Trends in Psychiatry and Psychotherapy
https://trends.org.br/article/doi/10.1590/2237-6089-2016-0085
Trends in Psychiatry and Psychotherapy
Original Article

High burden and frailty: association with poor cognitive performance in older caregivers living in rural areas

Sobrecarga elevada e fragilidade: relação com baixo desempenho cognitivo em idosos cuidadores moradores de comunidades rurais

Allan Gustavo Brigola; Bruna Moretti Luchesi; Tiago da Silva Alexandre; Keika Inouye; Eneida Mioshi; Sofia Cristina Iost Pavarini

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Abstract

Abstract Introduction: Older caregivers living in rural areas may be exposed to three vulnerable conditions, i.e., those related to care, their own aging, and their residence context. Objective: To analyze the association of burden and frailty with cognition performance in older caregivers in rural communities. Method: In this cross-sectional survey, 85 older caregivers who cared for dependent elders were included in this study. Global cognition (Addenbrooke's Cognitive Examination – Revised; Mini Mental State Examination), burden (Zarit Burden Interview) and frailty (Fried's frailty phenotype) were assessed. All ethical principles were observed. Results: Older caregivers were mostly women (76.7%); mean age was 69 years. Cognitive impairment was present in 15.3%, severe burden in 8.2%, frailty in 9.4%, and pre-frailty in 52.9% of the older caregivers. More severely burdened or frail caregivers had worse cognitive performance than those who were not, respectively (ANOVA test). Caregivers presenting a high burden level and some frailty degree (pre-frail or frail) simultaneously were more likely to have a reduced global cognition performance. Conclusion: A significant number of older caregivers had low cognitive performance. Actions and resources to decrease burden and physical frailty may provide better cognition and well-being, leading to an improved quality of life and quality of the care provided by the caregivers.

Keywords

Aged care, caregivers, frail elderly, cognition, rural population

Resumo

Resumo Introdução: Idosos cuidadores que moram em comunidades rurais podem estar expostos a uma tripla condição de vulnerabilidade, por exemplo, condições relacionadas a ser cuidador de outro, condições inerentes ao seu próprio envelhecimento e ao seu contexto de moradia. Objetivo: Analisar a associação entre sobrecarga, fragilidade e desempenho cognitivo em idosos cuidadores que moram em comunidades rurais. Método: Tratou-se de uma pesquisa transversal com 85 idosos cuidadores que cuidavam de idosos dependentes na comunidade. A cognição global (Exame Cognitivo de Addenbrooke – Revisado; Mini Exame do Estado Mental), a sobrecarga (Entrevista de Sobrecarga de Zarit) e a fragilidade (Fenótipo de Fragilidade de Fried) foram mensuradas. Todos os princípios éticos foram respeitados. Resultados: Os idosos cuidadores foram predominantemente mulheres (76.7%) com média de idade de 69 anos. A proporção de indício de alteração cognitiva foi de 15.3%, sobrecarga severa de 8.2%, fragilidade de 9.4% e pré-fragilidade de 52.9% nos idosos cuidadores. Cuidadores severamente sobrecarregados ou frágeis apresentaram pior desempenho cognitivo comparado àqueles levemente sobrecarregados e não frágeis, respectivamente (teste ANOVA). Apresentar simultaneamente sobrecarga elevada e algum grau de fragilidade (pré-frágil ou frágil) esteve associado à redução do desempenho cognitivo global. Conclusão: Um significante número de idosos cuidadores teve indício de alteração cognitiva. Estratégias e recursos para reduzir o sentimento de sobrecarga e a fragilidade física podem melhorar o desempenho mental e o bem estar, levando assim a uma melhora da qualidade de vida do idoso que cuida, bem como a qualidade do cuidado prestado por ele.

Palavras-chave

Cuidado a idosos, cuidadores, idoso frágil, cognição, população rural

References

Brigola AG, Luchesi BM, Rossetti ES, Mioshi E, Inouye K, Pavarini SCI. Health profile of family caregivers of the elderly and its association with variables of care: a rural study. Rev Bras Geriatr Gerontol.. 2017;20:409-20.

Pinquart M, Sorensen S. Associations of stressors and uplifts of caregiving with caregiver burden and depressive mood: a meta-analysis. J Gerontol B Psychol Sci Soc Sci.. 2003;58:112-28.

Pinquart M, Sorensen S. Spouses, adult children, and children-in-law as caregivers of older adults: a meta-analytic comparison. Psychol Aging.. 2011;26:1-14.

Pinquart M, Sorensen S. Gender differences in caregiver stressors, social resources, and health: an updated meta-analysis. J Gerontol B Psychol Sci Soc Sci.. 2006;61:33-45.

Balardin JB, Palma KAXA, Garcia Junior ME, Bromberg E. Déficits cognitivos em cuidadores de pacientes com demência. Rev Bras Cienc Envelhec Hum.. 2007;4:55-64.

Robertson DA, Savva GM, Coen RF, Kenny R-A. Cognitive function in the prefrailty and frailty syndrome. J Am Geriatr Soc.. 2014;62:2118-24.

Dumurgier J, Artaud F, Touraine C, Rouaud O, Tavernier B, Dufouil C. Gait speed and decline in gait speed as predictors of incident dementia. J Gerontol A Biol Sci Med Sci.. 2017;72:655-61.

Artaud F, Singh-Manoux A, Dugravot A, Tzourio C, Elbaz A. Decline in fast gait speed as a predictor of disability in older adults. J Am Geriatr Soc.. 2015;63:1129-36.

Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci.. 2001;56:146-56.

Diretoria de Pesquisas, Coordenação de Trabalho e Rendimento. Pesquisa Nacional por Amostra de Domicílios 2013. 2013.

Travassos C, Viacava F. Acesso e uso de serviços de saúde em idosos residentes em áreas rurais, Brasil, 1998 e 2003. Cad Saude Publica.. 2007;23:2490-502.

Chadiha LA, Feld S, Rafferty J. Likelihood of African American primary caregivers and care recipients receiving assistance from secondary caregivers: a rural-urban comparison. J App Gerontol.. 2011;30:422-42.

Goins RT, Spencer SM, Byrsd JC. Research on rural caregiving: a literature review. J App Gerontol.. 2009;28:139-70.

Innes A, Morgan D, Kosteniuk J. Dementia care in rural and remote settings: a systematic review of informal/family caregiving. Maturitas.. 2011;68:34-46.

Pavarini SCI, Neri AL, Brigola AG, Ottaviani AC, Souza EN, Rossetti ES. Elderly caregivers living in urban, rural and high social vulnerability contexts. Rev Esc Enferm USP.. 2017;51.

Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW. Studies of illness in the aged. The index of ADL: a standardized measure of biological and psychosocial function. JAMA.. 1963;185:914-9.

Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist.. 1969;9:179-86.

Mioshi E, Dawson K, Mitchell J, Arnold R, Hodges JR. The Addenbrooke's Cognitive Examination Revised (ACE-R): a brief cognitive test battery for dementia screening. Int J Geriatr Psychiatry.. 2006;21:1078-85.

Folstein MF, Folstein SE, McHugh PR. "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res.. 1975;12:189-98.

Brucki SMD, Nitrini R, Caramelli P, Bertolucci PHF, Okamoto IH. Suggestions for utilization of the mini-mental state examination in Brazil. Arq Neuro-Psiquiatr.. 2003;61:777-81.

Scazufca M. Brazilian version of the Burden Interview scale for the assessment of burden of care in carers of people with mental illnesses. Rev Bras Psiquiatr.. 2002;24:12-7.

Valer DB, Aires M, Fengler FL, Paskulin LMG. Adaptation and validation of the Caregiver Burden Inventory for use with caregivers of elderly individuals. Rev Lat Am Enfermagem.. 2015;23:130-8.

Gratão ACM, Vale F de AC do, Roriz-Cruz M, Haas VJ, Lange C, Talmelli LF da S. The demands of family caregivers of elderly individuals with dementia. Rev Esc Enferm USP.. 2010;44:873-80.

Gratão ACM, Talmelli LF da S, Figueiredo LC, Rosset I, Freitas CP, Rodrigues RAP. Dependência funcional de idosos e a sobrecarga do cuidador. Rev Esc Enferm USP.. 2013;47:137-44.

Brigola AG, Rossetti ES, Santos BR, Neri AL, Zazzetta MS, Inouye K. Relationship between cognition and frailty in elderly: a systematic review. Dement Neuropsychol.. 2015;9:110-9.

Canevelli M, Cesari M. Cognitive frailty: what is still missing?. J Nutr Health Aging.. 2015;19:273-5.

Dartigues JF, Amieva H. Cognitive frailty: rational and definition dorm an (IANA/IAGG) International consensus group. J Nutr Health Aging.. 2014;18:95.

Aggarwal NT, Wilson RS, Beck TL, Rajan KB, Mendes de Leon CF, Evans D a. Perceived stress and change in cognitive function among adults 65 years and older. Psychosom Med.. 2014;76:80-5.

Wilson RS, Bennett DA, Mendes De Leon CF, Bienias JL, Morris MC, Evans DA. Distress proneness and cognitive decline in a population of older persons. Psychoneuroendocrinology.. 2005;30:11-7.

Reyazuddin M, Azmi SA, Islam N, Rizvi A. Oxidative stress and level of antioxidant enzymes in drug-naive schizophrenics. Indian J Psychiatry.. 2014;56:344-9.

Sánchez-Rodríguez M a, Santiago E, Arronte-Rosales A, Vargas-Guadarrama LA, Mendoza-Núñez VM. Relationship between oxidative stress and cognitive impairment in the elderly of rural vs. urban communities. Life Sci.. 2006;78:1682-7.

Ohta M, Kumashiro M, Eguchi Y, Morita Y, Konno Y, Yamato H. The relationship between work ability and oxidative stress in Japanese workers. Ergonomics.. 2014;57:1265-73.

Bertuzzi D, Paskulin LMG, Morais EP de. Arranjos e rede de apoio familiar de idosos que vivem em uma área rural. Texto Context Enferm.. 2012;21:158-66.

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