Zitat Farlow MR, Cyrus PA. Metrifonate therapy in Alzheimer’s disease: a pooled analysis of four randomized, double-blind, placebo-controlled trials. Dement Geriatr Cogn Disord 1999; 11: 202–11CrossRef Farlow MR, Cyrus PA. Metrifonate therapy in Alzheimer’s disease: a pooled analysis of four randomized, double-blind, placebo-controlled trials. Dement Geriatr Cogn Disord 1999; 11: 202–11CrossRef
62.
Zurück zum Zitat Williams BR. Metrifonate: a new agent for the treatment of Alzheimer’s disease. Am J Health Syst Pharm 1999; 56: 427–32PubMed Williams BR. Metrifonate: a new agent for the treatment of Alzheimer’s disease. Am J Health Syst Pharm 1999; 56: 427–32PubMed
63.
Zurück zum Zitat Shikiar R, Shakespeare A, Sagnier P, et al. The impact of metrifonate therapy on caregivers of patients with Alzheimer’s disease: results from the MALT clinical trial. J Am Geriatr Soc 2000; 48(3): 268–74PubMed Shikiar R, Shakespeare A, Sagnier P, et al. The impact of metrifonate therapy on caregivers of patients with Alzheimer’s disease: results from the MALT clinical trial. J Am Geriatr Soc 2000; 48(3): 268–74PubMed
64.
Zurück zum Zitat Clipp EC, Moore MJ. Caregiver time use: an outcome measure in clinical trial research on Alzheimer’s disease. Clin Pharmacol Ther 1995; 58(2): 228–36PubMedCrossRef Clipp EC, Moore MJ. Caregiver time use: an outcome measure in clinical trial research on Alzheimer’s disease. Clin Pharmacol Ther 1995; 58(2): 228–36PubMedCrossRef
65.
Zurück zum Zitat Feldman, H. Caregiver burden: an important concept in the management of Alzheimer’s disease. Alzheimer Insights online: an international educational newsletter [online]. Available from URL: http://www.alzheimer-insights.com/ [Accessed 2000 Sep 18] Feldman, H. Caregiver burden: an important concept in the management of Alzheimer’s disease. Alzheimer Insights online: an international educational newsletter [online]. Available from URL: http://​www.​alzheimer-insights.​com/​ [Accessed 2000 Sep 18]
66.
Zurück zum Zitat Hauber AB, Gnanasakthy A, Mauskopf JA. Savings in the cost of caring for patients with Alzheimer’s disease in Canada: an analysis of treatment with rivastigmine. Clin Ther 2000; 22: 439–51PubMedCrossRef Hauber AB, Gnanasakthy A, Mauskopf JA. Savings in the cost of caring for patients with Alzheimer’s disease in Canada: an analysis of treatment with rivastigmine. Clin Ther 2000; 22: 439–51PubMedCrossRef
67.
Zurück zum Zitat Knopman D, Schneider L, Davis K, et al. Long-term tacrine (Cognex) treatment: effects on nursing home placement and mortality. Neurology 1996; 47: 166–77PubMedCrossRef Knopman D, Schneider L, Davis K, et al. Long-term tacrine (Cognex) treatment: effects on nursing home placement and mortality. Neurology 1996; 47: 166–77PubMedCrossRef
68.
Zurück zum Zitat Feldman H, Gauthier S, Hecker J, et al. Donepezil provides benefits in global function in moderate to severe Alzheimer’s disease [poster session 419]. Neurobiol Aging 2000; 21(1S): S93CrossRef Feldman H, Gauthier S, Hecker J, et al. Donepezil provides benefits in global function in moderate to severe Alzheimer’s disease [poster session 419]. Neurobiol Aging 2000; 21(1S): S93CrossRef
69.
Zurück zum Zitat Vellas B, Feldman H, Gauthier S, et al. Donepezil treatment in patients with moderate to severe Alzheimer’s disease may reduce caregiver stress [poster session 425]. Neurobiol Aging 2000; 21(1S): S94CrossRef Vellas B, Feldman H, Gauthier S, et al. Donepezil treatment in patients with moderate to severe Alzheimer’s disease may reduce caregiver stress [poster session 425]. Neurobiol Aging 2000; 21(1S): S94CrossRef
70.
Zurück zum Zitat Cummings J, Anand R, Koumaras B, et al. Rivastigmine provides behavioral benefits to Alzheimer disease patients residing in a nursing home: findings from a 26-week trial [abstract S79.002]. Neurol 2000; 547 Suppl. 3: A468 Cummings J, Anand R, Koumaras B, et al. Rivastigmine provides behavioral benefits to Alzheimer disease patients residing in a nursing home: findings from a 26-week trial [abstract S79.002]. Neurol 2000; 547 Suppl. 3: A468
71.
Zurück zum Zitat Avorn J, Dreyer P, Connelly K, et al. Use of psychoactive medication and the quality of care in rest homes: findings and policy implications of a statewide study. N Engl J Med 1989; 320: 227–32PubMedCrossRef Avorn J, Dreyer P, Connelly K, et al. Use of psychoactive medication and the quality of care in rest homes: findings and policy implications of a statewide study. N Engl J Med 1989; 320: 227–32PubMedCrossRef
72.
Zurück zum Zitat Lantz MS, Louis A, Lowenstein G, et al. A longitudinal study of psychotropic prescriptions in a teaching nursing home. Am J Psychiatry 1990; 147: 1637–9PubMed Lantz MS, Louis A, Lowenstein G, et al. A longitudinal study of psychotropic prescriptions in a teaching nursing home. Am J Psychiatry 1990; 147: 1637–9PubMed
73.
Zurück zum Zitat Lanctot KL, Best TS, Mittmann N, et al. Efficacy and safety of neuroleptics in behavioral disorders associated with dementia. J Clin Psychiatry 1998; 59(10): 550–61PubMedCrossRef Lanctot KL, Best TS, Mittmann N, et al. Efficacy and safety of neuroleptics in behavioral disorders associated with dementia. J Clin Psychiatry 1998; 59(10): 550–61PubMedCrossRef
74.
Zurück zum Zitat Katz IR, Jeste KV, Mintzer JE, et al. Comparison of risperidone and placebo for psychosis and behavioral disturbances associated with dementia: a randomized, double-blind trial. J Clin Psychiatry 1990; 60(2): 107–15CrossRef Katz IR, Jeste KV, Mintzer JE, et al. Comparison of risperidone and placebo for psychosis and behavioral disturbances associated with dementia: a randomized, double-blind trial. J Clin Psychiatry 1990; 60(2): 107–15CrossRef
75.
Zurück zum Zitat Herrmann N, Lanctot KL, Naranjo CA, et al. Behavioural disorders in demented elderly patients. CNS Drugs 1996; 6(4): 280–300CrossRef Herrmann N, Lanctot KL, Naranjo CA, et al. Behavioural disorders in demented elderly patients. CNS Drugs 1996; 6(4): 280–300CrossRef
76.
Zurück zum Zitat Patterson CJS, Gauthier S, Bergman H, et al. The recognition, assessment, and management of dementing disorders: conclusions from the Canadian consensus conference on dementia. Can Med Assoc J 1999; 160 (12 Suppl.): S1–15 Patterson CJS, Gauthier S, Bergman H, et al. The recognition, assessment, and management of dementing disorders: conclusions from the Canadian consensus conference on dementia. Can Med Assoc J 1999; 160 (12 Suppl.): S1–15
77.
Zurück zum Zitat Gwyther LP. Non-pharmacologic approaches to behavior [poster presentation]. Symposium 334. The World Alzheimer Conference; 2000 Jul 9–18; Washington, DC Gwyther LP. Non-pharmacologic approaches to behavior [poster presentation]. Symposium 334. The World Alzheimer Conference; 2000 Jul 9–18; Washington, DC
78.
Zurück zum Zitat Haley WE. The family caregiver’s role in Alzheimer’s disease. Neurology 1997; 485 Suppl 6.: S25–9PubMedCrossRef Haley WE. The family caregiver’s role in Alzheimer’s disease. Neurology 1997; 485 Suppl 6.: S25–9PubMedCrossRef
79.
Zurück zum Zitat Lawton MP, Brody EM, Saperstein AR. Respite for caregivers of Alzheimer’s patients: research and practice. New York: Springer Verlag, 1991 Lawton MP, Brody EM, Saperstein AR. Respite for caregivers of Alzheimer’s patients: research and practice. New York: Springer Verlag, 1991
80.
Zurück zum Zitat Zarit SH, Stephens MA, Townsend A, et al. Stress reduction for family caregivers. Effects of daycare use [presentation]. Annual Meeting of the American Psychological Association; 1996 Aug; Toronto (ON) Zarit SH, Stephens MA, Townsend A, et al. Stress reduction for family caregivers. Effects of daycare use [presentation]. Annual Meeting of the American Psychological Association; 1996 Aug; Toronto (ON)
81.
Zurück zum Zitat Hebert R, Leclerc G, Bravo G, et al. Efficacy of a support group programme for caregivers of demented patients in the community: a randomized controlled trial. Arch Gerontol Geriatr 1994; 18: 1–14PubMedCrossRef Hebert R, Leclerc G, Bravo G, et al. Efficacy of a support group programme for caregivers of demented patients in the community: a randomized controlled trial. Arch Gerontol Geriatr 1994; 18: 1–14PubMedCrossRef
82.
Zurück zum Zitat Brodaty H, Peters K. Cost effectiveness of a training program for dementia carers. Int Psychogeriatr 1991; 3(1): 11–22PubMedCrossRef Brodaty H, Peters K. Cost effectiveness of a training program for dementia carers. Int Psychogeriatr 1991; 3(1): 11–22PubMedCrossRef
83.
Zurück zum Zitat Magai C, Hartung R, Cohen CI, et al. Caregiver distress and behavioral symptoms. In: Lawlor BA, editor. Behavioral complications in Alzheimer’s disease. Washington, DC: American Psychiatric Press, 1995: 223–43 Magai C, Hartung R, Cohen CI, et al. Caregiver distress and behavioral symptoms. In: Lawlor BA, editor. Behavioral complications in Alzheimer’s disease. Washington, DC: American Psychiatric Press, 1995: 223–43
84.
Zurück zum Zitat Reisberg B, Kenowsky S, Franssen EH, et al. Towards a science of Alzheimer’s disease management: a model based upon current knowledge of retrogenesis. Int Psychogeriatr 1999; 11(1): 7–23PubMedCrossRef Reisberg B, Kenowsky S, Franssen EH, et al. Towards a science of Alzheimer’s disease management: a model based upon current knowledge of retrogenesis. Int Psychogeriatr 1999; 11(1): 7–23PubMedCrossRef
85.
Zurück zum Zitat Molloy DM, Guyatt GH, Russo R. Systematic implementation of an advance directive program in nursing homes: a randomized controlled trial. JAMA 2000; 283(11): 1437–44PubMedCrossRef Molloy DM, Guyatt GH, Russo R. Systematic implementation of an advance directive program in nursing homes: a randomized controlled trial. JAMA 2000; 283(11): 1437–44PubMedCrossRef
86.
Zurück zum Zitat Gauthier S. Functional assessment tools and their use in long term management of Alzheimer’s disease [poster session 339]. Neurobiol Aging 2000; 21(1S): S75CrossRef Gauthier S. Functional assessment tools and their use in long term management of Alzheimer’s disease [poster session 339]. Neurobiol Aging 2000; 21(1S): S75CrossRef
87.
Zurück zum Zitat Gupta R. The revised caregiver burden scale: a preliminary evaluation. Res Soc Work Pract 1999; 9(4): 1–9CrossRef Gupta R. The revised caregiver burden scale: a preliminary evaluation. Res Soc Work Pract 1999; 9(4): 1–9CrossRef
88.
Zurück zum Zitat O’Brien B, Goeree R, Hux M, et al. Economic evaluation of donepezil for Alzheimer’s disease in Canada. J Am Geriatr Soc 1999; 47(5): 570–8PubMed O’Brien B, Goeree R, Hux M, et al. Economic evaluation of donepezil for Alzheimer’s disease in Canada. J Am Geriatr Soc 1999; 47(5): 570–8PubMed
89.
Zurück zum Zitat Winblad B, Wimo A. Assessing the societal impact of acetylcholinesterase inhibitor therapies. Alzheimer Dis Assoc Disord 1999; 13Suppl. 2: S9–S19PubMed Winblad B, Wimo A. Assessing the societal impact of acetylcholinesterase inhibitor therapies. Alzheimer Dis Assoc Disord 1999; 13Suppl. 2: S9–S19PubMed
Metadaten
Titel
Assessment, Measures and Approaches to Easing Caregiver Burden in Alzheimer’s Disease
verfasst von
Karl Farcnik
Dr Michelle S. Persyko
Publikationsdatum
01.03.2002
Verlag
Springer International Publishing
Erschienen in
Drugs & Aging / Ausgabe 3/2002
Print ISSN: 1170-229X
Elektronische ISSN: 1179-1969
DOI
https://doi.org/10.2165/00002512-200219030-00004

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