Objective:
To assess the caregiver burden and factors determining it in patients with PD. To assess the anxiety and depression amongst caregivers.

Background: Patients with PD need help with drug compliance and daily activities. The provision of care can be overwhelming, lead to impoverished caregiver’s social network, and disorganized family dynamics. Reducing the burden on caregivers is essential optimize patient care. Scarce data exists on the caregiver burden in patients with PD in rural India.

Method: A total of 104 consecutive consenting patients with PD and their caregivers, attending the Parkinson’s disease Clinic of Shree Krishna Hospital, a medical teaching hospital in the Gujarat state of India, between June 2020 to March 2021 were enrolled in this study. PD was diagnosed using UKBBPD criteria. modified UPDRS score, Hoehn and Yahr scale, Barthel Index (IB), Activities of Daily Living subscale of the SCOPA-Motor scale (SMS-ADL) were used for assessing the patients. Caregivers were assessed using the Hospital Anxiety and Depression Scale (HADS) and The Zarit Caregiver Burden Scale. Modified Kuppuswami Scale was used to assess the socio-economic status of the participants.

Results: The mean duration of disease in the patients [104; mean age 67.35 +/-9.27 years, 75 males] was 53.9 months [range 34-103 months]. The mean UPRDS was 72.07 ± 32.86, the mean Scopa Motor was 43.34 ± 16.61, and the mean Barthel index was 65.36 ± 16.0. The caregiver relation to patients consisted of offspring [45.2%], spouse [25 %], or daughter-in-law in 29.8%.  Most of the patients (62.5%) were from the upper class and the rest 37.5% were patients from the upper-middle class.
42.3% of caregivers had a severe burden, 22.1% had a moderate to severe burden. The mean Zarit index was 48.1 ± 21.4. Caregiver burden was significantly higher in patients where wife, son, and daughter in law were primary caregivers, for patients in upper-middle socioeconomic class and when caregiver had low education. (p<0.05). 33.7% of caregivers had anxiety based on HADS, while 28.8% had borderline anxiety, and 22.1% of caregivers had borderline depression.

Conclusion: Caregiver givers of patients with PD face significant caregiver burden, and anxiety in our region. Assessing caregivers of patients with PD and undertaking measures to reduced burden may help improve the overall care of PD in our region.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/parkinsons-disease-caregiver-burden-in-rural-india/