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Sex Differences Identified With Caregiver Burden in Parkinson Disease

Data suggest that certain activities of daily living are more prevalent depending on whether the caregiver is a man or a woman.

Findings presented at the International Parkinson and Movement Disorders (MDS) Society Virtual Congress 2021, September 17-22, concluded that burden for male and female caregivers of patients with Parkinson disease (PD) were associated with differences in activities of daily living (ADLs) and instrumental activities of daily living (IADLs).

Findings showed that patients were more likely to have a caregiver of the opposite sex, with male patients with PD more likely to have female caretakers (73.2%) and female patients with PD more likely to have male caretakers (90%; P <.001)(FIGURE). Other demographics were similar among male and female care partners, who also cared for patients who had similar demographics (age, education, and disease duration) and disease severity. On average, female care partners knew their patients for an average of 38.5 years (standard deviation [SD], 16.0) and male care partners knew their patients for an average of 38.1 years (SD, 14.6). 

Female care partners were more likely to assist their patients with food preparation (P <.005) and laundry (P <.010) compared with male care partners, who reported their patients needed more help with physical ambulation (P = .038). Higher burden for female care partners was associated with the need for additional shopping assistance (B = –11.1; P <.001), and higher burden for male care partners was associated with patients needing more help with transportation (B = –21.4; P = .001) and toileting (B = –18.2; P <.001). 

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“Sex differences for the onset, progression, and the treatment effects have already been shown in Parkinson disease,” Rhea Gandhi, BSc, research assistant, department of neurosciences, University of California–San Diego, said in her presentation. “However, impact of Parkinson disease expands beyond the people having the disease, and the care partners are also substantially affected.” Gandhi further addressed the commonality of PD in men, with most care partners being female or spouses of the patients. According to existing studies, she said, female care partners experience higher levels of burnout and may be at risk for higher burden. 

Investigators included a total of 142 care partners, 42 of whom were men and 100 of whom were women. All care partners were caring for patients with PD who did not have dementia and completed the ADL, IADL scales for dependency levels of their respective PD patients. Care partners also completed the Zarit Burden Interview to assess care partner burden, with female care partners scoring an average of 12.6 points (SD, 11.3) and male care partners scoring an average of 13.3 points (SD, 11.7). 

Female patients with PD had an average age of 68.4 years (SD, 8.6), male patients with PD averaged 65.9 years (SD, 7.8), female care partners averaged 62.8 years (SD, 11.7), and male care partners averaged 64.6 years (12.7). Other ADLs evaluated in the study were telephone use, housekeeping, responsibility for own medications, ability to handle finances, feeding, dressing, grooming, physical ambulation, and bathing. 

“There is quite a difference between male and female care partners. Focusing on individual daily living activities and considering the care partner’s sex can improve the quality of life for both the care partner and the patient, preventing care partner burnout. Reducing the care partner will have substantial implications on both the patients and care partners, and subsequently, the health care,” Gandhi said. As findings indicate that the sex of the care partner needs to be taken into consideration, investigators note that specific ADLs and IADLs can be prioritized in order to address and further reduce care partner burden in PD. 

For more coverage of MDS 2021, click here.

REFERENCE
Gandhi R, Schiehser D, Whiteley V, et al. Sex-specific associations between care partner burden and activities of daily living in Parkinson’s disease. Presented at MDS Congress 2021; September 17-22; Virtual. Poster 1148.