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      Impact of advanced Parkinson’s disease on caregivers: an international real-world study

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          Abstract

          Background

          Caring for a partner or family member with Parkinson’s disease (PD) negatively affects the caregiver’s own physical and emotional well-being, especially those caring for people with advanced PD (APD). This study was designed to examine the impact of APD on caregiver perceived burden, quality of life (QoL), and health status.

          Methods

          Dyads of people with PD and their primary caregivers were identified from the Adelphi Parkinson’s Disease Specific Program (DSP™) using real-world data from the United States, Japan and five European countries. Questionnaires were used to capture measures of clinical burden (people with PD) and caregiver burden (caregivers).

          Results

          Data from 721 patient-caregiver dyads in seven countries were captured. Caregivers had a mean age 62.6 years, 71.6% were female, and 70.4% were a spouse. Caregivers for people with APD had a greater perceived burden, were more likely to take medication and had lower caregiver treatment satisfaction than those caring for people with early or intermediate PD; similar findings were observed for caregivers of people with intermediate versus early PD. Caregivers for people with intermediate PD were also less likely to be employed than those with early PD (25.3% vs 42.4%) and spent more time caring (6.6 vs 3.2 h/day).

          Conclusions

          This real-world study demonstrates that caregivers of people with APD experience a greater burden than those caring for people with early PD. This highlights the importance of including caregiver-centric measures in future studies, and emphasizes the need for implementing treatments that reduce caregiver burden in APD.

          Trial registration: N/A.

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          Most cited references69

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          A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation

          The objective of this study was to develop a prospectively applicable method for classifying comorbid conditions which might alter the risk of mortality for use in longitudinal studies. A weighted index that takes into account the number and the seriousness of comorbid disease was developed in a cohort of 559 medical patients. The 1-yr mortality rates for the different scores were: "0", 12% (181); "1-2", 26% (225); "3-4", 52% (71); and "greater than or equal to 5", 85% (82). The index was tested for its ability to predict risk of death from comorbid disease in the second cohort of 685 patients during a 10-yr follow-up. The percent of patients who died of comorbid disease for the different scores were: "0", 8% (588); "1", 25% (54); "2", 48% (25); "greater than or equal to 3", 59% (18). With each increased level of the comorbidity index, there were stepwise increases in the cumulative mortality attributable to comorbid disease (log rank chi 2 = 165; p less than 0.0001). In this longer follow-up, age was also a predictor of mortality (p less than 0.001). The new index performed similarly to a previous system devised by Kaplan and Feinstein. The method of classifying comorbidity provides a simple, readily applicable and valid method of estimating risk of death from comorbid disease for use in longitudinal studies. Further work in larger populations is still required to refine the approach because the number of patients with any given condition in this study was relatively small.
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            "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician.

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              “Mini-mental state”

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                Author and article information

                Contributors
                pmm650@hotmail.com
                mskorvanek@gmail.com
                then0003@bbh.regionh.dk
                susanna.lindvall@gmail.com
                domingosjosefa@gmail.com
                ali.alobaidi@abbvie.com
                lakshmi.kandukuri@abbvie.com
                vivekschaudhari87@gmail.com
                apeksha.patel@abbvie.com
                juancarlos.parrariaza@abbvie.com
                james.pike@adelphigroup.com
                angelo3000@yahoo.com
                Journal
                J Neurol
                J Neurol
                Journal of Neurology
                Springer Berlin Heidelberg (Berlin/Heidelberg )
                0340-5354
                1432-1459
                12 January 2023
                12 January 2023
                : 1-12
                Affiliations
                [1 ]GRID grid.413448.e, ISNI 0000 0000 9314 1427, Center for Networked Biomedical Research, , Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, ; Madrid, Spain
                [2 ]GRID grid.11175.33, ISNI 0000 0004 0576 0391, Department of Neurology, , P. J. Šafárik University, ; Košice, Slovakia
                [3 ]GRID grid.412894.2, ISNI 0000 0004 0619 0183, Department of Neurology, , University Hospital L. Pasteur, ; Košice, Slovakia
                [4 ]GRID grid.475435.4, Movement Disorder Clinic, , University Hospital of Bispebjerg, ; Copenhagen, Denmark
                [5 ]European Parkinson’s Disease Association (EPDA), Sevenoaks, UK
                [6 ]GRID grid.431072.3, ISNI 0000 0004 0572 4227, AbbVie Inc., ; North Chicago, IL USA
                [7 ]GRID grid.185648.6, ISNI 0000 0001 2175 0319, University of Illinois at Chicago, ; Chicago, IL USA
                [8 ]Adelphi Real World, Adelphi Mill, Bollington, UK
                [9 ]GRID grid.5608.b, ISNI 0000 0004 1757 3470, Movement Disorders Unit, Department of Neuroscience, , University of Padova, ; Padua, Italy
                Author information
                http://orcid.org/0000-0003-0837-5280
                http://orcid.org/0000-0001-5497-8715
                http://orcid.org/0000-0002-5171-1166
                http://orcid.org/0000-0001-9390-6183
                http://orcid.org/0000-0002-0720-7894
                http://orcid.org/0000-0002-3702-4343
                http://orcid.org/0000-0002-5286-9213
                http://orcid.org/0000-0002-8948-6785
                http://orcid.org/0000-0002-5613-6121
                http://orcid.org/0000-0002-4208-2871
                http://orcid.org/0000-0003-1040-2807
                Article
                11546
                10.1007/s00415-022-11546-5
                9835744
                36633671
                d104ddc9-eedd-4c59-b787-dc665ff82f14
                © The Author(s) 2023

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 18 May 2022
                : 25 November 2022
                : 22 December 2022
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/100006483, AbbVie;
                Categories
                Original Communication

                Neurology
                advanced parkinson’s disease,caregiver burden,zarit burden interview,euroqol 5 dimension,quality of life

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