Problems and carer strain amongst outpatients clinic attendees on Cholinesterase Inhibitors : A two-year longitudinal observational study

Abstract

In the earlier stages of dementia sufferers live independently but gradually rely increasingly on loved ones or formal carers for support as the illness progresses. This two year longitudinal study looks at the impact of cholinesterase inhibitors on patients and their carers. The Problems Checklist and Carer Strain, the Minimental State Examination (MMSE) and a proforma were used to assess all patients on cholinesterase inhibitors who attended a memory clinic over a six-month period and repeated the assessments, two years later. 102 patients were initially assessed and at follow-up two years later, 58 (56.8%) of these patients were still on acetyl cholinesterase inhibitors. There were significantly higher initial Problem Checklist and Carer Strain scores in those patients who were no longer on acetyl cholinesterase inhibitors compared to those who were still on treatment. Greater severity of problems and carer strain along with lower cognitive scores were associated with shorter duration of cholinesterase inhibitors being prescribed possibly due to poorer response and prognosis.