Objective:

Examine the longitudinal relationship between caregiver strain and Parkinson patient depression, daytime sleepiness, and treatment with dopamine agonists and antidepressants.

Background:

PD is a progressive neurodegenerative disorder characterized by both motor and nonmotor symptoms, with family caregivers playing an integral part of PD patient care. The substantial demands of caregiving, coupled with the long course of PD, place caregivers at significant risk of strain. Several clinical variables in PD patients have been shown to influence caregiver burden, such as depression and daytime sleepiness.  

Design/Methods:

This study was a longitudinal analysis of clinic data in which patients (N = 434) completed measures on depressive symptoms and sleep, while their family caregivers completed a measure on caregiver burden. Caregivers’ burden scores were modeled as a function of cumulative time between visits, independent main effects of PD patient depression and sleep scores, and their interactions with time using SAS statistical software. 

Results:

Across all models of patient depression, we found that caregiver burden increased across time. In the model of patient daytime sleepiness, caregivers reported greater burden when patients had increased sleepiness scores. In the combined main effects model including both depressive symptoms and daytime sleepiness, depressive symptoms remained significant predictors of caregiver burden. 

Conclusions:

Patient depressive symptoms were the most consistent predictor of caregiver burden, highlighting the central role of depression in shaping caregiver well-being. The consequences of depression in PD include greater functional disability, increased mortality, poorer quality of life, and heightened caregiver strain. Covariates such as older patient age at baseline predicted greater caregiver burden, whereas female sex of the patient, shorter disease duration, and dopamine agonist use were associated with lower burden.  Our findings support the recommendation for routine caregiver evaluations during patient visits, as these may facilitate timely interventions that benefit both patient and caregiver.