Spousal caregiver burden in patients with cognitive impairment: Effects on nutrition and other related factors with cognition.

BACKGROUND: With the rapid aging process, the number of elderly couple househol is increasing. Accordingly, when a patient with cognitive impairment occurs, the elderly spouse tends to take care of patient, and undergoes physical and psychological stress and changes in nutritional status due to the care, which can be a risk factor for cognitive decline.Therefore, this study aims to evaluate the spousal caregiver`s lifestyle, psychosocial factors and nutritional status related with cognition according to the burden of care for elderly couples.

METHOD: From May to December 2020, clinical evaluation and blood tests were conducted for patients who visited Chungnam National University Hospital Geriatric Neuropsychiatric Clinic with their spouse. A total of 39 subjects were included in the analysis. As clinical assessment, we evaluated the care burden(Zait burden interview), depression(Geriatric-Depression-Scale), sleep quality (Pittsburgh-Sleep-Quality-Index), cognitive function(Mini-Mental-state-exmination) and subjective cognitive decline, physical activity(International-Physical-Activity-Questionnaire), and dietary habits(Mini-Nutrional-Assessment). And, serum total protein, albumin, Hemoglobin and Lipid pannel was measured.

RESULT: As the patient's cognitive function declined, the burden of care increased(p<0.001). In univariate analysis, the spousal caregiver`s burden was significantly associated with the worse the dietary habits(p=0.003) and increased level of depression(p=0.001) and subjective cognitive decline(p=0.038). The spousal caregiver`s burden showed trend level association with sleep quality(p=0.074), but there was no significant relationship with physical activity(p=0.653). When the age, sex, and caring assistant type were adjusted, dietary habits (p=0.002), depression(p=0.003), and sleep quality(p=0.023) worsened as the spousal caregiver`s burden increased.

CONCLUSION: Even if cognitive function in the older adult was normal, the higher the burden among spousal caregivers of patients with cognitive decline, the lower the diet habit and sleep quality, and the higher the level of depression. All of these factors could lower cognitive function. Early intervention on these factors is necessary to prevent the cognitive impairment in spouse due to the burden of care.