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Caregiver Burden of Patients With Huntington's Disease in South Korea
Chan Young Lee1, Chaewon Shin2, Yun Su Hwang3,4
1Department of Neurology, Ewha Womans University Mokdong Hospital, Ewha Womans University College of Medicine, Seoul, Korea.
Insights
Caregiver burden in Huntington's disease (HD) is significantly linked to patient's neurological status, not caregiver demographics. This highlights the need for tailored support systems for HD families in Korea.
Area of Science:
- Neurology
- Geriatrics
- Psychiatry
Background:
- Huntington's disease (HD) is a progressive neurodegenerative disorder.
- Caregiver burden is a significant issue in chronic diseases.
- Limited research exists on caregiver burden in HD within the Korean population.
Purpose of the Study:
- To conduct the first prospective cohort study of Huntington's disease (HD) in Korea.
- To investigate the relationship between caregiver burden and patient/caregiver characteristics in HD.
Main Methods:
- Prospective cohort study involving 65 HD patients and 45 caregivers from 13 Korean university hospitals (August 2020 - February 2022).
- Caregiver burden assessed using the 12-item Zarit Burden Interview (ZBI-12).
- Linear regression analysis used to evaluate clinical associations with ZBI-12 scores and compare low- vs. high-burden groups.
Main Results:
- The median ZBI-12 score was 17.6 ± 14.2.
- Higher caregiver burden correlated with more severe Shoulson-Fahn stage (p=0.038), lower independence scale (B=-0.154, p=0.006), and reduced functional capacity (B=-1.082, p=0.002) in patients.
- Longer caregiving duration was observed in the high-burden group; caregiver demographics, relation, marital, and social status did not significantly impact burden.
Conclusions:
- Patient's neurological status is a primary driver of caregiver burden in HD, irrespective of caregiver demographics.
- There is a critical need for optimized support systems for HD-affected families in Korea.
- Longitudinal studies are recommended to understand how disease progression influences caregiver burden over time.
Objective:
This is the first prospective cohort study of Huntington's disease (HD) in Korea. This study aimed to investigate the caregiver burden in relation to the characteristics of patients and caregivers.
Methods:
From August 2020 to February 2022, we enrolled patients with HD from 13 university hospitals in Korea. We used the 12-item Zarit Burden Interview (ZBI-12) to evaluate the caregiver burden. We evaluated the clinical associations of the ZBI-12 scores by linear regression analysis and investigated the differences between the low- and high-burden groups.
Results:
Sixty-five patients with HD and 45 caregivers were enrolled in this cohort study. The average age at onset of motor symptoms was 49.3 ± 12.3 years, with an average cytosine-adenine-guanine (CAG)n of 42.9 ± 4.0 (38-65). The median ZBI-12 score among our caregivers was 17.6 ± 14.2. A higher caregiver burden was associated with a more severe Shoulson-Fahn stage (p = 0.038) of the patients. A higher ZBI-12 score was also associated with lower independence scale (B = -0.154, p = 0.006) and functional capacity (B = -1.082, p = 0.002) scores of patients. The caregiving duration was longer in the high- than in the low-burden group. Caregivers' demographics, blood relation, and marital and social status did not affect the burden significantly.
Conclusion:
HD patients' neurological status exerts an enormous impact on the caregiver burden regardless of the demographic or social status of the caregiver. This study emphasizes the need to establish an optimal support system for families dealing with HD in Korea. A future longitudinal analysis could help us understand how disease progression aggravates the caregiver burden throughout the entire disease course.
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