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. 2016 Dec;5(2):183-192.
doi: 10.1007/s40120-016-0049-1. Epub 2016 Aug 9.

Priority of Treatment Outcomes for Caregivers and Patients with Mild Cognitive Impairment: Preliminary Analyses

Polaris González Barrios  1 , Ricardo Pabón González  1 , Sherrie M Hanna  2 , Angela M Lunde  2 , Julie A Fields  2 , Dona E C Locke  3 , Glenn E Smith  4
Affiliations

Priority of Treatment Outcomes for Caregivers and Patients with Mild Cognitive Impairment: Preliminary Analyses

Polaris González Barrios et al. Neurol Ther. 2016 Dec.

Abstract

Introduction: The patient-centered movement advocates for greater attention to the outcomes that matter most to patients and their families. In neurodegenerative disease, determination of patient and caregiver priorities has received scant attention in part because dementia patients are deemed unreliable reporters. However, people with mild cognitive impairment (MCI) likely retain capacity to report their preferences.

Methods: In two separate MCI cohorts, we conducted preliminary analyses of patient and caregiver priorities among seven patient and five caregiver outcomes of the HABIT® Healthy Action to Benefit Independence & Thinking program (Mayo Clinic, Rochester, MN, USA).

Results: Via interview and paper-and-pencil reporting both patient and caregiver respondents' ranked patient and caregiver quality of life and patient self-efficacy as highest priorities, ranking them ahead of patient and caregiver mood, patient functional status, patient distressing behaviors and caregiver burden. Patients and caregivers tended to value the outcomes for their loved ones higher than their own outcomes.

Conclusion: Caregivers appeared to be reasonable, but not perfect, proxies for patient reports. Additional research with larger cohorts and a more comprehensive range of outcomes is needed.

Keywords: Alzheimer’s disease; Caregivers; Mild cognitive impairment; Patient preference; Quality of life.

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Figures

Fig. 1
Fig. 1
Mean rankings of post-intervention outcome priorities for caregivers (study 1). Rank ordering on a scale of 1 = most important to 12 = least important thus lower rankings equal higher priority. Arcs identify rankings that differ at p < .05. Beh, behavior; Mem-Based Act, memory-based activities of daily living; QoL, quality of life; Prt, participant; Self-Eff, self-efficacy
Fig. 2
Fig. 2
Pre- and post-intervention rankings for patients with MCI and their caregivers (study 2). Rank ordering on a scale of 1 = most important to 12 = least important thus lower rankings equal higher priority. Asterisked line identifies rankings that differ at p < .01. ADLS, activities of daily living; QoL, quality of life; Prt, participant; Self-Eff, self-efficacy
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