Predictors of Health-Related Quality of Life in Informal Caregivers of Dementia Patients in Zagreb, Croatia, a Cross Sectional Study.

ABSTRACT

We aimed to estimate health-related quality of life (HRQoL) in family-member caregivers of patients with dementia in Croatia and to assess relevant predictors. A cross-sectional study in family medicine practices in Zagreb (Health Care Center Zagreb-West) was performed in period 10/2017-9/2018 and included 131 dyads consisting of a patient with dementia and one dominant informal caregiver. Patient measures included Mini-mental-state-examination (MMSE), Barthel-index and the Neuropsychiatric Inventory-Questionnaire (NPI-Q). Caregiver measures included 36-Item Short-Form-Health-Survey (SF-36), Zarit-Burden-Interview (ZBI) and structured questionnaire regarding general information on caregiver and patient. SF-36 is a reliable instrument to estimate HRQoL (Cronbach α ≥0.79 for all domains). Caregiver HRQoL was higher than reported in Croatian population in physical functioning (PF), role physical (RP), general health (GH), social functioning (SF) and role emotional (RE) domains. More pronounced neuropsychiatric symptoms in patient with dementia were associated with caregiver's lower HRQoL in vitality (VT) and mental health (MH) domains. Caregivers with higher caregiver burden assessed by ZBI had lower HRQoL in RP, bodily pain (BP), GH, VT, SF, RE and MH domains. In multivariate analyses, higher caregiver's burden was independent predictor of lower HRQoL in RP, VT, RE and MH domains. Neuropsychiatric symptoms and use of day-care service were recognized as independent predictors of lower HRQoL (in PF, BP and GH, SF, RE domains, respectively). Neuropsychiatric symptoms and caregiver burden are associated with HRQoL in caregivers of patients with dementia. Interventions including psychological support and learning of skills necessary to tackle individual problems may help in improvement of HRQoL.