Clinical Outcomes in Elderly Demented Patients and Caregiver's Stress: A 2-Year Follow-Up Study

V. Tibaldi,N. Aimonino,C. Costamagna,R. Obialero,C. Ruatta,M. F. Stasi,M. Molaschi

Archives of Gerontology and Geriatrics（2007）SCI 3区SCI 4区

Corresponding author. Tel.: +39 011 663 7140; fax: +39 011 696 1045. | Department of Medical and Surgical Disciplines

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Abstract

We have conducted a study on 82 elderly patients with advanced dementia admitted to the Geriatric Department of S. Giovanni Battista Hospital of Torino in order to evaluate mortality, functional and cognitive impairment and caregiver's stress at 2-year follow-up. Patients were examined using a standardized protocol which included demographic characteristics, comorbidity, duration and type of dementia, severity of disease (clinical dementia rating scale: CDR), behavioral disturbances (neuro-psychiatric inventory: NPI), functional status (activities of daily living: ADL, and instrumental activities of daily living: IADL), cognitive status (short portable mental status questionnaire: SPMSQ). Characteristics of primary caregivers were evaluated and their level of stress was assessed by the relatives' stress scale (RSS). After two years, mortality in the total sample was 61%; the mean age of survivors was 81.3+/-5.3 years; 88% of the sample was still living at home with a relative (76%) or with paid personnel (24%). A statistically significant worsening of the cognitive status was detected (baseline SPMSQ=7.5+/-1.7; follow-up SPMSQ=8.4+/-1.8; p<0.05). Functional status did not change significantly, since it resulted already seriously compromised at the beginning of the study. Most caregivers (80%) were the same as two years before and their stress level was very high (baseline RSS=36.6+/-13.9; follow-up RSS=33.2+/-14). In conclusion, most of the patients included in the follow-up were still living at home, despite the high caregiver's burden and the increasing severity of the disease. Therefore, there is a strong need to further improve health services for the patients with advanced dementia living in their homes.

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Key words

care of demented patients,clinical and cognitive deterioration,caregiver stress

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