Objective: This study aimed to investigate the impact of cognitive impairment in Parkinson’s disease (PD) on the quality of life (QoL) of carers.

Background: The QoL of informal caregivers of people with PD can be affected by the caring role. However, it may be postulated that the QoL of carers of people with cognitive impairment in addition to PD might be poorer compared to those who care for a person with PD who is cognitively intact, if other factors are equal.

Methods: PD subjects 36 months after diagnosis completed a schedule of neuropsychological assessments, clinical history and QoL measures as part of the ICICLE-PD study. Carers of PD subjects completed demographic questionnaires and assessments of mood and health. Carer QoL was measured using the Scale of Quality of Life of Caregivers (SQLC). Mild cognitive impairment (PD-MCI) and PDD were diagnosed using the International Parkinson and Movement Disorder Society criteria. Factor scores of Attention, Memory/Executive function, and Global cognition, as derived by principal component analysis, were used to evaluate cognitive domains.

Results: Sixty six dyadic couples were identified (60% of total sample). Carers of PDD subjects (n=9) had significantly poorer QoL compared to PD-MCI carers (n=18) and PD without cognitive impairment (PD-CN) carers (n=39, p<0.01). However, there was no significant difference between PD-MCI and PD-CN carer SQLC scores. Carer QoL was predicted by hours per week caring (β=-0.5 p<0.01), PD motor severity (β=-0.2 p<0.01) and carer depression (β=-0.3 p<0.01). PD MoCA score and cognitive classification were significant predictors of poorer carer QoL (ΔR2=0.04, β=0.3, p<0.05; and ΔR2=0.05, β=-0.3 p<0.01, respectively). However, attentional deficits accounted for the largest proportion of variance of carer QoL (ΔR2=0.09, β=0.4, p<0.001).

Conclusions: This study has shown an association between cognitive impairment in people with PD and carer QoL. Carers of people with PDD reported the poorest QoL. Attentional deficits were the strongest predictor of carer QoL compared to other cognitive predictors, suggesting that targeted interventions focusing on attention in the person with PD may improve carer QoL. However, interventions to reduce the number of hours the carer spends per week as a caregiver, such as respite, may be a more readily implemented means of improving carer QoL.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/cognitive-decline-in-parkinsons-disease-impact-on-quality-of-life-of-caregivers/