Objective: To determine whether different subdomains of the MoCA associate with caregiver burden.

Background: Caregivers improve the quality of life for Parkinson’s patients (PwP), despite motor and cognitive challenges. As disease severity increases, so does caregiver burden. Identifying specific cognitive subdomains that predict caregiver burden is essential. While the MoCA test has been reviewed as a whole, this study aims to identify which MoCA subdomains are associated with caregiver burden.

Method: A cross-sectional, observational, and analytical study was conducted, including PwP and their caregivers. Sociodemographic and clinical data were collected. MoCA subdomains were evaluated, and caregiver burden was assessed using the 22-item Zarit CBI (ZCBI-22), with scores of 47 or higher indicating significant caregiver burden. A linear regression model was developed to analyze the effect of MoCA subdomains on ZCBI-22 as the outcome. Covariates included gender, age, years of education, PD duration, PDQ39i, MDS-UPDRS 2, and MDS-NMS (anxiety and depression). These associations were examined to assess their impact on caregiver burden.

Results: Comparative analysis of the 316 PwP (54% male, mean age 62.6 ± 12.3 years) is presented in [Table 1]. The linear regression model (R²=0.186) showed a significant association between caregiver burden and the MoCA language subdomain (B=1.39875, p=0.041). The language subdomain was moderately correlated with ZCBI-22 (r=0.432, B=1.39875, p=0.041), with higher MoCA language scores notably associated with increased Zarit burden scores. A trend was noted for the orientation subdomain (B=-1.82, p=0.070), with higher orientation scores associated with lower caregiver burden [Table 2].

Additionally, poorer quality of life (higher PDQ-39i scores, B=0.16338) and greater motor impairment (higher UPDRS-2 scores, B=0.17595) are associated with higher caregiver burden.

Conclusion: Specific cognitive deficits, particularly in language and a trend for orientation, significantly influence caregiver burden. These domains, along with motor impairments and quality of life, should be key areas for interventions aimed at reducing caregiver burden. Efforts to support caregivers should include training on managing these specific cognitive impairments, which could potentially alleviate some of the burden.

Table 1.

Table 2.

References: 1. Macchi, Z. A., Koljack, C. E., Miyasaki, J. M., Katz, M., Galifianakis, N., Prizer, L. P., Sillau, S. H., & Kluger, B. M. (2020). Patient and caregiver characteristics associated with caregiver burden in Parkinson’s disease: A palliative care approach. Annals of Palliative Medicine, 9(Suppl 1), S24–S33. https://doi.org/10.21037/apm.2019.10.01
2. Liu, J., Massimo, L., McMillan, C. T., & Dahodwala, N. (2024). Novel computerized measure of apathy associates with care partner burden and instrumental activities of daily living in Parkinson’s disease. Parkinsonism & Related Disorders, 120, 105983. https://doi.org/10.1016/j.parkreldis.2023.105983
3. Prizer, L. P., Kluger, B. M., Sillau, S., Katz, M., Galifianakis, N. B., & Miyasaki, J. M. (2020). The presence of a caregiver is associated with patient outcomes in patients with Parkinson’s disease and atypical parkinsonisms. Parkinsonism & Related Disorders, 78, 61–65. https://doi.org/10.1016/j.parkreldis.2020.07.003
4. Chaudhary, S., Kumaran, S. S., Kaloiya, G. S., Goyal, V., Sagar, R., Kalaivani, M., Jaganathan, N. R., Mehta, N., & Srivastava, A. (2020). Domain specific cognitive impairment in Parkinson’s patients with mild cognitive impairment. Journal of Clinical Neuroscience, 75, 99–105. https://doi.org/10.1016/j.jocn.2020.03.015

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MDS Abstracts - https://www.mdsabstracts.org/abstract/subdomain-specific-cognitive-decline-and-its-effect-on-caregiver-burden-in-mexican-population-living-with-parkinsons-disease/